Widespread Screening Essential In Reducing India's Cancer Burden

Cancer, which affects million of people across the world, is a disease in which some of the body's cells grow uncontrollably and spread to other parts of the body. It can start in almost any part of the human body. The natural order of the human body dictates that human cells grow and multiply to form new cells. The older and the damaged cells die during the process and new cells take their place. But sometimes, abnormal or damaged cells grow and multiply when they shouldn't. These cells may lead to tumors that can be cancerous or not cancerous (benign).

According to the Indian Council of Medical Research (ICMR), there will be an estimated 12 per cent rise in cancer cases in India in the next five years. The projected annual incidence is 94 per lakh in men and 103 per lakh in women, according to the Cancer Statistics Report, 2020.

There are a number of reasons for this rise in cancer cases. Longer life expectancy is an important cause: Cancer is mainly a disease of older men and women, and the incidence is expected to be higher as life expectancy of a population improves rapidly, as has occurred in India in recent times.

Another factor is better recognition. In the past, cancer was an underground disease, often recognized late, seldom treated, and frequently leading to death which was never reported. With growing awareness, people are more likely to get themselves treated and thus, the accounted cancer cases are on a rise. Rapid urbanization is another reason. The incidence of many cancers is increasing due to large population shifting towards urban regions, increasing exposure to various harmful pollutants, chemicals and radiation, poor food habits, obesity and sedentary lifestyle. These are also responsible for an increasing cancer burden.

One of the best ways to battle against this disease is to catch it as early as possible. Checking for cancer or for abnormal and damaged cells that may become cancer in people who have no symptoms is called screening. Most cancers do not produce any symptoms in early stages, while cure rates are highest at earlier stages. Unfortunately, it is common for patients to catch their cancer only in stage 3 or 4. This makes screening important, so that the cancer can be detected and cured in stage 0 or stage 1.

A number of tests are available to screen for different cancers. In females, the most important cancer screening tests are mammography and pap smear/liquid based cytology. Mammography is a simple X ray of the breasts to be done once a year after the age of 40-50. This helps in early detection of breast cancer. Pap smear is a two-minute sample collected from the cervix by a gynaecologist that helps catch cervical cancer.

In males, prostate cancer can be identified through a blood test called Prostate Specific Antigen (PSA) together with examination by a doctor.

Other than these, important cancers that can be screened are lung cancer, for which a patient who has a heavy smoking history, can underdo a low-dose CT scan. People who have a history of chewing tobacco or smoking can undergo screening for Oral Cancer by careful examination of the mouth and throat by a qualified physician.

These are the main kind of screening tests recommended in India. Many other screening tests exist in appropriate populations. For example, in Japan where stomach cancer is common, endoscopy is done to look for early stage gastric cancer. In USA colon cancer is common and screening tests exist for colon cancer.

To conclude, screening is a way to catch cancers early at a highly curable stage and is an important part of routine health checkup for every man and woman.

(Dr. Vineet Govinda Gupta, Sr. Consultant - Medical Oncology, Hematology, Oncology)

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