CANCER CONTROL

PROGRAMME
(INDIA)
• Is an important public health
problem in India.
• Nearly 7-9 lakh new cases occur
every year.
• It is estimated that are 2-2.5
million cases of cancer in the
country at any given point of
time.
• More than 60% of these
affected patients are in the
prime of their life between
the ages of 35 and 65 years.
 GLOBAL OCCURRENCE
• 12 per cent of deaths are due
to cancer.

• Second leading cause of death

 OCCURRENCE IN INDIA
• one among ten leading causes of
death

• 7 lakh new cases of cancer and 4

lakh deaths annually

• 15 lakh patients lack facilities for

diagnosis, treatment and follow up
 CAUSES

1.ENVIRONMENTAL FACTORS.
2.GENETIC FACTORS
1.ENVIRONMENTAL FACTORS
1. Tobacco.
2. Alcohol.
3. Dietary Factors.
4. Occupational Exposures.
5. Viruses.
6.parasites.
7.Custom, habits & life styles.
8.Others
 2.GENETIC FACTORS

• E.g. Retinoblastoma.

• It is a complex inter relationship

between environmental factors &
the hereditary.
 WARNING SIGNS OF CANCER
1. A lump or a hard area in the
breast.
2. A change in wart or mole.
3. A persistent change in digestive &
bowel habits.
4. A persistent cough or hoarseness
5. Excessive loss of blood at the
monthly period or loss of blood
outside the usual dates.
6. Blood loss from any natural orifice.
7. A swelling or sore that does not get
better.
8. Un explained loss of weight.
COMMON SITES OF CANCER
MALE
Oral cavity
Pharynx
Larynx
Prostate
Rectum
Lung
Ca ORAL CAVITY
 FEMALE

• Cancers of oral cavity

• Cervix
• Breast
CANCER CONTROL
PROGRAMME
1975-76
 GOALS
1. The primary prevention of
tobacco related cancers.
2. Secondary prevention of
cancer of the uterine
cervix, mouth, breast etc.;
and
3. Tertiary prevention includes
extension and strengthening of
therapeutic services including
pain relief on a national scale
through regional cancer centres
and medical colleges (including
dental colleges).
• Palliative care in terminal
stage cancer.
 EXISTING SCHEMES UNDER
NATIONAL CANCER CONTROL
PROGRAMME
1. DISTRICT CANCER CONTROL SCHEME
( DCCS)
2. MODIFIED DISTRICT CANCER CONTROL
PROGRAMME( MDCCP)
3. DEVELOPMENT OF ONCOLOGY WING
4. SETTING UP OF COBALT
THERAPY UNIT
(TELETHERAPY UNIT)

5. VOLUNTARY ORGANISATIONS
SCHEME

6. NEW INITIATIVES
7.NATIONAL CANCER REGISTRY
PROGRAMME (NCRP)

8. POST PARTUM CENTERS

9. REGIONAL CANCER CENTERS

10. TOBACCO REGISTRATION

COUNSELLING
1. DISTRICT CANCER CONTROL
SCHEME (DCDS) 1990-1991
OBJECTIVES:

• To prevent and control cancer through health

education and early case detection &
treatment.
ACTIVITIES:

• 15 lakh to start the programme and then

Rs10,000 every year for four years.
 2. MODIFIED DISTRICT CANCER
CONTROL PROGRAMME( MDCCP)
• 1990-1991
COMPONENTS:
1. Health Education
2. Early Detection
3. Training of Medical & Para-Medical Personnel
4. Palliative Treatment and pain relief
5. Coordination and monitoring.
• Pilot study done among age group
20-65 years in 60 blocks of U.P,
Bihar, Tamil Nadu & West Bengal
with 1200 workers.

• Health education about general

ailments, cancer prevention and
early detection.
• The data collected are analyzed
and the project was completed
in a year.

• National Cancer Awareness Day

was observed on 7th November
every year.
• only for Government Medical
Colleges

• Rs.2.00 crores to purchase cobalt

unit.
3. DEVELOPMENT OF
ONCOLOGY WING
 4. SETTING UP OF COBALT
THERAPY UNIT
(TELETHERAPY UNIT)
• Rs.1.50 crore for setting up of Cobalt
Therapy Unit & 3 lakh for
establishing mammography unit in
Government & Non-governmental
Organization
 5. VOLUNTARY ORGANISATIONS
SCHEME
• IEC activities and early detection of
cancer. financial assistance up to
Rs.5.00 lakh

• Linkage with the Regional Cancer

Centre (or Medical College/ District
Hospital).
• The NGOs should be registered
under the Societies Registration
Act, 1860 and are charitable
organizations
 6. NEW INITIATIVES

• WHO funding under the

biennium pattern.

• In 1998-1999, 16
workshop/training programmes
organized
• Supplied the Pap Smear Kits and Can scan
software to 12 Regional Cancer Centers with
Morphine tablets.

In 2000-2001
1.Outreach activities by medical colleges
2.Training of personnel
3.Supply of Morphine
4.Telemedicine and supply of computer
hardware and software.
5. IEC activities.

6. Modified District Cancer Control

Programme

7. National Cancer Awareness Day

8. Cyto pathologists and cyto technicians in

Pap Smear technology

9. Participation in Health Melas and distribution

of health education material
• Postage stamp on National Cancer
Awareness Day

• Telecast of a health magazine

'Kalyani”and anti tobacco items with
Prasar Bharti

In 2002-03
• Screening OPD for cancer at Vardhman
Mahavir Medical College
 7.NATIONAL CANCER REGISTRY
PROGRAMME (NCRP) 1982
CANCER REGISTRATION:
• Collection and classification of
information on all cancer cases in order
to produce statistics on the occurrence of
cancer and to provide a framework for
assessing and controlling the impact of
cancer on the community.
 OBJECTIVES
• To generate data on magnitude of
cancer
• To undertake epidemiological
investigations
• Promote human resource
development in cancer
epidemiology.
 TYPES
• POPULATION BASED: [Bombay ,
Bangalore , Madras, Kolkatta,
Thiruvananthapuram,
Karunagapally and Ambillikai].

• HOSPITAL BASED: [Chandigarh,

Dibrugarh & Trivandrum].
 USES
1.Continued assessment of the levels of
cancer

2. Provision of facilities & equipment

needed

3. Evaluation of the effect of early

diagnosis and treatment.
4. Epidemiological and laboratory studies

5. Evaluation of removal of initiators and

promoters from the environment.

6. Helps in generation of hypothesis in

aetiology of various cancers.

7. To carry out research studies.

8. Planning for health services for
combating the disease.

9. Assessing the survival of cancer.

10. Cost-effective utilization resources

in activities of Control
Programme .
• sale of cigarette to age of 18 yrs.

• sale of cigarette near the educational

institutions etc.,

• Mandatory depiction of statutory

warning ( Pictorial)

• Mandatory depiction of tar and nicotinic

contents along with maximum
permissible limit
 8. POST PARTUM CENTERS

• early detection of cervical

cancer at postpartum
centers
9. REGIONAL CANCER CENTERS
• 14 RCC with 250 beds

ACTIVITIES:
perform diagnostic, therapeutic,
rehabilitation, education, training, cancer
registration and research functions
 LIST OF RCC
1.Kidwai Memorial Institute of
Oncology, Bangalore.
2.Gujrat Cancer 7 Research Institute,
Ahmedabad.
3.Cancer Hospital & Research
Institute, Gwalior.
4.Cancer Institute, Chennai
5. Regional Cancer Center,
Thiruvanathapuram.
6. Regional Center for Cancer
Research & Treatment Society,
Cuttack.
7. Dr. B.B Cancer Institute,
Guwahati.
8. Chittaranjan National Cancer
Institute, Kolkatta.
9. Institute Rotary Cancer Hospital
(AIIMS).

10. Tata Memorial Hospital, Mumbai.

11. Kamala Nehru Memorial

Hospital, Allahabad.

12. MNJ Institute of Oncology,

Hydrabad.
13.R.S.T. Cancer Hospital, Nagpur.

14.Indira Gandhi Institute of Medical

Sciences, Patna.

15.Acharya Harihar Tulsi Das Regional

Cancer Centre, Bikaner (Raj).

16.Indira Gandhi Medical College,

Shimla.
17. Post Graduate Institute of
Medical Sciences, Rohtak.(Har).

18. Pt. J.N.M. Medical College &

RCC, Raipur.

19. JIPMER, Puducherry.

 10. TOBACCO REGISTRATION
COUNSELLING
“The Cigarettes and other Tobacco
products Act 2003” passed in April, 2003

The important Provisions are Prohibition

of:
• smoking in public place
• direct and indirect advertisement
• sale of cigarette to age of 18 yrs.

• sale of cigarette near the educational

institutions etc.,

• Mandatory depiction of statutory warning

( Pictorial)

• Mandatory depiction of tar and nicotinic

contents along with maximum permissible
limit
 IX PLAN FOCUS
1. Identification of IEC activities so
that people seek care at the onset
of symptoms.
2. Provision of diagnostic facilities in
primary and secondary care level
so that cancers are detected at
early stages when curative
therapy can be administered.
3. Filling up of the existing gaps in
radiotherapy units in a phased manner
so that all diagnosed cases do receive
therapy without any delay as near to
their residence as feasible.
4. IEC to reduce tobacco consumption and
avoid life style which lead to increasing
risk of cancers.
ROLE OF HEALTH CARE SYSTEM
• REGIONAL CANCER CENTRE
• Health Promotion/Home Care/Early
Detection/Pain
• Relief/Palliative Care/Comprehensive Cancer
treatment/
• Organise screening programmes/Cytology
training/
• Basic and applied research/Training of all
categories of
• personnel/Cancer Registries/Epidemiology
• MEDICAL COLLEGE HOSPITAL
• Health Promotion/Home Care/Early
Detection/
• Pain Relief/Palliative Care/
• Treatment of common
cancers/Training of
• medical officers/paramedical
personnel
• DISTRICT HOSPITAL

• Health Promotion/Home Care/

• Early Detection/Pain Relief/
• Palliative Care/Treatment of
common cancers
• TALUK HOSPITAL/SUB DISTRICT
HOSPITAL

• Health Promotion/Home Care/Early

Detection/
• Pain Relief/Palliative Care
 CANCER CONTROL

1. PRIMARY PREVENTION.

2. SECONDARY PREVENTION.
 PRIMARY PREVENTION.
• Control of tobacco & alcohol
consumption.

• Personal hygiene.

• Reduction of radiation exposure.

• Measures to reduce occupational

exposures.
• Immunization.

• Quality of food, drugs & cosmetics

• Prevention of air pollution.

• Treatment of pre cancerous lesions.

• Legislation.

• Cancer education.
2. SECONDARY PREVENTION
1. cancer registration.

2.Early detection of cases.

3.Treatment.
 CANCER SCREENING
• Screening for cancer cervix.
• Cancer screening for breast
cancer.
• Cancer screening for lung cancer.