Cancer Detection Rates in a Population-Based, Opportunistic Screening Model, New Delhi, India

Background: In India, cancer accounts for 7.3% of DALY’s, 14.3% of mortality with an age-standardizedincident rate of 92.4/100,000 in men and 97.4/100,000 in women and yet there are no nationwide screeningprograms. Materials and
Methods: We calculated age-standardized and age-truncated (30-69 years) detectionrates for men and women who attended the Indian Cancer Society detection centre, New Delhi from 2011-12. Allparticipants were registered with socio-demographic, medical, family and risk factors history questionnaires,administered clinical examinations to screen for breast, oral, gynecological and other cancers through acomprehensive physical examination and complete blood count. Patients with an abnormal clinical exam orblood result were referred to collaborating institutes for further investigations and follow-up.
Results: A totalof n=3503 were screened during 2011-12 (47.8% men, 51.6% women and 0.6% children <15 years) with a meanage of 47.8 yrs (±15.1 yrs); 80.5% were aged 30-69 years and 77.1% had at least a secondary education. Tobaccouse was reported by 15.8%, alcohol consumption by 11.9% and family history of cancer by 9.9% of participants.Follow-up of suspicious cases yielded 45 incident cancers (51.1% in men, 48.9% in women), consisting of 55.5%head and neck (72.0% oral), 28.9% breast, 6.7% gynecological and 8.9% other cancer sites. The age-standardizeddetection rate for all cancer sites was 340.8/100,000 men and 329.8/100,000 women.
Conclusions: Cancer screeningcentres are an effective means of attracting high-risk persons in low-resource settings. Opportunistic screeningis one feasible pathway to address the rising cancer burden in urban India through early detection.