NEW DELHI: Odds of timely initiation of treatment of cancer patients in India have gone up by nearly 36% in the past six years, a new study claimed. It credited Ayushman Bharat-PM Jan Arogya Yojana (AB-PMJAY) for this change. Treatment initiation is considered timely if it starts within 30 days of diagnosis of the disease.
According to the study published in The Lancet Regional Health – Southeast Asia, which investigated treatment history of 6,695 patients undergoing cancer treatment at seven major hospitals in the country, most received treatment in 20 days. There were few instances of people getting treatment in two months from cancer diagnosis.
As compared to patients who were diagnosed between 1995 and 2017, those diagnosed after 2018 had 36% higher odds of timely initiation of treatment, the study found.
AB-PMJAY, a central health scheme, was launched in 2018 to provide an annual health cover of Rs 5 lakh per family for secondary and tertiary care hospitalisation to the poor and vulnerable families. Recently, govt extended the scope of the scheme to all senior citizens aged 70 years and above, regardless of their income.
The study claims while access for timely treatment initiation has increased by 30% for those who are not enrolled under the health scheme, it has increased by 90% for AB-PMJAY beneficiaries.
The study, led by Dr Prinja Shankar from PGIMER-Chandigarh, was funded by department of health research, health ministry. Poor education, lower socio-economic status, socio-cultural belief, gender, distance from healthcare facility, and access to appropriate financial protection such as insurance are key factors for delayed treatment, the researchers pointed out in the Lancet study. Each of these place the poor and vulnerable at a disadvantage, they added.
A NHA official said AB-PMJAY has helped bridge the gap to some extent. “Now, the poor don’t have to think about the cost as they have assurance of treatment up to Rs 5 lakh,” the official added. AB-PMJAY comprises 557 health benefits packages for cancer treatment.
The Lancet study found that cancer patients who required radiotherapy faced maximum delay in the initiation of treatment. In most high-income countries, there is at least one radiotherapy unit available for every 2,50,000 people. This, on an average, would mean 4 radiotherapy machines per million population. The study said applying this factor to India would translate into requirement of 5,000 radiation therapy units when there are less than 1,000 such units, a shortfall of over 4,000 machines.
The researchers have recommended that govt should increase infrastructure for radiotherapy, promote local production of quality equipment like linear accelerators and provide affordable and equitable radiation treatment by rationalising the existing health benefit packages pertaining to radiotherapy under AB-PMJAY.
As unknown cancer stage has also been observed as a determinant of delayed timely initiation of treatment, so there should be more focus on increasing population coverage under screening programmes, they added.