Each year, India reports more than a million new cases of cancer. Chances are that there were many more that remained undetected. This is a huge challenge that needs to be addressed because most of the cancers in India are diagnosed when the tumours are big or have spread in the body (metastasis), at which point they become either untreatable or are harder to treat.
A group of some of India's leading oncologists have developed new guidelines to help screen for and detect the top three cancers in the country.
Now a new development offers hope for potentially increasing detection rates and improving the likelihood that those in need receive treatment. A group of some of India's leading oncologists have developed new guidelines to help screen for and detect the top three cancers in the country as early as possible. These are breast cancer, cervical cancer and oral cancer.
Across the world, breast cancer is the leading cancer amongst women. It accounts for about 14% of new cancer cases detected in India. The guidelines now suggest that women as young as 30 years should be given the right information about breast cancer. Women between the ages of 40 and 60 years should be clinically screened, at least once every three years. Many oncologists also believe that women should be made aware of the genetic factors that contribute to this cancer so that they can voluntarily follow a regular screening schedule. However, "over-testing" is not the answer to the problem of detecting breast cancer and this is why education and accurate information become so critical.
Cervical cancer, caused by the human papillomavirus (HPV), is the second most common cancer among Indian women and accounts for roughly 12% of all new cancer cases diagnosed each year. Several developed countries have seen a significant drop in cervical cancer cases in the last 40 years, thanks in part to effective pap-based screening programmes. Such a screening programme would be challenging to implement in India because of the cost and personnel needed.
However, an inexpensive mode of screening that uses acetic acid is available and the guidelines recommend that the government consider implementing this method on a larger scale. It is also recommended that women between the ages of 30 and 49 years should be screened, perhaps every 5–10 years. In time, as it becomes more affordable, the more specific HPV DNA testing could be offered to all women who are over 30 years of age.
When screening is done correctly, we will be able to detect cancers earlier, giving us a better shot at treating them successfully.
It is important to remember that infection with the sexually transmitted HPV virus is common and most people are able to clear the infection. Only a few people will develop pre-cancerous lesions that, in some cases, develop into cancer. Today there are preventive vaccines available against some of the most important HPV types and we need to encourage wider use of these in India.
Globally, oral cancer is not very common, but in India, it accounts for about 7% of all new cancers diagnosed annually. Oral cancer includes cancers of the lip, mouth, palate, inner cheek, and most of the tongue.
This is ascribed to the Indian habit of chewing betel leaf and nut, using smokeless tobacco, cigarettes, bidis and alcohol abuse. The guidelines recommend that those who are at a high risk of these cancers (who use tobacco products or chew pan) should be screened every three years, especially in the age group of 30 and 60 years.
Years of research and clinical experience have given us the tools – including advanced software and imaging solutions – to detect cancer early. We also have an array of treatment regimens to tackle it. I hope that as infrastructure continues to improve, more people will be routinely screened. When screening is done correctly, we will be able to detect cancers earlier, giving us a better shot at treating them successfully.