Community Based Mobile Screening Programme for Oral, Breast and Cervical Cancers: A Programmatic Insight from rural Assam, India

AbstractOut of 39 billion people who are blind around the world, 20 billion (51.3%) is due to cataract, which is preventable. This study intended to assess the prevalence and factors associated with cataract among elderly in a divisional secretariat area in Sri Lanka. This community based cross sectional study assessed randomly selected470 adults over 60 years of age. Diagnosis of cataract was made by a slit lamp examination by medical officers, and classified according to Oxford Lens Opacity Classification system (LOCS III). Majority was between 60-69 age groups and 71% was females. The prevalence of cataract was estimated to be 80.6% including operated eye and 73.6% excluding the operated eye, with a female preponderance in lower age categories. Commonest type of cataract was the nuclear type (n=422; 44.9%), with a majority in grade 2 (218; 23.2%). The prevalence of cataract surgery in the diseased population was as low as 7%. Cataract leading to blindness is very prevalent among adults over 60 years of age in the studied area. Females tend to develop the disease at an early age than males. These findings warrant screening programme for elderly at community level, targeting females at a younger age than males. Future studies are recommended to assess the coverage and barriers for cataract surgeries at national level, which would be immensely useful in planning and improving health services.

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Spirometry performed as part of the Manchester community-based lung cancer screening programme detects a high prevalence of airflow obstruction in individuals without a prior diagnosis of COPD

Thorax ◽

10.1136/thoraxjnl-2019-213584 ◽

2020 ◽

Vol 75 (8) ◽

pp. 655-660 ◽

Cited By ~ 1

Author(s):

Haval Balata ◽

Jonathan Harvey ◽

Phil V Barber ◽

Denis Colligan ◽

Rebecca Duerden ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Screening Programme ◽

Risk Estimation ◽

Airflow Obstruction ◽

Lung Cancer Screening ◽

Symptom Assessment ◽

Community Based ◽

Previous Diagnosis ◽

Cancer Screening Programme

BackgroundCOPD is a major cause of morbidity and mortality in populations eligible for lung cancer screening. We investigated the role of spirometry in a community-based lung cancer screening programme.MethodsEver smokers, age 55–74, resident in three deprived areas of Manchester were invited to a ‘Lung Health Check’ (LHC) based in convenient community locations. Spirometry was incorporated into the LHCs alongside lung cancer risk estimation (Prostate, Lung, Colorectal and Ovarian Study Risk Prediction Model, 2012 version (PLCOM2012)), symptom assessment and smoking cessation advice. Those at high risk of lung cancer (PLCOM2012 ≥1.51%) were eligible for annual low-dose CT screening over two screening rounds. Airflow obstruction was defined as FEV1/FVC<0.7. Primary care databases were searched for any prior diagnosis of COPD.Results99.4% (n=2525) of LHC attendees successfully performed spirometry; mean age was 64.1±5.5, 51% were women, 35% were current smokers. 37.4% (n=944) had airflow obstruction of which 49.7% (n=469) had no previous diagnosis of COPD. 53.3% of those without a prior diagnosis were symptomatic (n=250/469). After multivariate analysis, the detection of airflow obstruction without a prior COPD diagnosis was associated with male sex (adjOR 1.84, 95% CI 1.37 to 2.47; p<0.0001), younger age (p=0.015), lower smoking duration (p<0.0001), fewer cigarettes per day (p=0.035), higher FEV1/FVC ratio (<0.0001) and being asymptomatic (adjOR 4.19, 95% CI 2.95 to 5.95; p<0.0001). The likelihood of screen detected lung cancer was significantly greater in those with evidence of airflow obstruction who had a previous diagnosis of COPD (adjOR 2.80, 95% CI 1.60 to 8.42; p=0.002).ConclusionsIncorporating spirometry into a community-based targeted lung cancer screening programme is feasible and identifies a significant number of individuals with airflow obstruction who do not have a prior diagnosis of COPD.

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An evaluation of the change in activity and workload arising from diabetic ophthalmology referrals following the introduction of a community based digital retinal photographic screening programme

British Journal of Ophthalmology ◽

10.1136/bjo.2004.060723 ◽

2005 ◽

Vol 89 (8) ◽

pp. 971-975 ◽

Cited By ~ 10

Author(s):

P H Scanlon

Keyword(s):

Screening Programme ◽

Community Based

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Community-Based Cancer Screening Program: The DESH (Detect Early Save Her, Him) Initiative of Piramal Swasthya

Journal of Global Oncology ◽

10.1200/jgo.18.52900 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 146s-146s

Author(s):

S.K.B. Hegde ◽

S. Sadanand ◽

S.M. Bhagabaty ◽

A.C. Kataki ◽

S. Chanda ◽

...

Keyword(s):

Cancer Screening ◽

Late Stage ◽

Diagnostic Tests ◽

Screening Program ◽

Community Level ◽

Community Based ◽

Cervical Cancers ◽

Oral Cancers ◽

Late Stage Diagnosis ◽

Screening Unit

Background and context: Two-thirds of global cancer deaths are from less developed countries. Late stage presentation and inability to access care are observed to be higher in lower and middle-income countries resulting in avoidable deaths and disability. Kamrup district in Assam has the fourth highest incidence of cancers in India. Detect Early Save Her, Him (DESH) initiative by Piramal Swasthya in Kamrup district focuses on reducing late-stage diagnosis and mortality. Aim: To reduce the proportion of late-stage diagnosis and mortality from breast, cervical and oral cancers through a community based screening and referral program. Strategy: 1. Community level interventions to increase awareness, improve knowledge, alter attitudes and motivate and mobilize people to undergo screening. 2. Evidence based highly sensitive screening and referral through mobile cancer screening unit. 3. Partnering with a regional cancer care institute (Dr. B. Borooah Cancer Institute - BBCI) to ensure end to end care to the patients. Program: DESH initiative in partnership with BBCI was launched in November 2017. The Mobile Cancer Screening Unit (MCSU) is fully equipped with state-of-the-art cancer screening facilities including a mammography unit. It is staffed by trained medical doctor, two nurses, a radiographer, two community mobilization officers, a counselor, a driver and a helper. Apart from the driver and the helper, the entire staff is women. In consultation with community networks, a schedule is prepared to conduct awareness programs at the community level. Subsequently, the MCSU visits the village and the staff screen the adult population over the age of 30 years for the presence of oral, breast and cervical cancer. A vehicle ferries those who are screened positive, to BBCI for diagnostic tests. The program is also supported by a helpline, which provides tele-counseling for suspected cases of cancer. Outcomes: A total of 1750 beneficiaries have been screened for oral, breast and cervical cancers through 43 screening clinics in 18 villages of Kamrup district from November 2017 through March 2018. Of them, 57% were females. 57 beneficiaries (3.25%) were screen-positive. Majority were positive for oral cancers (n=50) followed by breast and cervical cancers. Out of the 15 beneficiaries who visited BBCI, 3 were confirmed to have oral cancer. What was learned: Rural community of Kamrup district has been very receptive of the screening program with 1750 people screened in a short duration of time. Many screen-positive patients have not yet to visited the hospital for diagnostic tests, due to their financial difficulties. With financial support from the government through a special scheme, the number of screen-positive patients reaching the hospital for diagnostic tests is expected to increase substantially. DESH initiative aims to screen 15,000 individuals in the next 12 months and the results will provide better insights about the scalability and impact of the program.

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Epidemiology of chronic kidney disease of undetermined aetiology in Taiwanese farmers: a cross-sectional study from Changhua Community-based Integrated Screening programme

Occupational and Environmental Medicine ◽

10.1136/oemed-2021-107369 ◽

2021 ◽

pp. oemed-2021-107369

Author(s):

Jerry Che-Jui Chang ◽

Hsiao-Yu Yang

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Sex Education ◽

Screening Programme ◽

Asian Countries ◽

Community Based ◽

Cross Sectional ◽

Thermal Hazards ◽

Increased Risk ◽

Integrated Screening

ObjectivesChronic kidney disease of undetermined or non-traditional aetiology (CKDu or CKDnT) has been reported in Mesoamerica among farmers under heat stress. Epidemiological evidence was lacking in Asian countries with similar climatic conditions. The objective of this study was to investigate the prevalence of CKDu and possible risk factors.MethodsWe used the data from the Changhua Community-based Integrated Screening programme from 2005 to 2014, which is the annual screening for chronic diseases in Taiwan’s largest rice-farming county since 2005. Our study population included farmers and non-farmers aged 15–60 years. CKDu was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2 at age under 60 years without hypertension, diabetes, proteinuria, haematuria or using Chinese herbal medicine. We estimated the adjusted prevalence OR (POR) of CKDu by farmers, age, sex, education, urbanisation, smoking, body mass index, hyperuricaemia, hyperlipidaemia, heart disease and chronic liver disease.Results5555 farmers and 35 761 non-farmers were included in this study. CKDu accounted for 48.9% of all CKD cases. The prevalence of CKDu was 2.3% in the farmers and 0.9% in the non-farmers. The crude POR of CKDu in farmers compared with non-farmers was 2.73 (2.13–3.50), and the adjusted POR was 1.45 (1.10–1.90). Dehydration (blood urea nitrogen-to-creatinine ratio >20) was found in 22% of the farmers and 14% of the non-farmers.ConclusionsFarmers in subtropical Asian countries are at increased risk of CKDu. Governments should take the CKDu epidemics seriously and provide farmers with occupational health education programmes on thermal hazards.

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