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Cervical Cancer Screening Program


Overview

432.2 million women aged 15 years and older are at risk of developing cervical cancer in India. Despite cervical cancer being completely preventable, current estimates indicate, that every year, almost 1, 22, 844 women are diagnosed with cervical cancer and 67,477 die from the disease. Cervical cancer is the 2nd most frequent cancer among Indian women between 15 and 44 years of age.


About the program

The incidence of cervical cancer being extremely high among women in India, Biocon Foundation has initiated a Cervical Cancer Screening Program. The core components of the cervical cancer program are:

1) Early detection of cervical cancer through community information and education
2) Management in secondary and tertiary stages with screening services, diagnostic     and/or treatment services

Cervical Cancer awareness session conducted at Austin Town

Biocon Foundation trains community health workers on reproductive and sexual health, and they in turn educate women from underserved communities. The Foundation has also collaborated with Tertiary Cancer Centers to incorporate a cervical cancer screening and prevention program into its current preventive and primary healthcare model through our network of 9 clinics in Karnataka. The Foundation’s first camp was conducted in May 2013.


The stages for implementation of the program are as follows:

  1. The key to last mile reach is education and awareness generation. A lot of emphasis is placed on sensitizing under privileged women about cervical cancer. This education is carried out by the community health workers, who are trained in the basics of sexual and reproductive health. They in turn educate women in small clusters in the community level.

  2. Biocon Foundation decides on the eligibility criteria for women to be screened for cervical cancer. Women above 21 years, sexually active for more than three years are the primary target audience.

  3. A pictorial module of reproductive and sexual health including basic information on cervical cancer detection and prevention is our primary tool for education.  Health workers use this module for awareness generation in the communities.

  4. Women matching the criteria for screening are pre-registered for cervical cancer screening. To maintain quality and provide focussed attention, the centre limits the number to 20 per session .Specialists from the tertiary cancer centres visit each clinic once a month and screen these 20 pre-registered women. Every woman undergoes a highly systematic examination including a pelvic examination (per vagina and per speculum). A clinical breast examination is conducted to screen for Breast Cancer. Women are also educated about the importance of regular self-breast examination.

  5. A doctor conducts a systematic pelvic examination and Pap smear. Patients found to have candidiasis or Cervicitis/Vaginitis are given appropriate medication. PAP slides are sent to the Mazumdar Shaw Medical Center (MSMC) or St. John’s Hospital, both in Bangalore. The cost of screening and reporting is borne by Biocon Foundation.

  6. Further investigations if required, are done at subsidized rates at the tertiary cancer centres. These include, Colposcopy, Biopsy, LEEP and Cryotherapy. All women are counselled about repeating the Pap smear after five years and all diagnostic tests for follow up patients are also borne by Biocon Foundation.

  7. Patients who are diagnosed with pre-cancerous or cancerous lesions are counselled by our health workers about the importance of early treatment. We facilitate treatment by helping the patient choose a cancer centre most suited to their socio-economic needs with financial support if required, regular follow up and counselling is done by our health workers to ensure compliance for treatment.

Since its inception, the program has benefitted a large section of women from the underserved communities, women with significant lesions and those who ignored common reproductive tract infections due to lack of knowledge and privacy. Thus the community level awareness generation and the focussed group discussions on health seeking behaviour has helped them understand the importance of reproductive health. Easy accessibility to tertiary cancer centres also help them to treat cervical cancer on time.



Intervention Area

The cervical cancer awareness program is operational in 8 geographical areas where the Foundation has its Arogya Raksha Yojana (ARY) Clinics. The reach for this program is in a proximity of 3km-10 km (radius). The target population for the awareness program include women above 16 years.

Clinic

Field practice area
(Radius)

Target group (women above 16 years)*
Huskur 5 Km 1627
Hennagara 9 Km 4113
Austin Town 5Km 2569
Kalkunte 7 Km 2843
KR Puram 6 Km 3781
Kaladgi 3km 3883
Chikkaballapura 10km 4882
Mandya 9km 3950
Total 27,648

  *Numbers from baseline survey conducted by Biocon Foundation

Cervical cancer awareness is focussed on women above 16 years of age but the screening is only conducted for women above 21 years.

Biocon Foundation has partnered with Mazumdar Shaw Cancer Center, St John’s Hospital, Dr Smitha Binod (MS OBG, Consultant Gynaecologist at Apollo clinic, VIMS and MGA Hospital) for referring cases for tertiary care.

Women taking part in an awareness session in Kalkunte

In order to reach out to a larger population at risk, Biocon Foundation has partnered with NGOs and conducting cervical cancer screening at work place settings. These partners include Bangalore Club, Jana Urban Foundation and GMR Foundation.


Beating Cervical Cancer: Testimonials

Case 1:
Forty five year old Chinnamma, wife of a farmer and mother of four, residing in rural Bangalore, had a chance encounter with dreaded cancer at a cervical screening program held by the Biocon Foundation in her village.

“One day, I met Biocon Foundation’s community health worker from the Arogya Raksha clinic in Kalkunte. The doctors and staff at the clinic did my screening free of cost and were kind to me. They took a pap smear and got it analysed from St. John’s Hospital. The doctor told me that my report was not good and I would need to do more tests. I got scared and worried.

I kept this as a secret from my family until Biocon Foundation’s doctor counselled me and my family and convinced us to go to the hospital. Luckily, the abnormal pap smear showed a very early stage lesion, which was treated early and today, I am fully recovered.”


Case 2:
Thirty five year old Shanti attended the screening facility at one of the urban slums. She is the sole bread winner of the family with 3 dependents, one alcoholic husband and two daughters who are still studying. When Shanti’s Pap smear report was abnormal, she was scared as she didn’t have any family support.

The Biocon Foundation community health worker accompanied her and her daughter to the hospital for follow up investigations. On further investigation, she was found to have cervical intraepithelial neoplasia, a pre-cancerous lesion. She underwent a short procedure to remove the diseased tissue.

She is glad, her condition was diagnosed before it progressed to full blown cancer, thus reducing the economic burden on her significantly. Shanti is back to work, to ensure that her daughters have a secure and happy future.



 
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