Cancer control and prevention

1. CANCER
Control & Prevention
Presented By : Niteesh Kumar
Roll No. : 46
Para : 18

2. Introduction
A neoplasm or tumour is a mass of tissue formed as a
result of abnormal, excessive, uncoordinated, autonomous
and purposeless proliferation of cells even after cessation
of stimulus for growth which caused it. In general , a
malignant neoplasm is called as cancer.

3. Control
About 30-50% of all cancers are preventable.
Primary Prevention Secondary Prevention
It incudes Cancer
Based on knowledge of registration , early detection
Etiology of cancers. And treatment.

4. Factors Believed to Contribute to Global
Causes of Cancer

6. Primary Prevention
1) Control of tobacco & alcohol consumption.
2) Personal hygiene – Decrease risk of Ca Cervix.
3) Radiation – Reduce the amount of radiation to minimum without
reducing benefits.
4) Occupational exposure – Well protection from carcinogens in the
industry.
5) Immunisation against HBV (causes hepatocellular carcinoma) and
HPV ( causing Ca Cx)

8. 6) Foods , drugs & cosmetics – should be checked for carcinogens.
7) Air Pollution Control
8) T/t of precancerous lesions
Early detection & T/t of Cx tears , intestinal polyposis, warts ,
chronic gastritis , chronic cervicitis , adenomata.
9) Legislation – Control known environmental carcinogens ( tobacco
alcohol , air pollution) using various types of acts & laws.
10) Physical inactivity, Dietary factors, Obesity and being overweight
play Important role.

9. 11) Cancer Education – Should be directed at “High risk’’ groups to
motivate people for early diagnosis and early T/t.
Warning sign of Cancer :-
I. A lump or hard area in the breast
II. A change in a wart or mole
III. A persistent change in digestive and bowel habits
IV. A persistent cough or hoarseness
V. Excessive loss of blood at the monthly period or loss of
VI. blood outside the usual dates
VII. Blood loss from any natural orifice
VIII. A swelling or sore that does not get better
IX. Unexplained loss of weight.

10. Tobacco
• Raise excise (specific) tobacco taxes to keep up with or outpace inflation and
income increases to at least prevent tobacco products from becoming more
affordable, and at best make them less affordable.
• Tax all tobacco products to maintain a comparable price to prevent consumers
switching from highly taxed or high priced products to less taxed and lower
priced ones.
• Require by law and enforce 100% smoke-free environments in all indoor
workplaces and public places.
• Ban all advertising, promotion and sponsorship of tobacco products, brands and
related trade, including cross-border advertising, promotion and sponsorship.

12. • Put health warnings on all tobacco packaging, and ensure that product
descriptions, packaging and labelling are in accordance with the provisions of
the WHO Framework Convention on Tobacco Control.
• Establish a national pilot cessation programme in health-care facilities in
accordance with available resources.
• Build media awareness of both the addictive nature of tobacco use and treatment
options.
• Work with appropriate media, in accordance with available resources, to build
Awareness among key groups, such as health professionals and policy-makers,
on the health impact of smoking and exposure to tobacco smoke,
and on the relevant tobacco control policies.

13. Oral Cancer (Laryngeal Cancer)

14. Unhealthy diet, physical inactivity, overweight
and obesity
• Develop and implement national dietary guidelines and nutrition
policies.
• Promote educational and information campaigns about reducing salt,
sugar and fat consumption and eliminating cooking and
preservation methods known to increase cancer
risk, for example aflatoxins.
• Develop and implement national guidelines on physical activity.
• Implement community-wide campaigns to promote the benefits of
physical activity.

16. • Promote physical activity in workplaces.
• Introduce a national chronic disease prevention policy and action
plans with specific reference to prevention and control
of overweight and obesity.
• Promote public awareness campaigns about the links between
overweight, obesity and cancer, recognizing that an unhealthy
diet and physical inactivity are risk factors

19. Alcohol
• Develop and implement an evidence-based national policy aimed at
reducing or stabilizing the overall level of alcohol consumption, and
link interventions to reduce alcohol problems with activities in other
relevant sectors.
• Raise public awareness, especially among young people, about
alcohol related health risks, including cancer, using
gender-specific messages.
• Promote participation of nongovernmental organizations and
relevant stakeholders in reducing alcohol problems.

20. Radiation
• Provide information about sources and effects of all types of
radiation.
• Establish national radiation protection standards (using
internationally available guidelines).
• Ensure regular safety training of radiation workers.
• Establish technical guidelines for radiation sources, medical and
industrial equipment.
• Promote UV risk awareness and UV protection actions (including for
industrial applications).

21. Environmental exposure to carcinogens
• Stop using all forms of asbestos.
• Provide safe drinking water.
• Reduce the use of biomass and coal for heating and cooking at home,
and promote use of clean burning and efficient stoves.
• Implement food safety systems (i.e. legislation and monitoring)
focusing on key contaminants.

22. Secondary Prevention
1) Cancer Registration
Provide base for
A) Assessing the magnitude of the problem
B) Planning of necessary services.

23. Cancer Registration
Hospital based Population based
At hospital level Can be used for epidemiological use
Standard Unified set of data as
Per WHO.

24. 2. Early Detection of Cancer
Cancer screening is possible due to –
 In many instances, malignant disease is preceded for a period of
months or years by a premalignant lesion, removal of which
prevents subsequent development of cancer.
 Most cancers begin as localized lesions and if found at this stage a
high rate of cure is obtainable.
 75% of all cancers occur in body sites that are accessible.

25. Methods Of Cancer Screening
 Mass screening by comprehensive cancer detection examination :
Rapid clinical examination of one or more site by physician.
 Mass screening at single sites : This comprises examination of
single sites such as uterine cervix, breast or lung.
 Selective screening : This refers to examination of those
people thought to be at special risk.

26. Screening of Ca Cervix
1) Pap test (Pap smear)
2) Periodic Pelvic examination
3) Visual Inspection based screening test –
- VIA
- VIAM
- VILI
4) Biopsy

27. Screening of Ca Breast
1) Breast Self Examination (BSE) by patient : M/C used
2) Palpation by physician
3) Thermography
4) Mammography :
- Exposure to radiation
- Should not be taken as routine examination in young female.

29. Screening of Ca Lung
Chest Radiography
Sputum Cytology
Mass Radiography

30. 3) Treatment
• Surgical method
• Radiotherapy
• Chemotherapy

31. National Cancer Control Programme (NCCP)
 In 1976 by Indian Gov.
 Launched with the objectives of primary prevention of cancers, early
detection and prompt treatment.
 Tobacco is the most important identified cause of cancer and is
responsible for about 40 to 50% of cancers in men and about 20% of
cancers in women.
 Cancers namely those of oral and lungs in males and cervix and
breast in females account for over 50% of all cancer deaths in India.

32. GOALS & OBJECTIVES OF NCCP
1. Primary prevention of cancers by health education specially regarding hazards of
tobacco consumption and necessity of genital hygiene for prevention of cervical
cancer.
2. Secondary prevention i.e. early detection and diagnosis of cancers, for example,
cancer of cervix, breast and of the oro-pharyngeal cancer by screening methods and
patients’ education on self examination methods.
3. Strengthening of existing cancer treatment facilities, which are woefully inadequate.
4. Palliative care in terminal stage of the cancer.

33. Evolution of NCCP
1976 National Cancer Control Programme was launched with
priorities given for equipping the premier cancer hospital
/institutions. Central assistance at the rate of Rs.2.50 lakhs was
given to each institution for purchase of cobalt machines.
1984-85 The strategy was revised and stress was laid on primary
prevention and early detection of cancer cases.
1990-91 District Cancer Control Programme was started in selected
districts (near the medical college hospitals).

34. 2000-01 Modified District Cancer Control programme
initiated.
2004 Evaluation of NCCP was done by National Institute of
Health & Family
Welfare, New Delhi.
2005 The programme was further revised after evaluation

35. The current programme has 5 schemes under NCCP :-
1. Recognition of new Regional Cancer Centres (RCCs)
2. Strengthening of existing RCCs
3. Development of oncology wings in medical colleges
4. District Cancer Control Programme
5. Decentralized NGO Scheme

36. National Cancer Registry Programme (NCRP)
 In 1982 by ICMR .
 Aim :- To give a picture of the magnitude and patterns of cancer.
 Two types of registries :-
- Population Based Cancer Registry
- Hospital Based Cancer Registries
 21 Population-based registries and 6 Hospital-based registries
all over the country.

37. Thank You