Door-to-door oral cancer screening for 22,278 individuals (February 2020–April 2024): Breast Cancer Hub’s innovative grassroots approach addressing disparities and challenges in Assam’s underserved rural villages in India.

Abstract

e13523 Background: Oral cancer remains a significant health issue in India, with the Northeast (NE) region showing notably higher rates, mainly due to widespread smokeless tobacco, often starting at a younger age. The region also faces delayed diagnosis and inadequate treatment access, resulting in a poor survival rate. This study aimed to investigate awareness, screening, and access to oral cancer care in 18 interior villages of Cachar, Assam, a region severely impacted by tobacco use. Methods: Between February 2020 and April 2024, Breast Cancer Hub (BCH), a nonprofit organization serving 100% Free, conducted a door-to-door oral cancer screening campaign in 8085 families across 22,278 individuals in rural Assam. A comprehensive questionnaire collected data on Signs and Symptoms, health, lifestyle, demographics, and socio-economic factors. Descriptive statistics were applied to analyze the results. This study is the first to conduct oral cancer screening at this scale in the region. Results: The findings revealed alarming gaps in awareness and self-screening for oral cancer, with 0% of participants aware of the symptoms, performing self-screening, or undergoing clinical oral exams. Furthermore, 76% of villagers were regular tobacco users (9395 males and 7540 females), with a significant number starting at a young age. The lifestyle is influenced by the tremendous intake of tobacco in all forms, especially adding tobacco, betel nut, slaked lime, and other ingredients to the betel leaves and chewing in the form of Paan, in parallel to alcohol consumption. Ninety-nine (99) cases showed suspicious signs of oral cancer, including red or white patches, ulcers, tissue growth, swelling, unusual discoloration, and 70.40% presented a direct correlation with tobacco intake. Despite this, financial constraints prevented most villagers from seeking medical care, often turning to local faith healers instead. Lack of knowledge about government health schemes further hindered access to proper treatment. In response, BCH implemented a sustainable framework to address these challenges. This included educating villagers on self-screening, assisting with transport to hospitals, securing health cards and income certificates, and ensuring that patients received proper diagnosis, treatment, and follow-up care. BCH’s efforts proved instrumental in overcoming systemic barriers and improving healthcare access. Conclusions: This study underscores the critical need for improved awareness, healthcare infrastructure, and financial support in combating oral cancer in underprivileged regions. BCH’s innovative model offers a blueprint for addressing these challenges and highlights the importance of policy changes to serve vulnerable populations better and reduce tobacco-related cancers.