A 13 year relapse
The Indian Council of Medical Research (icmr) has recently released the National Cancer Registry, presumably under pressure from an article in Down To Earth (Read: 'Faceless figures'). Thank you, Sir. The report is evidently a rush job as it offers data only till 1996, while most of the registries have figures till 1998! So why has icmr not published more recent data? But then, cancer does not seem to be a problem, if one reads the report carefully. Going by the report the growth rates are lower than most others countries and therefore there is no reason to fuss.
icmr and the medical system are actually failing patients by presenting a tranquil picture while there is in reality, what could be called, a national emergency. Why then have specialised cancer hospitals sprung up in all metros and even small towns? icmr's poor compliance with recommendations, failure to collect data, and failure to run adequate multidisciplinary teams is all too evident. Our findings clearly demonstrate that a larger number of patients are today being admitted to cancer hospitals and that people are more sick than 10 years ago.
The report fails to make any predictions, depict trends or offer any regional analyses of cancer prevalence. Nor does it offer any value addition on the three critical aspects of cancer treatment: cancer care, critical care services, and pathology. Instead, like raw meat, data is served for us to interpret. The now-familiar findings of wide variation in hospital case loads and experience, inadequate staging by clinicians, insufficient reporting of stage by pathologists and poor compliance with diagnosis guidelines are reflected by lower survival in India more than elsewhere in the world! The icmr promises to present its trends in a subsequent report. But a report on out-dated data several months or years from now will have little value.
Like we have said before, we need comprehensive, up to date epidemiological data, a control programme that identifies susceptible populations and devise strategies to check the spread of the killer. And importantly, an acceptance of the fact that cancer is a killer and is here to stay.
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