Indian Journal of Forensic and Community Medicine


A Community - Based Primary Care Approach for Cancer Screening


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Author Details: Selvam Paramasivam, Jayakrishnan Thayyil, Meera S Nair

Volume : 3

Issue : 1

Online ISSN : 2394-6776

Print ISSN : 2394-6768

Article First Page : 51

Article End Page : 55


Abstract

Background: Cancer is a major disease that affects all sections of the human population. The stage at presentation is the most important determinant of survival in cancer. It was aimed to find out whether primary health care workers could be used for cancer screening effectively.
Materials and Methods: A screening programme was conducted among persons aged ≥30yrs. This screening programme was conducted in three stages. The first stage is done by primary health care workers for cancer symptom screening, the second stage by specialist doctors to confirm symptoms and to collect specimens and next confirmation by cytology. Sixty out of sixty-six primary health care workers and volunteers were selected and trained by faculties in various departments from medical college to administer the tool for cancer screening. The initial survey was conducted by each worker visiting 50 families with a pre-tested semi-structured questionnaire. Those people who found to have cancer symptoms were examined by the specialist doctors at the primary health centres.
Results: In the initial survey, 6801 individuals aged ≥ 30 yrs were studied. Mean age in years was 47.5 13.2) and men constituted 49.9% of the study population. Among the study population, 299(4.4%) showed symptoms suggestive of cancer (4.3% of males and 4.5% of females). Swelling was the most common symptom. Among the symptomatic individuals, 29(9.7%) have already been diagnosed as having cancer and on treatment. The positive predictive value found to be 11.4% for cancer detection but when the precancerous lesions considered the positive predictive value increased to 21.4%.
Conclusion: The cancer detection rate in our study was comparable with the incidence rate in India. Utilization of primary care workers for cancer screening through this model would ensure that the population over 30 years of age would be screened once every 3-5 years without burdening the routine health system.

Keywords:
Cancer prevention, Early detection, Health care workers, Kerala.

Key Message:
Cancer screening with the help of primary health care workers would enable the health system to identify and cater to needs of the high-risk population at the earliest through primary health care level