Designing and Implementing a Cancer Screening Program for Underserved Tribal Women in Jharkhand

The status of cancer screening in India is concerning, especially in tribal states like Jharkhand, where the percentage of women who have ever undergone screening for cervical, breast, and oral cancer is 0.5, 0.1, and 0.2 percent, respectively. Adopting the community-led approach, Karkinos Healthcare, a purpose driven oncology platform, conducted a cancer screening program in collaboration with a livelihood-focused NGO in selected districts of Jharkhand. This study aims to describe the program's implementation and assess the program's performance vis a vis provision of care continuum from screening to treatment.

The program was designed to provide comprehensive services including cancer awareness, enrolment for specialized cancer insurance for one year to cover the cost of treatment, risk assessment, screening for oral, breast, and cervical cancers, diagnostics to screen positive cases, and treatment to the confirmed cancer cases.

A total of 16875 women underwent risk assessments, all of whom were invited for screening at community clinics. A total of 5993 women (34.9%) reported at community clinics and 5873 (34.9%), 5843 (34.7%), and 5029 (29.9%) underwent screening for oral, breast, and cervical cancer. 70% of the total HPV-positive cases had high-risk types other than HPV 16 and 18. 22.4% of the total screened women were navigated for advanced diagnostics and treatment among which 6 confirmed cases of cancer were reported.

While the program design tried to address the implementation challenges like fragmented care, accessibility, and affordability of cancer care services, conversion from screening to treatment was limited.