Cancer control programme in India

The National Cancer Control Programme (NCCP) was initiated in 1975. The objectives of the programmes are mentioned below (Rao et al. 2002).

1. Primary prevention of cancers by health education regarding hazards of tobacco consumption and necessity of genital hygiene for prevention of cervical cancer.

2. Secondary prevention by early detection and diagnosis of cancers for example, cancer of cervix, breast cancer and the oro-pharyngeal cancer by screening methods and patients education on self examination methods.

3. Strengthening of existing cancer treatment facilities, which were inadequate.

4. Palliative care in terminal stage cancer.

Under the NCCP following schemes exist, the details of the scheme were explained (Rao et al. 2002, Gupta et al. 2006).

a. Oncology wing scheme: This scheme has been initiated to bridge the geographical gaps in the availability of cancer treatment facilities in the country.

Central assistance was provided for the purchase of equipment, which includes radiotherapy equipment and also other equipment of related specialty. The civil work and manpower are to be provided by the State government/ institutions concerned. In view of the recommendation of the evaluation report of the NCCP as well as the working group for the 10^th plan strategies, the financial assistance under this scheme has now been raised from Rs. 20.00 million (US$ 416,667) to Rs. 30.00 million (US$ 625,000). There are several district hospitals, which are comparable to Medical College in terms of facilities and need enhanced financial assistance, which is now taken care of by this scheme.

b. Regional Cancer Center Scheme: There are 25 Regional Cancer Centre (RCCs) recognized by the Government of India. Assistance to RCCs is provided not exceeding Rs. 30 million (US$ 625,000) for existing RCCs and Rs. 50 million (US$ 1,041,667) for new RCCs based on the action plan for developing the infrastructure of the institution including equipment for cancer treatment to bring them to the desired level. The grant, which was provided annually, was now been increased and is made as a one-time grant.

c. District Cancer Control Programme: According to the scheme cancer prevention, health education, early detection and pain relief measures were started in 1990-1991. Under this scheme a provision of Rs. 2.2 million (US$ 45,830) is provided to the State government concerned for each district project selected under the scheme with a provision of Rs. 1.7 million (US$ 35,417) every year for the remaining four years of the project period. The project is linked to a Regional Cancer Centre or an institution having good facilities for the treatment of cancer patients. The patients are provided with treatment at the Regional Cancer Centre or the nodal institution concerned. The financial assistance is now proposed to be released to the nodal agency (RCC/well developed Oncology wings in medical college) instead, to the State government as an earlier scheme.

registered voluntary organization recommended by the nodal agency and the State government for undertaking health education and early detection activities.

e. Modified District Cancer Control Programme: The objective of this programme is to conduct a baseline health information and health education drive for 1.2 million women in the age group 20–65. This programme has been initiated in four States namely Uttar Pradesh, Bihar, Tamil Nadu and West Bengal. Health education about general ailments, cancer prevention and early detection besides

‘Breast Self Examination’ was imparted. This project will provide much needed information on the prevalence of the risk factors and will help to identify a high risk group, who can provided with services for early detection.

There were some other activities carried out under the National Cancer Control Programme such as training of cytopathologists and cytotechnicians in the quality assurance in Pap smear technology, training of personnel in early detection and awareness of cancer, telemedicine and supply of hardware and software, Information, Education and Communication activities (IEC activities).

Figure 4. Location of Regional Cancer Centres in India, numbers refer to the list on page 33.

The list of regional cancer centre is given below. These centres, providing the cancer treatment services and working for cancer control in their respective regions. The map (Figure 4) shows the geographical locations of RCC in India with corresponding numbers.

1. Kidwai Memorial Institute of Oncology, Bangalore (Karnataka) 2. Gujarat Cancer and Research Institute, Ahmedabad, (Gujarat) 3. Cancer Hospital Research Institute, Gwalior (Madhya Pradesh) 4. Cancer Institute, Chennai (Tamil Nadu)

5. Regional Cancer Centre, Thiruvananthapuram (Kerala)

6. Regional Centre for Cancer Research and Treatment Society, Cuttack (Orissa) 7. Dr. B.B. Cancer Institute, Guwahati (Assam)

8. Chittaranjan National Cancer Institute, Kolkata (West Bengal) 9. Dr. B.R.A. Institute Rotary Cancer Hospital, AIIMS, (New Delhi) 10. Tata Memorial Hospital, Mumbai (Maharashtra)

11. Kamala Nehru Memorial Hospital, Allahabad (Uttar Pradesh) 12. M.N.J. Institute of Oncology, Hyderabad (Andhra Pradesh) 13. R.S.T. Cancer Hospital, Nagpur (Maharashtra)

14. Indira Gandhi Institute of Medical Science, Patna (Bihar)

15. Acharya Harihar Tulsi Das Regional Cancer Centre, Bikaner (Rajasthan) 16. Indira Gandhi Medical College, Shimla (Himachal Pradesh)

17. Post Graduate Institute of Medical Sciences, Rohtak (Haryanana) 18. Pt. J.N.M. Medical College and RCC, Raipur (Chattisgarh) 19. Pondicherry Regional Cancer Society, JIPMER, (Pondichery)

20. Post Graduate Institute of Medical Education and Research (PGIMER), (Chandigarh).

21. Civil Hospital, Aizawal (Mizoram)

22. Sher-I –Kashmir Institute of Medical Science, Srinagar (Jammu and Kashmir) 23. Sanjay Gandhi Post-graduate Institute of Medical Sciences, Lucknow (Uttar

Pradesh)

24. Regional Institute of Medical Sciences, Imphal (Manipur)

25. Government Arignar Anna Memorial Cancer Research Institute and Hospital, Kancheepuram (Tamil Nadu)

Cancer has become one of the ten leading causes of death in India. As per the 10^th plan the emphasis is on the generation of comprehensive data, primary and secondary prevention of cancers and strengthening of existing treatment facilities along with palliative care.