Our concept:

One of major limitation of conventional screening method is need for physical examination of person by health-worker and this needs to be repeated at periodic interval. This process is not feasible or sustainable in large and diverse country like ours.

It is also known that physical screening is not necessary for entire population but is very effective in select high-risk group population. We have conceptualised a way to create mass pre-screening survey for entire population without need for health system. This process will filter-out high-risk individuals that can be traced and screened physically. The entire process is one time exercise with further follow-up through stored data and tele-medicine. The process is feasible, sustainable and cost-effective based on our pilot study.

Model:

The program is designed to be executed in district-based manner. The screening programme is structured in two phases:

• Phase 1: Pre-screening
• Phase: Physical screening

Pre-screening: To check all people in community for cancer through physical survey (rural population) or mobile self-screening (educated group) – Identify high risk group in contact-less manner and refer them for physical screening.

Each district will be divided in Taluka places and we will appoint a social worker per Taluka place. The social worker will undergo training to conduct pre-screening. He will visit each village in his Taluka and conduct awareness camps and do house to house survey with our pre-designed forms / Mobile application. The high-risk population will be referred to a nearby doctor or physical screening clinic. We expect the entire project to be over in 3-4 months.

• Physical pre-screening: Train & use primary health workers / Educated young people to do door-to-door survey and identify high-risk group for proper screening with examination and tests.
• Mobile pre-screening: Use media and encourage self-screening in educated group. High risk score individuals would be contacted over phone to refer for physical examination.
• Reference of high-risk population: The central team will contact each patient and arrange for their physical consult and tests as advised.

Physical screening units: The proposed plan is to develop screening centres in taluk place with facility for male and female screening tests. The patients will be referred from our pre-screening and tests will be done at nominal charges. Any NGO (Rotary / Lions / Trust hospitals / Individual donors) can consider helping with this initiative and center will run on their name. We have model ready for this type of unit.

Pilot project:

The concept is been tested in one district of north Gujarat with approximately 1,00,000 people pre-screened. The process of conducting pre-screening is well understood and refined with us. We wish to scale the project to many districts now.

How to participate?

The community oncology program is executed by Harikrishna cancer foundation Mehsana with support of Shashwat oncocare LLP. This is a registered not-for-profit trust with a vision to support cancer patients (Reg. No: F/4738/Mehsana). The donations to trust are exempt under the Indian Income Tax Act 1961. (Vide certificate No. CIT (E) / AHM / 80G (5) / 1044 / HCF / 2017-18 / 746 – Date 29.08.2018.

This program can be executed in one districts / state / Region / Nation. We can establish this program anywhere in world but is most suitable in developing countries.

• Any NGO / Corporate for CSR / Individual willing to contribute can adopt.
• Cancer hospitals willing to create impact in surrounding 2-3 district can adopt.
• We are happy to execute this program under any banner.
• One can support all initiatives in entire district or can support individual aspect.

Costs:

The costs are calculated based on following formula. The project is expected to be over within 2-3 months but costs are calculated based on 4-month duration. Each district will have varying number of Talukas but we have taken 10 talukas / district. The costs below is on higher side for safety and may vary a bit.

• Taluka worker salary + Travel allowance (4 months): 7000 x 4 = 28,000
• Central team (Staff / Travel / Training / Monitoring / Software / Help-line / Data) = 50,000 / Month.
• Print material= Actuals (50-75,000).
• Media drive = 25,000 / district / Month
• District = 7-10 Taluka
• Costs (Per district) = 2,80,000 + 2,00,000 + 1,00,000 = 6,00,000 (4 months inclusive of all)

Summary:

A unique program designed by oncologists to optimise cancer care in developing countries. Most of initiative lack one or more components like Compassion, cost-effectiveness, science, operational feasibility or sustainability. Our program integrates all and have practical experience to show.

This program can grow in to one or many districts as per availability of resources.