Delivery of cancer care in rural India: Experiences of establishing a rural comprehensive cancer care facility

Banavali, Shripad

doi:10.4103/0971-5851.158848

Cited by 25 publications

(16 citation statements)

References 9 publications

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“…The COVID-19 pandemic is likely to exacerbate these conditions, as travel bans and disruption of existing cancer services further limit access to treatment for these populations ( 7 ). The burden is worsened in developing countries such as India, where nearly 70% of the national population resides in rural areas and must travel to urban tertiary care centers for treatment ( 101 , 102 ). Studies have also revealed racial disparities in access to cancer treatment worldwide ( 103 , 104 ).…”

Section: Resultsmentioning

confidence: 99%

Call for Action to Address Equity and Justice Divide During COVID-19

et al. 2020

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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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Section: Resultsmentioning

confidence: 99%

Call for Action to Address Equity and Justice Divide During COVID-19

et al. 2020

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“…Compared to no screening, even a single screening is effective in reducing the incidence and mortality of advanced cervical cancer [4]. Although proven strategies for cancer screening exist, the provision of accepted standard of care remains to be materialized, especially in rural India [5].…”

Section: Introductionmentioning

confidence: 99%

“…In India, opportunistic cervical cancer screening is conducted at the primary, secondary, and tertiary level health-care facilities; however, a systematic screening program covering the entire population is lacking [2,7]. Lack of awareness, financial constraints, cultural barriers, lack of social support, and stigma attached to the disease and denial of the screening outcome prevent the women from attending further evaluation, disrupting the care continuum [5]. Although projects such as the Tamil Nadu Health Systems Project (Tamil Nadu is a state/province in South India) have conducted long-standing breast and cervical cancer screening programs [8], the care continuum is not reported.…”

Section: Introductionmentioning

confidence: 99%

Cervical Cancer Care Continuum in South India: Evidence from a Community-based Screening Program

Vidhubala¹,

Niraimathi²,

Shewade³

et al. 2019

JEGH

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In India, cervical cancer screening is conducted at various levels; however, after screening, the adherence to the cancer care continuum is barely understood. This study evaluated a community-based cancer screening program conducted in a rural setting (Tirunelveli and Tuticorin districts) in South India and reviewed the completion of care continuum. In this longitudinal descriptive study involving secondary data collection, data from the case records of 2192 women who were consecutively screened between March 2015 and May 2016 were included. All women underwent conventional cytology-based screening (Pap smear) and Visual Inspection with Acetic Acid (VIA). Those for whom either test was positive were referred for histopathological confirmation. Patients with confirmed precancerous conditions and unsatisfactory Pap smears were referred for further management. In total, 2192 women were screened [age range, 17-69 years; mean (standard deviation), 39.2 (8.5)]. Common symptom and sign were white discharge per vaginum (34.9%) and cervical erosion (34.4%), respectively. The VIA was positive for 24% (523/2178; 14 women did not cooperate for VIA) and 113 (5.1%) had epithelial cell abnormality in the Pap smear test. Per histopathology findings, one woman had non-keratinizing squamous cell carcinoma. Seven, three, and four had cervical intraepithelial neoplasia I, II and III, respectively. Of 2192, 807 were eligible for referral (597 had positive results on either Pap or VIA). Among the 807 women referred, only 74 (9.2%) women visited the referral center. The follow-up rate was very poor accounting to fragmentation of care continuum. The success of the screening program depends on the completion of the care continuum.

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“…Many tertiary care centres (not all) have a comprehensive team of professionals comprising medical, radiation and surgical oncologists, pain and palliative care experts and auxiliary services, for example, diagnostics and pathological tests. A complex team like this is yet to be a reality in rural India6.…”

Section: Infrastructurementioning

confidence: 99%