Cancer Screening in India

Screening for cancers aims to detect cancers early among asymptomatic individuals when it may be easier to effectively treat them that will help prevent premature cancer deaths and improve quality of life. Evidence-based cost-effective cancer screening technologies have the potential to substantially reduce the cancer incidence and mortality to consider its implementation in national public health screening programs. Cancers of the uterine cervix, breast, lip and oral cavity are the three most common cancers contributing to the majority of the burden of cancer in India. The article explores the evidence and current developments in common cancer screening technologies to identify effective evidence-based, resource-appropriate, relevant cancer screening tools and strategies for low–middle-income countries (LMICs). The challenges posed due to the logistics, trained manpower and financial requirements in implementing high-quality organized cervical cytology screening in LMICs have led to the identifying and evaluating alternative screening approaches such as visual inspection with acetic acid (VIA) and human papillomavirus (HPV) DNA testing with novel approaches of self-collected vaginal samples. Mammography screening programs as adopted in the high-income countries are complex multidisciplinary undertaking with associated burden of overdiagnosis and overtreatment. Evidence from current ongoing clinical trials on clinical breast examination (CBE) will aid public health policymakers on taking informed decisions on introducing CBE in screening programs as a more efficacious, practical and cost-effective option in LMICs. Improved breast awareness and CBE by trained health workers will provide opportunity for undertaking regular breast examinations among women in LMICs for early detection of breast cancer. Despite limited evidence, oral cancer screening by oral visual inspection (OVI) in high-risk individuals combined with an increased public education and awareness about prevention and screening for oral cancer in general will help attain the goal of decreasing the burden of oral cancers in low resource settings. There is limited scientific evidence currently to recommend screening for lung, ovarian or prostate cancer screening in public health programs.