Leveraging Local Self-Government for Implementing Cancer Screening and Continuum of Care – A Model from Kerala State, India

Abstract

The emergence of cancer as a major public health problem in India has raised concerns among 
policymakers regarding reducing cancer-related morbidity, mortality, and catastrophic treatment 
expenditure. Along with increasing awareness of cancer warning signs, early detection offers immense 
scope, particularly for common cancers of the breast, cervix, and oral cavity. Local Self Governments 
(LSG) can play a prominent role by allocating funds for cancer prevention, infrastructure strengthening 
of primary health centres for screening and training healthcare providers. Yet another screening model 
implemented in an LSG in the Thiruvananthapuram district, Kerala, involved sensitizing elected 
representatives, resulting in dedicated plan funds not only for cancer screening, but also for expenses 
related to follow-up investigation at the nearest Apex Cancer Centre (ACC).  In collaboration with the 
Preventive Oncology Wing of the ACC, the LSG implemented community-based screening, followed by 
diagnostic evaluation at the ACC. 4,717 individuals were screened through 53 screening programmes. 
237 screen-positive subjects completed follow-up investigations at the ACC using project funds. This 
model demonstrates that enhancing awareness and strengthening the capacity of LSG’s on their role 
in prevention, early detection, and continuum of care may substantially improve the effectiveness and 
sustainability of cancer control initiatives in the country.