Individual decisions or Population approaches?...individual approaches • They are not competitors...
Transcript of Individual decisions or Population approaches?...individual approaches • They are not competitors...
Cancer screening: Individual decisions or Population approaches?
http://screening.iarc.fr/
R. Sankaranarayanan MD
Special Advisor on Cancer Control Head, Early Detection and Prevention Section (EDP)
Head, Screening Group (SCR)
• Population approaches are complimentary to and facilitate individual approaches
• They are not competitors to individual approaches!
• Both approaches are needed!
Cancer Screening: population approaches
• Involves population-based mass communication activities aimed at changing or maintaining people’s behaviour for the benefit of individuals and society as a whole
• Predominantly uses “ Social marketing” principles and methods
Cancer Screening: population approaches
• In the context of screening programmes, they aim to increase awareness, to encourage health care seeking behaviour, to empower individuals, to increase participation and to improve coverage in all aspects of screening.
• Facilitate informed consent processes.
Cancer Screening: population approaches
• Facilitates uniform messaging
• Allow messages to be reviewed and revised
• More feasible in low- and medium-resource settings
• Intuitively cost effective and efficient
• Offers equitable access to messaging
• Facilitates an organized screening programme
Cancer Screening: population approaches
• Politically more attractive and acceptable
• Contents are uniform
• Allows contents to be scrutinised and reviewed by range of stake holders
• Allows contents to be revised
Cancer Screening: population approaches
• Seeks to develop and integrate marketing concepts
• With other approaches to influence behaviours that benefit individuals and communities
• For the greater social good
Cancer Screening: population approaches
based on social marketing
Scaling up of breast (CBE) and cervix (VIA) screening in Tamil Nadu State, India, 2012-2013
Tamil Nadu state
Phasing of districts
Phase I (16 districts)
Phase II (16 districts)
The Nilgiris
Coimbatore
Tirunelveli
Kanniyakumari
Thoothukkudi
Ramanathapuram
Vellore
Tiruvan-namalai
Krishnagiri
Erode
Dharmapuri
Solem
Narnakkal
Karur
Thiruvallur
Kancheepuram
Viluppuram
Cuddalore
Pudukkottai Nagapattinam
Thiruvarur
Tiruchirappalli
Thanjavur
Perambular
Dindigul
Theni Madurai
Virudhunagar
Sivaganga
Karaikal
Based on the evidence from a randomized trial and lessons learnt from a pilot project, a population based screening program was introduced supported by population based awareness campaign in the entire state of Tamil Nadu, targeting 4 NCDs, namely • Cancer cervix • Cancer breast • Hypertension • Diabetes
Mellitus
IEC Hoardings – Cancer Breast
IEC Hoardings – Cancer Breast
IEC – Bus boards
Tamil Nadu: Scaling up of cervical screening (July 2012-December 2013) Target population 7
million women aged 30-59 years Number (%)
Women screened with VIA and VILI 2,249,617
VIA/VILI positive 84,545 (3.8)
Women detected with Cervical Cancer 6137 (0.3)
Women who had CBE 3,281,411
Women positive on CBE 43,195 (1.3)
• Population approaches are complimentary to and facilitate individual approaches
• They are not competitors to individual approaches!
• Both approaches are needed!
Cancer Screening: population approaches