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Gupta S, Sinha Gupta S, De A, Banerjee R, Goel S. Socio-cultural and financial issues against breast cancer screening behaviour among eligible Indian women: evidence for action. Breast Cancer Res Treat 2024; 205:169-179. [PMID: 38347257 DOI: 10.1007/s10549-024-07244-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 12/10/2023] [Indexed: 05/02/2024]
Abstract
PURPOSE Breast cancer, a common malignancy in Indian women, is preventable and curable upon early diagnosis. Screening is the best control strategy against breast cancer, but its uptake is low in India despite dedicated strategies and programmes. We explored the impact of socio-cultural and financial issues on the uptake of breast cancer screening behaviour among Indian women. METHODS Breast cancer screening-uptake and relevant social, cultural, and financial data obtained from the National Family Health Survey (NFHS) round 5 were used for analysis. We studied 399,039 eligible females to assess their breast cancer screening behavior and determine the impact of socio-cultural and financial issues on such behavior using multivariable logistic regression. RESULTS Most participants were 30-34-year-old (27.8%), educated to the secondary level (38.0%), and 81.5% had bank accounts. A third (35.0%) had health insurance, and anaemia was the most common comorbidity (56.1%). Less than 1.0% had undergone breast cancer screening. Higher age, education, urban residence, employment, less privileged social class, and access to the Internet and mass media were predictors of positive screening-uptake behavior (p < 0.05). Mothers of larger number of children, tobacco- and alcohol-users, the richer and having health insurance had negative uptake behavior (p < 0.05). CONCLUSION A clear impact of socio-cultural and financial factors on breast cancer screening behavior is evident among Indian women. Therefore, apart from the ongoing health system strengthening efforts, our findings call for targeted interventions against prevailing misconceptions and taboos along with economic and social empowerment of women for the holistic success of India's cancer screening strategy.
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Affiliation(s)
- Shibaji Gupta
- Department of Community Medicine, Midnapore Medical College, Midnapore, India.
| | - Sharmistha Sinha Gupta
- Department of General Medicine, Ramakrishna Mission Seva Pratishthan, Kolkata, West Bengal, India
| | - Abhishek De
- Department of Community Medicine, Midnapore Medical College, Midnapore, India
| | | | - Sonu Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Sharma P, Khanna D, Pradhan S, Birur P. Community cancer screening at primary care level in Northern India: determinants and policy implications for cancer prevention. Fam Med Community Health 2023; 11:e002397. [PMID: 38105243 PMCID: PMC10729271 DOI: 10.1136/fmch-2023-002397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
OBJECTIVE Despite the established cancer screening programme for oral, breast and cervical cancer by the Government of India, the screening coverage remains inadequate. This study aimed to describe the determinants for oral, breast and cervical cancer prevention in a rural community at the primary care level of Northern India and its policy implications. DESIGN This was a camp-based project conducted for 1 year, using oral visual examination, clinical breast examination and visual inspection of cervix by application of 5% acetic acid according to primary healthcare operational guidelines. During the project, screen-positive participants were followed through reverse navigation. Information about socio-demographic profile, clinical and behavioural history and screening were collected. Predictors for screen-positivity and follow-up compliance were identified through multivariable analysis. SETTINGS Based on the aim of project, one of the remotely located and low socioeconomic rural blocks, having 148 villages (estimated population of 254 285) in Varanasi district, India was selected as the service site. There is an established healthcare delivery and referral system as per the National Health Mission of Government of India. Oral, breast, gallbladder and cervical cancers are the leading cancers in the district. PARTICIPANTS We invited all men and women aged 30-65 years residing in the selected block for the last 6 months for the screening camps. Unmarried women, women with active vaginal bleeding, those currently pregnant and those who have undergone hysterectomy were excluded from cervical cancer screening. RESULTS A total of 14 338 participants were screened through 190 camps and the majority (61.9%) were women. Hindu religion, tobacco use, intention to quit tobacco and presence of symptoms were significantly associated with screen-positivity. Nearly one-third (220; 30.1%) of the screened-positives complied with follow-up. Young age and illiteracy were significantly associated with lower compliance. CONCLUSION Poor follow-up compliance, despite the availability of tertiary cancer care, patient navigation, free transportation and diagnostic services, calls for research to explore the role of contextual factors and develop pragmatic interventions to justify 'close the care gap'. Community cancer screening needs strengthening through cancer awareness, establishing referral system and integration with the National Tobacco Control and Cancer Registry Programmes.
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Affiliation(s)
- Priyanka Sharma
- Preventive Oncology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Varanasi, Uttar Pradesh, India
| | - Divya Khanna
- Preventive Oncology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Varanasi, Uttar Pradesh, India
| | - Satyajit Pradhan
- Radiation Oncology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Varanasi, Uttar Pradesh, India
| | - Praveen Birur
- KLE Society's Institute of Dental Sciences, Bangalore, Karnataka, India
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Shruti T, Khanna D, Khan A, Dandpat A, Tiwari M, Singh AG, Mishra A, Shetty A, Birur P, Chaturvedi P. Status and Determinants of Early Detection of Oral Premalignant and Malignant Lesions in India. Cancer Control 2023; 30:10732748231159556. [PMID: 36809192 PMCID: PMC9947682 DOI: 10.1177/10732748231159556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
It has been over four decades since the launch of the National Cancer Control Programme in India, yet the cancer screening rates for oral cancer remain unremarkable. Moreover, India is bracing a large burden of oral cancer with poor survival rates. An effective public health programme implementation relies on a multitude of factors related to cost-effective evidence-based interventions, the healthcare delivery system, public health human resource management, community behaviour, partnership with stakeholders, identifying opportunities and political commitment. In this context, we discuss the various challenges in the early detection of oral premalignant and malignant lesions and potential solutions.
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Affiliation(s)
- Tulika Shruti
- Departmentof Preventive Oncology,
Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha
Cancer Hospital (HBCH), Tata Memorial Centres, Varanasi, India
| | - Divya Khanna
- Departmentof Preventive Oncology,
Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha
Cancer Hospital (HBCH), Tata Memorial Centres, Varanasi, India,Divya Khanna, MD, Department of Preventive
Oncology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi
Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, Banaras Hindu University,
Campus, Sundar Bagiya Colony, Sundarpur, Varanasi 221005, India.
| | - Aqusa Khan
- Departmentof Preventive Oncology,
Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha
Cancer Hospital (HBCH), Tata Memorial Centres, Varanasi, India
| | - Abhishek Dandpat
- Departmentof Preventive Oncology,
Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha
Cancer Hospital (HBCH), Tata Memorial Centres, Varanasi, India
| | - Manish Tiwari
- Department of Head and Neck
Oncology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi
Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, Varanasi, India
| | - Arjun G. Singh
- Department of Head and Neck
Oncology, Tata Memorial Centre, Mumbai, India
| | - Aseem Mishra
- Department of Head and Neck
Oncology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi
Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, Varanasi, India
| | | | - Praveen Birur
- Department of Oral Medicine and
Radiology, Consultant Biocon Foundation and Integrated Head and Neck Programme,
Mazumdar Shaw Medical Foundation, KLES Institute of Dental
Sciences, Bengaluru, India
| | - Pankaj Chaturvedi
- Department of Surgical Oncology, Homi Bhabha National
Institute, Anushakti Nagar, India,Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
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Shirsat A, Pashilkar S, Chavan A, Kalra D, Gota V, Joshi A, Nookala Krishnamurthy M. Effect of the Pandemic on Quality-of-Life Data Collection in Prostate Cancer Patients. CLINICOECONOMICS AND OUTCOMES RESEARCH 2021; 13:937-941. [PMID: 34819738 PMCID: PMC8607989 DOI: 10.2147/ceor.s321638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/02/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To understand the difficulties that happen during the quality of life (QoL) data collection in a pandemic and provide measures to overcome them. Methods We analyzed the recruitment and follow-up data of patients in one of our ongoing study whose aim was to collect the Adverse drug reactions and QoL (at regular intervals) in prostate cancer patients who were on docetaxel. Before the pandemic, we could enroll 31 patients in the study over four months. We analyzed the difficulties experienced by these patients and consultants in collecting QoL data during the pandemic, especially in situations with limited availability of resources and also where the patients are not technologically advanced. Results Due to the pandemic, we could not recruit a single new patient into the study. Complete QoL assessments were available in only two patients, and the disease progressed in five patients. QoL assessment was not possible in 19 of 31 enrolled patients. More than 44% of the enrolled patients had difficulty commuting to the hospital despite transport services to hospitals. Due to the risk of acquiring COVID19 infection during traveling to the hospital, follow-ups were affected. Conclusion There should be increased support for novel technologies that can successfully capture and transfer patients' QoL data to the treating consultant.
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Affiliation(s)
- Aditi Shirsat
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Siddhi Pashilkar
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Ashish Chavan
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Devanshi Kalra
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Vikram Gota
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Manjunath Nookala Krishnamurthy
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Mohanty B, Costantino V, Narain J, Chughtai AA, Das A, MacIntyre CR. Modelling the impact of a smallpox attack in India and influence of disease control measures. BMJ Open 2020; 10:e038480. [PMID: 33318109 PMCID: PMC7737064 DOI: 10.1136/bmjopen-2020-038480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 09/10/2020] [Accepted: 10/04/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To estimate the impact of a smallpox attack in Mumbai, India, examine the impact of case isolation and ring vaccination for epidemic containment and test the health system capacity under different scenarios with available interventions. SETTING The research is based on Mumbai, India population. INTERVENTIONS We tested 50%, 70%, 90% of case isolation and contacts traced and vaccinated (ring vaccination) in the susceptible, exposed, infected, recovered model and varied the start of intervention between 20, 30 and 40 days after the initial attack. PRIMARY AND SECONDARY OUTCOME MEASURES We estimated and incorporated in the model the effect of past vaccination protection, age-specific immunosuppression and contact rates and Mumbai population age structure in modelling disease morbidity and transmission. RESULTS The estimated duration of an outbreak ranged from 127 days to 8 years under different scenarios, and the number of vaccine doses needed for ring vaccination ranged from 16 813 to 8 722 400 in the best-case and worst-case scenarios, respectively. In the worst-case scenario, the available hospital beds in Mumbai would be exceeded. The impact of a smallpox epidemic may be severe in Mumbai, especially compared with high-income settings, but can be reduced with early diagnosis and rapid response, high rates of case finding and isolation and ring vaccination. CONCLUSIONS This study tells us that if smallpox re-emergence occurs, it may have significant health and economic impact, the extent of which will depend on the availability and delivery of interventions such as a vaccine or antiviral agent, and the capacity of case isolation and treatment. Further research on health systems requirements and capacity across the diverse states and territories of India could improve the preparedness and management strategies in the event of re-emergent smallpox or other serious emerging infections.
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Affiliation(s)
- Biswajit Mohanty
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Valentina Costantino
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Jai Narain
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Abrar Ahmad Chughtai
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Arpita Das
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - C Raina MacIntyre
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
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Bhaskar S, Rastogi A, Menon KV, Kunheri B, Balakrishnan S, Howick J. Call for Action to Address Equity and Justice Divide During COVID-19. Front Psychiatry 2020; 11:559905. [PMID: 33343410 PMCID: PMC7744756 DOI: 10.3389/fpsyt.2020.559905] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 11/13/2020] [Indexed: 12/29/2022] Open
Abstract
The coronavirus 2019 disease (COVID-19) is deepening the inequity and injustice among the vulnerable communities. The current study aims to present an overview of the impact of COVID-19 on equity and social justice with a focus on vulnerable communities. Vulnerable communities include, but not limited to, healthcare workers, those from lower socioeconomic backgrounds, ethnic or minority groups, immigrants or refugees, justice-involved populations, and people suffering from chronic diseases or mental illness. The implications of COVID-19 on these communities and systemic disparities beyond the current pandemic are also discussed. People from vulnerable communities' experience disproportionately adverse impacts of COVID-19. COVID-19 has exacerbated systemic disparities and its long-term negative impact on these populations foretell an impending crisis that could prevail beyond the COVID-19 era. It is onerous that systemic issues be addressed and efforts to build inclusive and sustainable societies be pursued to ensure the provision of universal healthcare and justice for all. Without these reinforcements, we would not only compromise the vulnerable communities but also severely limit our preparedness and response to a future pandemic.
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Affiliation(s)
- Sonu Bhaskar
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Health Equity and Justice Study Group, Sydney, NSW, Australia
- Department of Neurology, Liverpool Hospital and South Western Sydney Local Health District, Sydney, NSW, Australia
- Neurovascular Imaging Laboratory & NSW Brain Clot Bank, Ingham Institute for Applied Medical Research, The University of New South Wales, Sydney, NSW, Australia
| | - Aarushi Rastogi
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Health Equity and Justice Study Group, Sydney, NSW, Australia
- South West Sydney Clinical School, The University of New South Wales Sydney, Sydney, NSW, Australia
| | - Koravangattu Valsraj Menon
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Health Equity and Justice Study Group, Sydney, NSW, Australia
- Department of Psychiatry, South London and Maudsley NHS Foundation Trust, Kings Health Partners, London, United Kingdom
- Manasvi, Kochi, India
| | - Beena Kunheri
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Health Equity and Justice Study Group, Sydney, NSW, Australia
- Department of Radiation Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Sindhu Balakrishnan
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Health Equity and Justice Study Group, Sydney, NSW, Australia
- Department of Anaesthesia and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Jeremy Howick
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Health Equity and Justice Study Group, Sydney, NSW, Australia
- Faculty of Philosophy and Oxford Empathy Programme, University of Oxford, Oxford, United Kingdom
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Luo F, Zou P, Zhang H, Pang S. Exploration of village health centres in Northern and Central China: A qualitative study. Aust J Rural Health 2020; 28:271-280. [PMID: 32558026 DOI: 10.1111/ajr.12635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 01/25/2020] [Accepted: 05/03/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE China faces issues associated with urban-rural health inequities. This study explores functions of village health centres through a community perspective. Four research questions were asked, including: (a) What are the functions of village health centres? (b) How is medication administered in village health centres? (c) What are the roles of village doctors? (d) What are the evaluation mechanisms of village health centres? DESIGN In-depth interviews and field observations are used in the study. SETTING Nine rural villages in two provinces in Northern and Central China. PARTICIPANTS A total of 93 people across were interviewed. RESULTS Village health centres are primarily responsible for providing public health services and essential medical care. In addition, village health centres also function as a social venue of a rural community. A centralised medication scheme augments these processes through supplying health centres with affordable medications. Village doctors are expected to take the needs and preferences of their patients into consideration when creating care plans, and must establish trusting rapport with patients by upholding their unique values. This results in care that is convenient, accessible, and person-centred. Village health centres are evaluated through a 2-step process which has direct effects on the amount of government subsidy received. CONCLUSION Village health centres have multi-faceted functions in rural Chinese communities. Overall, the benefits of village health centres include convenient and timely access to care for rural residents. Improvements can be made in certain areas, such as streamlining provincial medication schemes and adopting a strengths-based model of evaluation.
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Affiliation(s)
- Feng Luo
- Department of Sociology, Humanities and Social Sciences College, Huazhong Agricultural University, Wuhan, China
| | - Ping Zou
- School of Nursing, Nipissing University, Toronto, ON, Canada
| | - Hui Zhang
- Department of Cardiology, Guizhou Provincial People's Hospital, Guiyang, China
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Rao RRR, Acharya RP, Bajpai P, Abbas W, Khetrapal R. Cancer Awareness amongst Nurses in a Tertiary Care Hospital in North Delhi, India. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_159_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Background: Nursing staff is the first of a constant line of contact with the patients and serve a prodigious responsibility. They play a pivotal role in disseminating knowledge to the patients in their daily practice. The present study was conducted to assess the level of cancer awareness among hospital nurses, identify the knowledge gaps and to incorporate them into training. Cancer is the most prominent cause of morbidity and mortality in both developed and developing countries like India where nearly 5 lakh deaths per year occur according to the recent GLOBOCAN data. Materials and Methods: A cross-sectional survey was conducted among nurses in a tertiary care hospital in North Delhi. Of 458 employed nurses, 53.3% nurses working in the hospital participated in the study on a voluntary basis. A structured pretested questionnaire was administered to the study subjects. The questionnaires were coded, and information on personal details was not included. To warrant an effective measure of study outcomes, a Cancer Awareness Score (CAS) was developed. CAS of individual participants was achieved by dividing the total average score of each subject by ten that will help in quantifying the cancer awareness. A total of 244 nurses (53.3%) out of 458 employed were surveyed. A total of 146 forms were filled manually and 78 forms were completed electronically. Results: The return rate was 65.5% of the CAS. The completion rate was 100% and the rejection rate was zero. Of these 223 were female and 21 were male. The study subjects were in the age range of 19–56 years. Out of the 244 nurses, 75.81% were aware about general aspects of cancer. 77.5% of the nurses acknowledged that cancer is a serious health problem in India, and 79.9% were aware of the increasing incidence of cancer. About 66.4% subjects knew that cancer is a lifestyle disease. About 75.4% were aware that cancer is preventable, and 78.7% agreed that early detection is possible. About 23% believed that all lumps are cancerous. Almost 75% of the study subjects were aware of warning symptoms of cancer, nearly 90% of them were aware about all the causative factors. In this study, 21% of nurses were observed to have one or more myths about cancer during the survey. 23.4% believed that cancer is contagious; 25% of the study subjects believed that cancer is familial, 13.9% believed that cancer is due to God’s curse! Another alarming observation is that they believe that procedures such as biopsy (17%) or surgery (21.7%) can spread cancer!. It is vital to work on removing these myths. Conclusion: Authors perceive that the study subjects lack adequate knowledge about cancer. The total average score of the study subjects was <75%. General awareness about cancer treatment needs to be reinforced. There is a pressing need to bust the myths by using appropriate information education communication strategies. Repeated training of nurses on cancer awareness is warranted. If well equipped with knowledge on cancer, they can further impart information to patients, caregivers and other hospital staff.
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Affiliation(s)
| | - Rudra Prasad Acharya
- Departments of GI and Thoracic Oncology, Max Superspeciality Hospital, New Delhi, India
| | - Peush Bajpai
- Departments of Medical Oncology, Max Superspeciality Hospital, New Delhi, India
| | - Waseem Abbas
- Departments of Medical Oncology, Max Superspeciality Hospital, New Delhi, India
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Ahlawat P, Batra N, Sharma P, Kumar S, Kumar A. Knowledge and Attitude of Adolescent Girls and Their Mothers Regarding Cervical Cancer: A Community-Based Cross-Sectional Study. J Midlife Health 2018; 9:145-149. [PMID: 30294187 PMCID: PMC6166420 DOI: 10.4103/jmh.jmh_45_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Cervical cancer is the second most commonly diagnosed cancer in India. The mother's awareness about the symptoms and risk factors has a large impact on the daughter's knowledge and attitude. Mother and adolescent daughter duos were selected as the sample as they are the target population at risk for suffering from carcinoma cervix. Mothers are the prime information providers and in an excellent position to aware their adolescent daughters about cervical cancer. Objectives: The aim of this study is to determine knowledge and attitude of adolescent girls and their mothers regarding cervical cancer and to find the association between the education of the mothers and their knowledge about risk factors. Materials and Methods: A community-based cross-sectional study was conducted among 100 duos of adolescent daughters along with their mothers residing in Balmiki Basti (Delhi), using a predesigned, pretested, semi-structured interview schedule. The collected data were analyzed using SPSS-22 version. Results: Only 61% of mothers and 52% of daughters have heard about cervical cancer. Inter-menstrual bleeding was the most common symptom recognized by the mother (50%) and daughter (44%) duos followed by postmenopausal bleeding (47% of mothers and 33% of daughters). Most common risk factors recognized by mothers and their daughters were promiscuity and tobacco and smoking. About 81% of mothers and 68% of daughters have a positive attitude toward internal examination by a gynecologist at least once in 3 years. Human papillomavirus infection was recognized as a risk factor by 13 among which 8 were educated till graduation (P < 0.05). Conclusions: Study revealed a low-level knowledge about cervical cancer among adolescent daughters and their mothers. Therefore, there is an urgent need to empower the women by educating them on this issue. Furthermore, there is a need to encourage the mothers to communicate the right information to their adolescent daughters.
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Affiliation(s)
- Pooja Ahlawat
- Department of Community Medicine, ICMR, New Delhi, India
| | - Nitya Batra
- Maulana Azad Medical College, ICMR, New Delhi, India
| | - Pragya Sharma
- Department of Community Medicine, ICMR, New Delhi, India
| | - Shiv Kumar
- Department of Epidemiology, ICMR, New Delhi, India
| | - Ajay Kumar
- Department of Paediatrics, Maharishi Valmiki Hospital, New Delhi, India
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Thakur J, Prinja S, Jeet G, Bhatnagar N. Costing of a State-Wide Population Based Cancer Awareness and Early Detection Campaign in a 2.67 Million Population of Punjab State in Northern India. Asian Pac J Cancer Prev 2017; 17:791-7. [PMID: 26925682 DOI: 10.7314/apjcp.2016.17.2.791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Punjab state is particularly reporting a rising burden of cancer. A 'door to door cancer awareness and early detection campaign' was therefore launched in the Punjab covering about 2.67 million population, wherein after initial training accredited social health activists (ASHAs) and other health staff conducted a survey for early detection of cancer cases based on a twelve point clinical algorithm. OBJECTIVE To ascertain unit cost for undertaking a population-based cancer awareness and early detection campaign. MATERIALS AND METHODS Data were collected using bottom-up costing methods. Full economic costs of implementing the campaign from the health system perspective were calculated. Options to meet the likely demand for project activities were further evaluated to examine their worth from the point of view of long-term sustainability. RESULTS The campaign covered 97% of the state population. A total of 24,659 cases were suspected to have cancer and were referred to health facilities. At the state level, incidence and prevalence of cancer were found to be 90 and 216 per 100,000, respectively. Full economic cost of implementing the campaign in pilot district was USD 117,524. However, the financial cost was approximately USD 6,301. Start-up phase of campaign was more resource intensive (63% of total) than the implementation phase. The economic cost per person contacted and suspected by clinical algorithm was found to be USD 0.20 and USD 40 respectively. Cost per confirmed case under the campaign was 7,043 USD. CONCLUSIONS The campaign was able to screen a reasonably large population. High to high economic cost points towards the fact that the opportunity cost of campaign put a significant burden on health system and other programs. However, generating awareness and early detection strategy adopted in this campaign seems promising in light of fact that organized screening is not in place in India and in many developing countries.
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Affiliation(s)
- Js Thakur
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India E-mail :
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Sarkar M, Konar H, Raut D. Clinico-pathological features of gynecological malignancies in a tertiary care hospital in eastern India: importance of strengthening primary health care in prevention and early detection. Asian Pac J Cancer Prev 2014; 14:3541-7. [PMID: 23886142 DOI: 10.7314/apjcp.2013.14.6.3541] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This cross-sectional observational study was undertaken to establish clinico-pathological characteristics of patients with gynecological malignancies, focusing mainly on symptoms, histological type and stage of the disease at presentation, in a tertiary care setting in Eastern India. MATERIALS AND METHODS In the gynecology out-patient clinic of a tertiary care hospital in Kolkata, India, the patients with suggestive symptoms of gynecological malignancies were screened. Their diagnoses were confirmed by histopathology. One hundred thirteen patients with histopathologically confirmed gynecological malignancies were interviewed. RESULTS The most frequently reported symptoms by the patients with histopathologically confirmed gynecological malignancies were excessive, offensive with or without blood stained vaginal discharge (69.0%), irregular, heavy or prolonged vaginal bleeding (36.3%) and postmenopausal bleeding (31.9%). The majority of the patients (61.0%) had squamous cell carcinoma on histopathological examination, followed by adenocarcinoma (30.1%). Nearly half of the patients (48.7%) were suffering from the Federation Internationale des Gynaecologistes et Obstetristes (FIGO) stage III, followed by stage II (40.7%) malignancy. CONCLUSIONS This study highlights that most of the patients with gynecological malignancies present late at an appropriate health care facility. Ovarian cancer may often have non-specific or misleading symptomatic presentation, whereas cervical cancer often presents with some specific symptoms. These observations point to the need for increasing awareness about gynecological malignancies in the community and providing easily accessible adequate facilities for early detection and treatment of the disease by optimal use of available resources, i.e. strengthening the primary health care system.
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Affiliation(s)
- Madhutandra Sarkar
- Department of Community Medicine, Chettinad Hospital and Research Institute, Chennai, India.
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