Status of Cancer Research in India: Do We Need to Accelerate it?
Over the years there has been a significant development in understanding the deadly disease through extensive research. Foundational discoveries also have been made that have changed the clinical practice. Technological advances in sequencing and model symptoms have yielded an unprecedented resolution of the molecular, cellular, and genomic complexity of cancer.
With the introduction of the era of big data, the researchers have changed their operation techniques and an accelerated collaboration between basic research and clinical practice has also been noticed. As the status of cancer research seems to bend towards the positive side, we felt the need to have a look at which side India is. If you need any guidance related to cancer and cancer treatments, do consult the Indian Pharma Network, New Delhi.
According to The National Centre for Diseases Informatics and Research of Indian Council of Medical Research, Bengaluru, 1.45 million cases of cancer were estimated to be diagnosed in 2016. These numbers are expected to become double in the next 20 years. According to the National Cancer Registry Programme, there is a significant geographical variation in the incidence of cancer in India. For example, the incidence of cancer in North-East region is highest in India. Nearly 70% of the cancer cases are caused due to the use of an unprecedented amount of tobacco in different forms. Tobacco causes cancers like head and neck cancer, lung cancer, pancreatic cancer, renal and urinary bladder cancer. As it is clear that the culprit of the rise in deaths due to cancer is Tobacco, there is a need to reduce the consumption of tobacco.
Cancer Research in India: Leaps and Possibilities
Cancer research in India is a complex environment and is different from many developed countries. India has a tradition of practising alternative forms of medicine like homoeopathy, Ayurveda, Siddha, Unani and Yoga than relying on the surgeries. There have been certain challenges in research of the cancer that our country is currently facing. Let’s decode these challenges and have a perspective about them.
Delay in Diagnosis
According to the researched reports, 75-80 per cent of patients have advanced disease at the time of diagnosis. This has been due to:
- Low level of awareness in the population and among community physicians
- Lack of screening programmes,
- Lack of diagnostic facilities available locally,
- Travelling long distances to reach a major tertiary cancer centre,
- Financial constraints
- The stigma associated with the diagnosis
- Extended Investigation Periods
When compared to urban Population-Based Cancer Registries (PBCR), there has been a low incidence rate of cancer in rural-based PBCRs in rural India. Even the pattern of cancers in rural PBCRs is different compared to those in urban PBCRs, suggesting a different policy/approach to adopt in rural areas.
Early detection of cancer directly impacts the rate of mortality. Statistics show that the timely screening of cancer has resulted in a decline in the mortality rates of these cancers
Infrastructure
One of the major issues in India for not being able to achieve success in the treatment of cancer in India has been lack of workforce, like physicians, health workers, technical staff and pathologist to review pathological material. Also, most of the healthcare personnel have chosen to work in the urban area rather than in rural area, which has resulted in an unequal distribution of healthcare centres and practitioners. Most of the parts in rural India do not have tertiary healthcare centre which has a comprehensive team of professionals who assists in treating the different diseases relating to different body parts.
According to the data collected from randomized trials from South India suggest simple innovative methods such as visual inspection-based screening with acetic-acid application for cervical cancer is useful enough and cost-effective method. Through the various research reports, we have concluded that the rise in the number of early diagnosis and screening programmes can bring down the incidence of some of the common cancers in India. Various initiatives have been taken by the Government of India has formed a committee to set up regional cancer centres in rural areas and upgrade medical colleges with the oncology department. There are many other steps that the Government has taken to reduce cancer centres in various regions all over India.
One of the solutions to this population might be setting up and improving primary care services in rural areas and educating people about cancer, environmental pollution, clean drinking water, healthy diet and avoid tobacco use.
Clinical Research to be Expanded in India
Although notable progress has been made in recent years, there is a need to develop proper clinical research environment. It includes turning in more graduates and post-graduate medical students, community physicians, professors about translation clinical research and developing adequate infrastructure.
As the Indian pharmaceutical industry has made an appreciating growth in the field of generic molecules, we also need to invest in the development of new molecules and India-centric cancer research. We also need to develop a consensus on key priorities for cancer research in the Indian context based on common cancers in males and females in every region. There is also a need to focus research on the prevention of some cancers with a high incidence rate in certain regions.
Therefore, we need to build a research strategy for all which should be cost-effective and less toxic for the patients. Active collaboration is necessary between investigators, funding agencies, industry and regulatory bodies to understand the needs of each other.
Paving the Way Forward
As cancer in India is emerging due to major changes in lifestyle and due to delay in detection of cancer. While we have to pave a long way to create the best possible infrastructure for the required treatment protocols to work in the best possible way, we also have to work hard in developing the planned framework for research at the institutional level and in collaboration with various research teams.
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