Perspectives of primary healthcare providers on implementing cancer screening services in tribal block of Maharashtra, India

Abstract

Background:

Breast, cervical, and oral cancers contribute to majority of cancer deaths among women in India. However, there is poor implementation of screening programs at primary health care (PHC). There is a need to understand the perspectives of healthcare providers at PHC level for feasibility of implementation of a cost-effective cancer screening program, particularly in the rural and tribal areas that are under served by cancer services.

Materials and Methods:

A continuous medical education (CME) program on “Prevention and early detection of common cancers” was held for all Medical Officers of Palghar District, Maharashtra. A self-administered questionnaire was used to assess the knowledge, attitude, practices, perspectives regarding common cancers, screening methods, and human papilloma virus (HPV) vaccination. A pre- and post-assessment was carried out before the commencement and on completion of the CME among 76 participants.

Results:

Knowledge about etiology of common cancers was high; however, awareness of risk factors was low. There were knowledge gaps about HPV vaccination. There was overall improvement about the available screening methods and knowledge of HPV vaccine and dosages after the CME (pretest 65% to posttest 95%). Providers had no experience in performing cervical cancer screening on a routine basis. While the majority of the providers (97%) indicated that screening for cancer was essential and feasible at PHC level; however, training (52%) and resources (53%) would be needed.

Conclusion:

Healthcare providers though from the underserved tribal areas, were optimistic to implement screening for common cancers and were willing to take training for the same. This emphasizes the need for educating and training the healthcare providers with simple techniques for effective implementation of cancer screening programs in underserved areas.