1,100 Women Screened For Cervical Cancer At Darjeeling Tea Garden Workplaces: KOLGOTRG Study
As per PRECERCA, access to cancer screening is considered a crucial problem in rural regions and amongst women who are working, especially those who are working as hourly and daily wage earners and do not get the required time for attending screening programs. Moreover, women in remote areas in India may not have the necessary education surrounding cervical cancer and its preventive measures. Limited or less access to healthcare facilities as well as resources and socio-economic barriers make it more difficult to go through regular cervical cancer screenings and follow-up care. These women are having demanding work schedules, and the kind of work that they do, along with added responsibilities, may make it tough for them to take care of their health and do regular screenings. Stigmas and cultural beliefs surrounding reproductive health, and a discussion of sensitive topics such as cervical cancer, may prevent awareness, hindering preventive measures in remote areas.
Around 100,000 women work in the North Bengal Tea gardens alone in the foothills of the Himalayas. These garden workers work in confined settings for hourly wages, mostly belonging to tribal communities and often regarded as the sole bread earners in the family. Thus, they belong to the most vulnerable group of people who are affected by this cancer. PRECERCA has proposed a same-day screen and treat strategy among the working women of these remote tea gardens, on the Himalayan Foothills. This is done at their working place itself by utilising point of care HPV DNA testing gene Xpert technology, reducing the need for 2-3 visits at healthcare centres/or hospitals which are located far away. This initiative will help to improve acceptance and attrition rates for Cervical Care programs. This program is proposed to be continued longitudinally over the next 10 years.
Simultaneous training sessions for the participants who are screened and local healthcare workers will take place along the screening and testing facility.
Cervical cancer is a serious disease, and if it is not checked in a timely manner, due to a lack of healthcare awareness as well as facilities, many working women are dying unnecessarily at a relatively younger age (30-50 years).
They are the only bread earners of the family with infants/ toddlers who are completely dependent on them. Treating one person with Cervical Cancer costs around INR 1-2 lakhs, although it is a preventable disease. One screening, which is worth of INR 2000 per woman, protects them for the upcoming 5 years. Therefore, INR 400 per year per woman can prevent a major cause of cancer mortality in women in India. The distinctive approach of PRECERCA of conducting screening camps within the tea gardens itself, along with free-of-cost HPV screening services (for first visit) and training program, is important in overcoming the obstacles to affordability and accessibility, ensuring health equality. The model is essential to prevent the spread of cervical cancer by reaching those who are vulnerable and providing them with timely interventions as well as education, making them realise the significance of regular screenings for early detection, so that they prioritise their health against all odds.
The majority of the screening programs done in India are costly and conducted within 50-100 km from the main cancer centres/ metro cities. This leaves women in the remotest parts of the country to suffer from health inequality.
Conventional cross-sectional programs thus fail to accomplish the desired objective of cancer elimination. This is because the HPV virus can be acquired anytime during one’s lifetime while women remain sexually active.
Most of the women will clear the virus on their own, but periodic testing at an interval of 5 to 10 years is required to pick up precancerous lesions, in instances they develop from persistence of the virus in the cervix. The other advantage of a longitudinal program is training and capacity building of a sustainable and regional workforce for prevention of cancer and public health. This program intends to train nursing staff and local health workers to form a nurse-led cancer screening program and follow up in the region, reducing the cost in the longer run, ensuring sustainability, as doctors are more likely to change their jobs, especially while working in remote regions.
Cervical cancer, which is considered the second most common cancer among women in India, is a curable and preventable disease, as long as it is detected early and follows a proper treatment procedure. It has claimed the lives of nearly 350,000 women in the year 2022, as per the World Health Organisation.
Around 94% of deaths happened in low and middle-income countries in 2022, since access to public health services is much less in those countries. It has been mandated by the WHO to keep the incidence rate of cervical cancer under 4 per 100000 women.
According to the WHO, every country should be meeting the 90-70-90 targets by the year 2030 for eliminating cervical cancer by the next century.
Cervical cancer shows no symptoms in the initial stages and develops in the cervix. It is caused by HPV (Human Papillomavirus), which is a sexually transmitted virus, and most infections tend to clear on their own. High-risk HPV, such as HPV 16 and HPV 18, lead to nearly 70% of all cervical cancers. Persistent high-risk HPV can result in precancerous cell changes, which are detected through HPV tests and Pap smears.
Management includes regular screening in order to detect cell changes early, enabling removal and prevention of cancer.
Treatments are available for cell abnormalities or warts, but not the virus itself.
In addition, Ovarian Cancer incidence is on the rise, which is deemed to become the next cancer pandemic alongside breast cancer as per the GLOBOCAN report and the recently published Every Woman study in the Lancet Journal, where India participated through KOLGOTRG. A significant proportion of breast and ovarian cancers have a genetic predisposition, and several countries have initiated population-based genetic testing and screening programmes.
Suraksha Clinic and Diagnostics will be helping in developing ovarian cancer awareness sessions, access to early diagnosis through ultrasound scanning and blood tests and access to genetic testing at a population level.
Access to clinical trials and new treatments is an unmet need that creates disparity in cancer care between many Western/ developed countries and low-resource settings. In India, KOLGOTRG has created the ROCK platform (Regional Ovarian Cancer centre) in collaboration with Suraksha Clinic & Diagnostics to bridge this gap and decentralise access to clinical trials through a network of diagnostics chain created by Suraksha Clinic and Diagnostics and more importantly, access to centralised high-quality onco-diagnostics that is necessary for including patients in clinical trials.
Sharing her thoughts on the Cervical Cancer Screening drive, Ms Ritu Mittal, Joint Managing Director & CEO, Suraksha Clinic and Diagnostics, said: “While vaccination drives are being initiated at the Governmental level in the near future, we have joined hands with ROCK KOLGOTRG, to take a pledge towards an effort for the WHO 2030 cervical cancer elimination mandate.”
The Cervical Cancer Screening study was launched in the year 2022, and through this initiative, Suraksha Clinic and Diagnostics and KOLGOTRG are inviting all women within the age-group of 30-60 years to receive information and awareness through Suraksha Clinic and Diagnostics and thereby avail the facility to get HPV testing done at least once in their lifetime. Women who screen positive will have the opportunity to get a colposcopy and appropriate treatments in a clinic set-up or referral.
About Suraksha Clinic and Diagnostics
Established in 1992, Suraksha Clinic and Diagnostics is one of Eastern India’s leading diagnostic providers and today ranks as the third largest diagnostic brand in India across both pathology and non-pathology services. Offering a comprehensive portfolio of over 2,300 diagnostic tests spanning pathology, radiology, and medical consultancy services, Suraksha Clinic and Diagnostics has built a strong reputation for trust and clinical excellence.
The organisation operates a central reference laboratory, nearly eight satellite laboratories, 65 advanced diagnostic outlets across four states, and approximately 166 sample collection centres across West Bengal, Bihar, Assam, and Meghalaya. Suraksha Clinic and Diagnostics’ commitment to technological advancement is reflected in its adoption of AI-enabled smart laboratories and digital platforms, streamlining operations and enhancing patient care.
Backed by cutting-edge technology and expert medical teams, Suraksha Clinic and Diagnostics ensures that high-quality, reliable, and accurate diagnostic services are accessible to millions, reaffirming its mission of excellence in healthcare delivery.
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