22-May-2024-Editorial

NITI AAYOG REPORT FINDS ‘HUGE GAP’ IN CANCER SCREENING AT AYUSHMAN CENTRES 

The NITI Aayog report highlighted critical gaps in cancer detection in India, raising concerns about public health risks. 

It focused on the screening programs at Ayushman Bharat Health and Wellness Centres (HWCs) meant for early detection of cancers like oral, breast, and cervical cancer. 

Key Findings: 

• Less than 10% of the visited HWCs had conducted even a single round of screening for non-communicable diseases, including cancer. 
• Screening for breast cancer was primarily through self-examination, while screening for cervical cancer was not yet operational. 
• Infrastructure and basic devices at the HWCs were inadequate, contributing to low screening rates. 
• Lack of awareness and training among healthcare staff, particularly Auxiliary Nurses and Midwives (ANMs), further hindered effective cancer screening. 

Early Cancer Detection: 

Cancer detection involves two components: screening and early diagnosis. 

Screening refers to testing healthy individuals to identify cancer before symptoms appear, while early diagnosis focuses on detecting symptomatic patients as early as possible. 

Challenges and Limitations: 

• Screening can lead to false-positive or false-negative results, and overdiagnosis/overtreatment. 
• Certain screening methods like mammography for breast cancer have limitations, especially for younger women. 
• The World Health Organization (WHO) advises against routine mammography for women under 50 due to potential harm. 

India’s Initiatives Related to Cancer: 

National Programmes and Awareness: 

• National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke. 
• National Cancer Grid and National Cancer Awareness Day aim to improve cancer prevention, diagnosis, and treatment. 
• Introduction of HPV vaccine for cervical cancer prevention. 

• Implementation of Ayushman Bharat Health and Wellness Centres (AB-HWCs) for early cancer detection and other healthcare services. 

Study Regarding Colorectal Cancer (CRC): 

Research Findings: 

• Researchers in the United States discovered a distinct subtype of Fusobacterium nucleatum (Fna) in CRC tumors. 
• The Fna C2 clade, characterized by specific genetic and physical traits, was significantly associated with CRC tumors. 
• Fna C2 bacteria possess unique genetic factors enabling them to colonize the human gut and survive in acidic conditions, challenging previous beliefs about their transmission. 
• Targeting Fna C2 for early detection and treatment of CRC could lead to significant advancements in CRC management. 

Colorectal Cancer (CRC): 

Global Burden and Trends: 

• CRC is the third most common cancer worldwide and the second leading cause of cancer-related deaths. 
• By 2040, the burden of CRC is projected to increase significantly in terms of new cases and deaths globally. 
• In India, CRC is the seventh most common cancer, with a rising number of cases over the past decade. 

Risk Factors and Prevention: 

• Risk factors include family history, unhealthy diet, lack of physical activity, smoking, and alcohol consumption. 
• Prevention strategies focus on adopting a healthy lifestyle and regular screening to detect CRC at an early stage. 

Symptoms and Treatment: 

• Common symptoms of CRC include changes in bowel habits, rectal bleeding, abdominal pain, and anaemia. 
• Treatment options include surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy, tailored based on cancer type, stage, and patient’s health. 

Conclusion: 

The NITI Aayog report underscores the need for strengthening cancer screening programs in India, particularly at HWCs, to detect cancers early and improve outcomes.  

Additionally, the discovery of Fna C2 subtype in CRC tumors offers promising prospects for early detection and targeted treatment, potentially reducing the burden of CRC globally.