Prevention and early detection of oral, breast and cervical cancers: a practical approach in Indian context

Cancer has emerged as a major killer disease in India. One-third of the total cancer load is constituted by oral, breast and uterine cervix cancers. Considerable knowledge is available on control strategies on these 3 major cancers and this can be transformed into the community through the individual health care practitioners. Oral cancer is preventable and both the precancerous and invasive lesions can be picked up easily by examination of the oral cavity. The occurrence of breast cancer in the country is on the increase. The poor survival rate indicates the impact of the major proportion of advanced cancer. An effective strategy comprising breast self-examination, examination by a physician and a mammography test, is described. Cancer of the uterine cervix is the commonest malignancy among females in several regions in India. An effective and definitive method is available in the form of Pap smear for the control of cervical cancer. An organised community screening programme is not economically viable at present. However, routine per speculum examination should be undertaken and this can result in clinical downstaging of cancer. Women above the age of 40 years should undergo regular Pap smear screening. Broad guidelines are presented for an opportunistic screening.