Best practices

As India braces for a projected rise in cancer incidence and mortality over the next decade, early detection and sustained awareness have emerged as the most effective tools to reduce the disease burden. While national and state-level strategies continue to evolve, a pioneering initiative from Kerala demonstrates how local governments can play a transformative role in cancer control.

The Pothencode Block Panchayat, in collaboration with the Regional Cancer Centre (RCC), Thiruvananthapuram, has launched a monthly cancer awareness and screening programme that is increasingly being recognised as a best practice model—one that holds the potential for replication across the state and the country.

The Programme: ‘First Check’

Launched in 2022, the First Check Programme stands apart for its continuity, assured funding, structured follow-up, and institutional linkage with a tertiary cancer care centre. Unlike one-off medical camps held on special occasions such as World Cancer Day or National Cancer Awareness Day, First Check operates every month, ensuring sustained engagement with the community.

The programme covers five grama panchayats—Andoorkonam, Kadinamkulam, Azhoor, Mangalapuram and Pothencode—across 13 block panchayat divisions, enabling wide and equitable reach. The Pothencode Block Panchayat has earmarked annual budget exclusively for cancer screening and follow-up, reflecting a strong political and administrative commitment to preventive healthcare.

 A Distinctive Funding and Follow-Up Model 

Explaining the uniqueness of the initiative, R. Anil Kumar, Chairman of the Health and Education Standing Committee of the Pothencode Block Panchayat, notes that the programme is entirely funded from the local body’s own resources.

“To our knowledge, no other local body has launched a programme like this. What we usually see are special camps with no follow-up. In our programme, we ensure that people suspected of cancer can undergo additional screenings without any financial hurdles,” he told.

A defining feature of First Check is its financial safety net. Individuals with suspicious findings during preliminary screening are issued a diagnostic card and an official letter from the Block Panchayat member, which enables them to access advanced diagnostic services at RCC free of cost.

“Our partnership with RCC ensures that funding never becomes a barrier. This encourages people to prioritise their health without worrying about expenses,” Kumar added.

 Ensuring Access, Equity and Awareness 

Inclusivity lies at the heart of the First Check programme. By pre-arranging funds with RCC, the Block Panchayat has removed one of the most significant barriers to cancer care—out-of-pocket expenditure. This system ensures that referrals are not abandoned due to financial constraints, a common challenge in cancer detection pathways.

The programme focuses on breast, cervical and oral cancers, which are among the most prevalent in India and are highly curable when detected early. This targeted approach significantly enhances the programme’s impact on reducing mortality.

Dr. Jayakrishnan R, Division of Community Oncology, RCC, underlined the importance of such decentralised interventions.

“Early detection can make a substantial difference in cancer care. The Kerala government has been moving towards a decentralised cancer control model, and Pothencode’s initiative aligns perfectly with this vision. This is an excellent model that can be replicated at the state or even national level,” he said.

While cancer prevention remains complex due to lifestyle and environmental risk factors, Dr Gigi Thomas, Head of  Community Oncology emphasised that early detection through programmes like First Check can reduce mortality, lower out-of-pocket expenses, and improve overall outcomes.

Results and Measurable Impact 

Since its inception, the First Check programme has demonstrated tangible results:

• 53 screening camps conducted
• Around 4,717 women screened
• 237 individuals referred to RCC for further evaluation
• 15 cancer cases diagnosed and further referred for investigation; all were detected at relatively early stages.

These numbers highlight the effectiveness of regular, accessible, and well-coordinated screening in identifying cancer early and initiating timely treatment.

The success of the programme is also attributed to the commitment of frontline health workers. ASHA workers, Family Health Centre staff, Health Inspectors, Junior Public Health Nurses, and other field-level personnel play a critical role in community mobilisation and awareness creation.

“There are still misconceptions that cancer is untreatable or even contagious. Dispelling these myths is essential so that people have the confidence to attend screenings,” Anil Kumar noted.

Towards a Nationally Replicable Model 

With India facing a steadily rising cancer burden, the need for community-based, scalable cancer control models has never been greater. Pothencode’s First Check programme demonstrates that local self-governments can be powerful agents of change in public health, particularly when supported by institutions like RCC.

Health experts point out that by prioritising regular screening, assured funding, decentralisation, and institutional partnerships, the programme offers a sustainable blueprint for other regions.

“This kind of initiative doesn’t just enable early detection—it can reshape how cancer care is delivered, making it more accessible and people-centric,” Dr. Jayakrishnan observed.

 Aligning with National and State Trends 

The relevance of the First Check model becomes even clearer in light of broader data. A study published in BMC Cancer, based on the Global Burden of Disease Study (1990–2021), projects a rise in cancer incidence and mortality in India, while also noting that early detection and improved treatment can significantly mitigate long-term impact.

The Pothencode Block Panchayat–RCC partnership illustrates how visionary local governance, backed by medical expertise and sustained funding, can bridge gaps in cancer care. By bringing early detection closer to the people and ensuring that no one is denied care due to cost, the First Check programme stands out as a best practice model—one that can inspire similar initiatives across Kerala and India.

As cancer awareness grows, such decentralised, community-driven programmes may prove critical in reducing mortality, empowering communities, and strengthening India’s fight against cancer.