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Lack of trained manpower main hurdle, says health secretary
More than a year after rolling out the national programme for prevention and control of cancer, diabetes, cardiovascular diseases and stroke, the Union Ministry of health and family welfare is still struggling to kick-start cancer screening in the district hospitals in the country.
Health secretary P K Pradhan says lack of trained manpower is the biggest hurdle in starting the screening for different types of cancers, which is required under the programme.
“Screening for cancer will be done at district level. We are facing problems of shortage of trained manpower at these hospitals,” he says.
If detected early, most of the cancer cases are curable, say doctors. This is the reason why screening is included in the national programme so that the disease is diagnosed early and patients can start treatment at the earliest. “Chances of curing cancer cases if detected early is 80 per cent,” says G K Rath, professor and head, department of radiation oncology at the All India Institute of Medical Sciences (AIIMS).
The health ministry is now planning to introduce short-term six-month courses where medical graduates will be trained to handle chemotherapy, conduct biopsy and handle other related tasks that are needed to screen patients. “The plan to introduce such diploma courses is being discussed. We also want to involve medical colleges so that students who are interested can participate,” says Pradhan. He was speaking to the press during a press meet in Delhi on Thursday.
With changing lifestyle, non-communicable diseases are rising in the country. By 2020, more than 60 per cent of disease burden in the country will be of these diseases. Each year, India adds 980,000 cancer cases, according to the health ministry figures released recently. It is projected that by 2016, this figure will increase to over 1.2 million when an estimated 631,899 women and 587,750 men will suffer from different kinds of cancers. These figures were released by professor G K Rath who is also the chairman of committee working on the national cancer registry programme in India.
In women, breast cancer overtakes cancer of cervix
In women, breast cancer remains the most common cancer which will affect over 140,000 women by 2016 followed by cancer of the cervix, which will affect over 125,000 women. The incidence these cancers was significantly lower in 2001 when 89,914 women were reported suffering from breast cancer and 79,827 women suffering from cancer of the cervix.
While the cause of rising number of breast cancer cases in women cannot be established, doctors say that late childbirth could be one of the reasons why more women develop tumour of the breast. “Late marriage and late child birth could be one of the causes as women start breast feeding late, which may lead to complications,” says Rath.
Cervix cancer, on the other hand, is commonly seen in women who marry early and give birth frequently. Unhygienic conditions can also lead to cervix cancer. “About a decade ago, maximum number of cancer cases among women were that of the cervix, now breast cancer has taken over,” he says.
In men, cancer of neck most common
In men, cancer of the pharynx and larynx is the most common. This type of cancer would affect 75,901 men in 2016 as against 49,331 in 2001. The second common cancer among men is oral cancer which is projected to affect 65,205 men by 2016 as against 42,725 in 2001.
In men, the primary reason for rising number of cancers of head and neck region and lung is tobacco consumption.
"This number is just going to rise with the rise in consumption of all forms of tobacco,” Rath explains.
According to the cancer registry, Aizawl district of Mizoram has the maximum number of cancer cases in the country at 249.5 per 100,000 in males and 210 per 100,000 in females. Least cases of cancers in men are in Barshi district of Maharashtra where incidence is 40.8 cases per 100,000; rural Ahmedabad in Gujarat records the lowest number of cancer cases among women at 49 per 100,000.
“More than 80 per cent cancer patients seek medical help after the disease reaches the last stage,” said Sushma Bhatnagar, professor and head in unit of pain and palliative care at AIIMS. Treating the disease at the late stage decreases chances of survival to 20 per cent, which is why it is important that people go for regular screenings so that the disease can be detected early and treated, she adds.
At any given time, India has over 30 lakh cancer patients. Tobacco is solely responsible for 40 per cent cancer cases in India. Each year, four lakh cancer patients die.