{"id":195985,"date":"2022-07-21T02:07:52","date_gmt":"2022-07-20T20:37:52","guid":{"rendered":"https:\/\/arunachaltimes.in\/?p=195985"},"modified":"2022-07-21T02:07:52","modified_gmt":"2022-07-20T20:37:52","slug":"findings-of-monitoring-survey-of-cancer-risk-factors-and-health-system-response","status":"publish","type":"post","link":"https:\/\/arunachaltimes.in\/index.php\/2022\/07\/21\/findings-of-monitoring-survey-of-cancer-risk-factors-and-health-system-response\/","title":{"rendered":"Findings of Monitoring Survey of Cancer Risk Factors and Health System Response"},"content":{"rendered":"

Dr. Sopai Tawsik<\/strong><\/p>\n

\n

Behavioural risk factors<\/strong><\/p>\n

Tobacco use<\/p>\n

The prevalence of current tobacco use (smoked or smokeless) was 36.1%. The prevalence of smokeless tobacco use (24%) was higher than smoked tobacco use (19.1%).<\/p>\n

Over a quarter (28.7%) of current tobacco users (smoked or smokeless) were daily users.<\/p>\n

The mean age at initiation of use was 18.3 years.<\/p>\n

The average duration of tobacco use among past smokers was 14.8 years.<\/p>\n

Only 22.7 % of the smoked tobacco users had made self-attempts to quit smoking, while only 3.3% had\u00a0been advised to quit tobacco use by doctor\/health worker<\/p>\n

\n

Exposure to second hand smoke<\/p>\n

Over half of the respondents (57.9%) reported exposure to second hand tobacco smoke in the past 30\u00a0days, either at home, during travel or at the work place.<\/p>\n

\n

Non tobacco betel products<\/p>\n

As many as 12.6% of the respondents were current users of non-tobacco betel products in the form of\u00a0 pan masala, betel quid or areca nut. The use of arecanut (7.6%) was highest among current users.<\/p>\n

\n

Alcohol use<\/p>\n

Over one third of the respondents (36.7%) had consumed alcohol over the past 12 months, while over\u00a0a quarter (27.4%) had consumed alcohol over the past 30 days.<\/p>\n

The mean age of initiation of alcohol use was 17.7 years.<\/p>\n

Among those who consumed alcohol in the past 12 months, 9.6% were daily users and 3.5 % felt the\u00a0 need for a drink first thing in the morning every day.<\/p>\n

11.5 % of the respondents engaged in heavy episodic drinking<\/p>\n

Only 2.2% of the respondents had been advised to quit alcohol use by doctor\/health worker<\/p>\n

\n

Diet<\/p>\n

The average number of days of fruit intake was 1.5 per week<\/p>\n

The average number of servings of fruits and vegetables was 2.3 per day.<\/p>\n

Over 80 % of the respondents consumed preserved\/salt curated and fermented products.<\/p>\n

Over90% of surveyed adults reported to be having sufficient level of physical activity.<\/p>\n

\n

Raised blood pressure<\/p>\n

Prevalence of raised blood pressure was reported to be 31.8% in males and 21.8% in females. It was\u00a0found to be slightly higher in adults from rural than in urban region.<\/p>\n

Over half of the respondents (55.8%) were pre-hypertensive.<\/p>\n

\n

Overweight\/Obesity<\/p>\n

According to WHO cut off values, 15.6% of the respondents were overweight, while 2.9 % were obese.<\/p>\n

The prevalence of obesity was higher in males (3.1%) than females (2.6%).<\/p>\n

Over half of the respondents had central obesity (52.5 %)<\/p>\n

\n

Raised blood glucose<\/p>\n

The prevalence of raised fasting blood glucose was 2.2%.<\/p>\n

\n

Clustering of risk factors<\/p>\n

Close to a fifth (19.6%) of respondents had a clustering of\u00a0>\u00a03 risk factors<\/p>\n

\n

Health seeking behaviour<\/p>\n

As many as 43.4% of respondents had never had their blood pressure ever measured in life.<\/p>\n

Among those with raised blood pressure, only 18.6% had their blood pressure under control.<\/p>\n

\n

Cancer screening<\/p>\n

Only 5.6% of the respondents were aware of cancer screening for the three common cancers: Oral,\u00a0breast and cervical cancer. Less than 1% had ever undergone screening for these cancers.<\/p>\n

\n

Health system response:<\/p>\n

Less than 6% of the surveyed PHCs\u2019 provided cancer screening services.<\/p>\n

Less than a quarter of the PHCs\u2019 had availability of counseling facilities for risk behavior through counselor or specialized personnel<\/p>\n

A little over 10% of the Medical Officers positioned at the PHCs\u2019 Proportion had been trained for\u00a0 NPCDCS\/NHM (NCD related)\/State program.<\/p>\n

Over 80% of the PHCs\u2019 reported to shortage of lab facilities for cancer detection.<\/p>\n

None of the CHCs\u2019 or District Hospitals provided cancer screening services.<\/p>\n

Physicians were available only in a little over a quarter of the CHCs\u2019. Gynaecologists were available in\u00a0 only about 50%of the CHCs\u2019 and district hospitals.<\/p>\n

Around 22.2% of the private secondary health facilities that were surveyed provided cancer screening,\u00a0 and close to half (44.4%) had cancer treatment facilities. However, only 11.1% of the facilities had\u00a0 supply equipment for VIA.<\/p>\n

HPV vaccination was provided by 13.3% of the CHCs\u2019 and 22.2% of the private health facilities<\/p>\n

\n

Recommendations<\/p>\n

This report gives a detailed current health system scenario in Arunachal Pradesh. This survey conducted among\u00a0the PBCR covered areas of Arunachal Pradesh helps re-iterate the need for cancer awareness and strengthen the\u00a0health care system to provide its treatment. The recommendations hence can be described under the following\u00a0topics:<\/p>\n

\n

Risk Reduction:<\/p>\n

Risk factors like tobacco & alcohol use, physical inactivity, and unhealthy diet start as young as early adolescence.\u00a0 Measures for behavioural change and awareness creation become crucial in such stages. Efforts to provide\u00a0information and awareness generation for the younger population and their caretakers should be implemented\u00a0at educational institutions and workplaces. IEC & BCC provision among the teachers and faculty of the institution\u00a0should be strengthened for implementing changes and guidance among the younger population.<\/p>\n

Counseling\u00a0providers should be made available in schools, colleges and hospitals to help in cessation programmes of tobacco & alcohol use and provide a healthy diet and lifestyle change guidance. Such provisions should also be\u00a0strengthened among the HWC of sub-centres and PHCs for easier access.<\/p>\n

\n

Tobacco and Alcohol Cessation:<\/p>\n

The prevalence of tobacco use is 36.1% in the state of Arunachal Pradesh, with 30% of the current tobacco users\u00a0 being consumers daily. The programmes that help in the cessation of tobacco & alcohol use should be catered\u00a0at the level of PHC & CHC, which will cover comparatively a larger population. Given the mean age of initiation\u00a0of tobacco use as 18.3 years in the state, more focus should be given to the reduction among early adolescent\u00a0 population and guide in follow up process.<\/p>\n

\n

Policy Implementation for Risk Factor Control:<\/p>\n

Strengthening the existing healthcare policies like COTPA Act (2003) which promotes smoke-free indoor air,\u00a0should be enforced at work places, leisure zones and educational institutions. The provision of alternative\u00a0livelihood for those who practice indigenous methods of producing alcohol should be considered. This may help\u00a0to reduce the availability of locally available alcohol products.<\/p>\n

The government of Arunachal Pradesh must take an appropriate policy decision to contain the tobacco sale and\u00a0use in the state. COPTA Act (2003) must be implemented in letter and spirit.<\/p>\n

Similarly, there must be some policy for curbing excessive alcoholism affecting the population of the state\u00a0especially, the younger population.<\/p>\n

\n

Early detection and Screening:<\/p>\n

Conducting periodic surveillance of behavioural and metabolic risk factors to measure the baseline prevalence\u00a0and monitor changing trends through regular surveys would help track the impact of preventive measures. To\u00a0enforce screening practices among a larger population, the regional & community leaders, along with the help\u00a0of peripheral healthcare workers can be used. Practicing village\/urban nutrition day and sanitation day will help achieve community participation. Through such measures, social and cultural acceptance of health practices can\u00a0be achieved.<\/p>\n

\n

Health System Strengthening:<\/p>\n

Expanding the availability of cancer care services with consideration of access in such geographical terrains\u00a0should be prioritized. Also, it facilitates the adoption of health technology for the prevention and treatment of\u00a0cancer, including digital tools for early detection and telemedicine for improved access to care in the healthcare\u00a0system.<\/p>\n

Strengthening the medical certification of cause of death for the availability of accurate and complete cancer\u00a0mortality should be given utmost importance. As there is a shortage of healthcare workers, increasing the\u00a0capacity building of healthcare providers through regular training, re-training and skill enhancement should be\u00a0done. Also, expanding and strengthening the services at secondary and tertiary level health facilities would help\u00a0reduce treatment-seeking for cancer outside of the region. The government ought to consider having proper secondary level facilities in all the districts of the state so that people are not denied\u00a0proper health care access considering the topography and terrain of the state.<\/p>\n

Cancer Registries of the state, which generate good data on cancer incidence, survival, and mortality in the state,\u00a0need to be supported by the government. Given the high incidence of cancer cases, the state should have at\u00a0least two full-fledged cancer hospitals. Facilities for early detection and diagnosis of cancer should be available\u00a0in all secondary and tertiary health facilities.<\/p>\n

As described in detail above, addressing cancer control requires a multidisciplinary approach with community participation.<\/p>\n

As the data proves, cancer does not appear to be a stigma; therefore, interventions to enhance\u00a0the health-seeking behaviour related to screening and early detection should be implemented with rigour. This\u00a0involves measures to strengthen prevention to palliation to provide the continuum of care required in this need\u00a0of the hour.<\/p>\n

(Dr. Tawsik is the DME\u00a0and Principal Investigator, West Arunachal Population Based Cancer Registry, Tomo Riba Institute of Health and Medical Sciences, Naharlagun)<\/p>\n","protected":false},"excerpt":{"rendered":"

Dr. Sopai Tawsik Behavioural risk factors Tobacco use The prevalence of current tobacco use (smoked or smokeless) was 36.1%. The prevalence of smokeless tobacco use (24%) was higher than smoked tobacco use (19.1%). Over a quarter (28.7%) of current tobacco users (smoked or smokeless) were daily users. The mean age at initiation of use was […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":{"0":"post-195985","1":"post","2":"type-post","3":"status-publish","4":"format-standard","6":"category-state-news"},"_links":{"self":[{"href":"https:\/\/arunachaltimes.in\/index.php\/wp-json\/wp\/v2\/posts\/195985","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/arunachaltimes.in\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/arunachaltimes.in\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/arunachaltimes.in\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/arunachaltimes.in\/index.php\/wp-json\/wp\/v2\/comments?post=195985"}],"version-history":[{"count":0,"href":"https:\/\/arunachaltimes.in\/index.php\/wp-json\/wp\/v2\/posts\/195985\/revisions"}],"wp:attachment":[{"href":"https:\/\/arunachaltimes.in\/index.php\/wp-json\/wp\/v2\/media?parent=195985"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/arunachaltimes.in\/index.php\/wp-json\/wp\/v2\/categories?post=195985"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/arunachaltimes.in\/index.php\/wp-json\/wp\/v2\/tags?post=195985"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}