Population-based cancer screening through community participation: Outcome of a district wide oral cancer screening program from rural Kannur, Kerala, India

Abstract

Background:Oral cancer is a major public health challenge, and about one-fifth of all oral cancer cases reported globally are from India. In spite of the potential for early detection by simple visual examination, the majority of patients report in later stages of the disease, especially in low and middle-income countries. We report the results from a district level population-based oral cancer screening program.Methods:A cross-sectional survey was carried out among people aged >15 years in 48 panchayats of Kannur district in Kerala, India. This comprehensive multi-stakeholder district-wide screening was carried out in six stages including planning, sensitization, recruiting of community volunteers and training, survey, organization of specialist camps and referring to cases to cancer center. The descriptive statistical analysis was performed using EpiData analysis software (Version 2.2.2.180).Results:Among the 1,061,088 people in 265,272 houses surveyed, 2507 of them attended the screening camps, and 13 oral cancers and 174 oral precancers were detected. Majority of the oral cancer patients were male (69%), with primary education or illiterate (62%) and low socioeconomic status (61%). Five of the patients diagnosed with early-stage cancer are alive and have good oral health-related quality of life.Conclusion:Detection of precancerous and early-stage cancers should be a priority of oral cancer screening programs. The possible key for addressing cancer screening needs of the rural population is to equip the primary health centers in cancer screening activities with available human resources while adapting to local context.

Diagnostic Accuracy of Screening of Lip and Oral Cavity Cancers or Potentially Malignant Disorders (PMD) by Frontline Workers: A Systematic Review and Meta-Analysis

“…In the community based oral cancer screening program conducted in Thailand, 88,201 individuals were screened by dental auxiliaries and 544 oral potentially malignant disorders (OPMDs) and 1,047 non-OPMDs were identified by the dentists (Klongnoi et al, 2021). A district-level oral cancer screening program conducted at 48 panchayats of Kannur district in Kerala, India, proved that trained FHW could be effectively used in oral cancer screening programs agreeing with our review (Philip et al, 2018). Almost half of the oral cancer patients detected were in the early stages of the disease in that populationbased cancer screening program (Philip et al, 2018).…”

“…A district-level oral cancer screening program conducted at 48 panchayats of Kannur district in Kerala, India, proved that trained FHW could be effectively used in oral cancer screening programs agreeing with our review (Philip et al, 2018). Almost half of the oral cancer patients detected were in the early stages of the disease in that populationbased cancer screening program (Philip et al, 2018).…”

Salivary Metabolomics for Oral Cancer Detection: A Narrative Review

“…In India, limited community-based screening programs and sporadic opportunistic camp-based screenings are performed. Therefore, high levels of awareness about screening and self-examination are recommended by the National Cancer Control Program of India [ 75 ]. In particular, screening (oral visual inspection) was recommended for individuals aged >35 years belonging to the high-risk group [ 76 ].…”

Pilot Model for Community Based Oral Cancer Screening Program: Outcome from 4 Northeastern Provinces in Thailand

“…In a study carried out in Gujrat, India, 5214 trained village healthcare workers screened 2,610,423 individuals and referred 3309 individuals to tertiary care centers, among which 1890 (57.1%) were diagnosed positive for malignancy [27]. Similarly, in a study conducted in Kannur, Kerala, 1,061,088 individuals were surveyed by 6325 volunteers who identified 3226 patients, out of which 2507 attended subsequent screenings, and 13 were identified with oral cancer and 174 with precancerous lesions [28]. A study by Chuang et al followed up with individuals with habits of smoking and betel quid chewing in Taiwan.…”