Why we need Cancer Awareness Programmes

As part of its strategy to identify cancer cases in a rural population, the cancer registry of Barshi, India, has developed a methodology which includes education of the population about likely symptoms of cancer, and motivation of symptomatic individuals to undergo medical investigation. Patients with cervical cancer from the registry area who attended Barshi Cancer Hospital (84% of the total) showed a significant improvement in stage at diagnosis between 1988-1989 (38% in stages I and II) and 1990-1992 ( 51% in stages I and II). No change was observed in those attending the same hospital from a control area (38% vs. 34%). Among a random sample of the population of the registry area, 76% of women were aware of the symptoms of cervical cancer, compared with 25% of the population of control areas. It is suggested that action to raise awareness of symptoms of cancer, and to encourage medical consultation, should form an important initial component of cervical-cancer control programmes.

Sixty consecutive patients admitted to an oncology unit in a general hospital were systematically assessed to determine the prevalence of psychiatric disorders. Patients' awareness of the diagnosis of cancer and their perception of treatment intention and outcome were assessed independently by another investigator who was blind to the psychiatric diagnosis. Forty percent of the sample had a diagnosis of psychiatric disorder, based on the Diagnostic and Statistical Manual for Mental Disorders (3rd edition, revised). Adjustment disorders comprised most of the psychiatric diagnoses. Major depression was seen in 8 (13%) patients. One third of the patients were estimated to be unaware of the diagnosis of cancer, and 82% of patients perceived the treatment given as curative. Psychiatric morbity was significantly less common in patients who did not know they had cancer, and in those who considered treatment as curative. the prevalence of depressive disorders in our sample was higher than in medical inpatients. It is concluded that psychiatric disorders, especially affective disorders, are common among cancer patients. Awareness of nature of the illness and expected outcome can affect the prevalence of psychiatric morbidity. Further studies investigating the relationship between psychiatric morbidity and duration of illness, type and stage of cancer, disabilities and coping strategies are warrented.

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