Current Status of Implementation of Cancer Screening Programme in India: A Review of Policies and Practice.

Abstract

Introduction: Cancer is becoming a leading cause of death and disability across the globe and India too has a high burden of disease with poor outcomes. The national cancer screening program has been rolled out since 2010 but has not yielded the desired results so far. The objective of the present review is to perform an analysis of the strengths and weaknesses of the cancer screening component of the National Program - Non Communicable Disease (NP-NCD) program based on a scoping review of policies, organization, and status of implementation of the program at the primary and secondary levels and also on observations from field experience of the program managers and other health professionals from selected states in India.

Methods: A mixed methodology was used to document the status of the implementation of the ongoing cancer screening program in India. The methodology included a literature review, observation of the frontline health professionals and an in-depth discussion with those in managerial capacity at the health facilities or the screening program.

Results: Cancer screening is a complex public health initiative requiring a highly organized framework for effective implementation. Although India has implemented a comprehensive Non-Communicable Disease (NCD) screening program since 2010, the results have been minimal. The latest National Family Health Survey (NHFS 2019-21)  reported that among the female population aged 30 to 49 years, only 1.9% and 0.9%  were ever screened for cervical cancer and breast cancer respectively. The proportion of 30-49 year-old males reported to be ever screened for oral cancer was only 1.2%. Tamil Nadu and Kerala showed significantly better screening participation compared to other states in the country.

Conclusion: Cancer screening is a complex public health initiative requiring a highly organized framework for effective implementation. The Ayushman Bharat comprehensive primary healthcare service package and plan to deliver cancer screening through the Health and Wellness centers (AB-HWCs) is a good opportunity to revamp the program.