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Universal screening for diabetes, hypertension and cancer

Global Burden of Disease estimates CVD (cardiovascular disease) death rate of 272 per 100,000 in India, higher than global average of 235.

Written by Abantika Ghosh | New Delhi | February 4, 2017 6:02:35 am

THE Union Health Ministry has decided to implement universal screening for diabetes, hypertension and three types of cancer for everyone over 30 years in 100 districts where the original UPA plan for a similar screening exercise failed to take off. The project is known to have been pushed by Prime Minister Narendra Modi who last year had set a deadline for the Ministry to come up with a screening framework for cancer. The target, according to Ministry officials, is to ensure that once there is a fullscale rollout, every Indian is screened for these diseases at least once in three years. Health workers’ training will start later this month and the programme is expected to take off in the chosen districts at the beginning of the next financial year, say sources. The programme will be integrated with one of referrals so that any early signs are treated to pre-empt what officials called “catastrophic health expenses” which many of these diseases entail. Hypertension and diabetes are the first warning signs of heart disease and stroke, commonly referred to as cardiovascular diseases.

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“Cardiovascular diseases (CVDs) have now become the leading cause of mortality in India. A quarter of all mortality is attributable to CVD. Ischemic heart disease and stroke are the predominant causes and are responsible for more than 80% of CVD deaths. The Global Burden of Disease study estimate of age-standardized CVD death rate of 272 per 100,000 population in India is higher than the global average of 235 per 100,000 population,” said a report published last year in medical journal Circulation.

India’s cancer burden is also a growing concern. Data complied by the Central Bureau of Health Intelligence (CBHI) shows that in 2012 the total number of cancer cases reported in India were 10,57,204.

In 2013 that figure rose to 10,86,783, in 2014 it was 11,17,269, and in 2015 it stood at 11,48,692. According to projections by Universal screening in 100 districts for diabetes, hypertension, cancer

CBHI, which analysed cancer time trends, in five years, the total number of cases in men will touch 6,22,203, while in women the figure will stand at 6,98,725. Pre-cancerous lesions in case of mouth and cervix and growths in case of breast can be detected early enough to ensure intervention.

While India does have a programme for screening of non-communicable diseases, cancer screening has been a virtual non-starter despite successive health reports presenting a grim picture of India’s cancer burden.

India’s National Cancer Control Programme was initiated in 1975-76. In 2010, it was integrated with the national programmes for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in 100 districts where screening was to be done for some forms of cancer. Five years on, the Ministry of Health does not know how many people have been screened for cancer. Dearth of trained personnel, officials say, is one of the main reasons for the screening programme’s failure.

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