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Cancer is emerging as one of the major Public Health problem in Tamil Nadu. The Cancer Registries in 1960's are mostly Hospital based registries. The patients attended the hospital only after symptoms are present and mostly in advanced stage of cancer and fit only for palliative treatment.
Cancer cervix, Oral cancer and cancer breast are the three most important cancers in Tamilnadu. Mass screening is effective in these three types of cancers. Cancer detection in premalignant condition can be treated effectively and a possible cancer may be avoided. Even in those cancer cases detected at early stage, with effective treatment cure is possible.
Thiru.C.N.Annadurai, the late Chief Minister of Tamil Nadu, started a Cancer Control Programme with the W.H.O. assistance in Tamil Nadu. Before the programme was finalized, he died due to Esophageal Cancer. Hence to launch the above project in a successful manner, a Institution namely as Government Arignar Anna Memorial Cancer Research Institute at Railway Road, Kancheepuram was inaugurated on 21.03.1969 in his birth Place – KANCHEEPURAM, which is about 75 KMs from Chennai.
SHORT TERM OBJECTIVES
- To organise a Cancer detection and treatment programme covering Oral and Cervical cancer in the Kancheepuram Municipality.
- To work out as soon as possible means and methods for making efficacious and meaningful studies.
- To train the relevant personnel wherever necessary.
LONG TERM OBJECTIVES:
1.To achieve Cancer Control.
2.To work out prevalence and incidence rates of cancer sites under study.
3.To record any suggestive causative factors for the disease and
4.To set up training centers for medical and paramedical personnel in cancer control.
To apply cytological screening techniques in large scale to identify apparently normal persons with disease and persons with symptomatic conditions may or may not have disease.
Most of the data available are from hospital based studies, but this study done in Kancheepuram is population based systematic search for socio-economic and cultural factors responsible for the onset of the disease i.e. Cancer cervix in order to understand in precise, scientific and conceptual frame of reference.
- To provide confirmatory diagnostic tests to those identified with suspicious lesions to arrange for suitable treatment as soon as the disease is confirmed.
- To reduce the number of new cases.
- To raise the cure rates.
- To educate the public through Health Education activities, to understand the importance of the programme and accept it.
- To identify and record the socio-cultural and psycho-social force that intervenes in cultural transformation and behavioral change.
- To use the social science knowledge in the formulation and development of methodology for health education to build up a positive attitude.
Pilot study during 1969 – 1989.
A pilot study was started in 1969 at Govt. A.A.M.Cancer Institute. To start with the Female Hospital Workers were sent to the Govt. Head Quarters Hospital, Kancheepuram to bring the suspicious women for screening programme. This was not accepted by most of the women.
Residential Screening Programme:
The Kancheepuram Municipal area was having a fixed population of 98000 and 30961 eligible women for screening.
1.Enumeration: The entire Municipal area was visited by the Hospital Worker and Social Worker to enumerate the total population and at risk population (Women for screening cancer cervix)
2.Health Education: A pre-study was conducted by the Department of Social Science and Health Education to assess the level of knowledge, attitude and practice with regard to cancer.
A planned, continued and watched programme was launched by the Department of Social Science and Health Education in order to provide basic information with regard to Cancer, motivated risk population for acceptance of Pap smear and Oral screening and to help the people to utilise the services provided by the Institute.
The methodology adopted was educating the risk population through the leaders and the reference women of the community by means of periodical Health Education meeting and organizing of Women Health Committee, Motivation and education for early detection of cancer cervix has been sought through the
Co-operation of Maternity Centers and Dispensaries. The personal of the Department of Social Science and Health Education went Door to Door around the Kancheepuram Municipal Area taught the people, talked with them, gave the health education, motivate and helped them in getting services provided by the Institute.
The great break through was launched by Residential screening programme. After Enumeration and Health Education, the screening was done in one of the houses in the street itself. The house was converted in to a temporary Cancer Control Centre. The place was acceptable and accepted by most of the women in the street. This method was accepted by most of the people and was a popular method for a long time.
In 1980, Dr. M. Narayanan, the then D.M.E. took over as DIRECTOR of Govt. A.A.M.Cancer Institute. The Primary Health Care was introduced in the Institute. The patient and family members were treated for non – malignant conditions in the Institute and it helped the patient to accept for PapSmear testing.
Satellite Cancer Screening.
In 1988, Dr. G. Munusamy took over as Director, along with screening in Kancheepuram Municipal area, Satellite Cancer screening programme in Taluk Hospitals was started. Cancer control programme in Kancheepuram Municipal Area was stopped in 1990.
Iyyampettai, Primary Health Centre was started as first satellite cancer screening centre and then extended to Kancheepuram Panchayat Union. Manampathy, Primary Health Centre was included in the screening programme later.
DISTRICT CANCER CONTROL PROGRAMME
The District Cancer Control Programme for Chengleput MGR District (Kancheepuram District) was sanctioned by Government of India on 30.03.92 and implemented in 1993–94. The project involved all the three Directorates:
(1) Director of Medical Education
(2) Director of Medical and Rural Health Services
(3) Director of Public Health and Preventive Medicine.
This has to be integrated with extension of health services such as TB, Family Welfare, etc. The main thrust of the screening was to create awareness among the people about the primary prevention and early detection of Common Cancer and also make them convinced that the cancer is curable if detected and treated early, which will also reduce the Morbidity and Mortality in the area.
CANCER SCREENING CAMPS & PUBLIC AWARENESS CAMPS
Govt. A.A.M.Cancer Institute, Kancheepuram, Govt. Hospital, Thiruthani, Ponneri and Maduranthagam are the centres for implementation. Then it was extended to Taluk Hospitals at Thirukazhukundram, Wandavasi, Cheyyar and Arakkonam. Till 2003, there were only 4 centers, Wandavasi, Cheyyar, Arcot and Arakkonam. The screening camps were conducted once in a week in the centers.
In 2006, Dr. M. Balu David took over charge as Director, the Satellite screening programme was extended to 25 centers with the available resources and without any additional expenditure. It includes 2 District Head Quarters Hospitals, 9 Taluk Hospitals, 1 Government Hospital and 13 Primary Health Centers covering 4 Districts, viz Kancheepuram, Thiruvallur, Thiruvannamalai and Vellore.
Dr.H.Muthukrishnan is the present director of this institution .He joined this institution on 2.2.2015 and under his able leadership the cancer awareness work and screening programmes are being conducted regularly.