Background and Context:
Punjab state is reporting a rising burden of cancer. A ‘door to door cancer awareness and early detection campaign’ was launched in Punjab State covering about 2.67 million population in 2013. After initial training, health staff working in public health care facilities conducted survey on a 12 sign and symptom based clinical algorithm in Phase 1 followed by investigation and treatment in Phase 2
To ascertain unit cost for undertaking a large scale population-based cancer awareness and early detection campaign for cancer.
Data were collected using bottom-up costing methods. Full economic cost of implementing the campaign from health system perspective was calculated. Time costs of the participants and resource persons were additional costs besides the capital costs in the form of office space, consumables, non-consumables and overheads. Costs were stratified by phase of implementation.
Campaign could detect 87409 suspected cases with sign and symptoms, 24659 new or old confirmed cases (91/100,000) and 34430 cancer deaths in last five years. Full economic cost of implementing the campaign in pilot district was INR 74,59,849 (USD 122280). However, the financial cost was approximately INR 400,000 (USD 6557). Start-up phase of campaign was more resource intensive (63% of total) than the implementation phase. The economic cost per person contacted and suspected by clinical algorithm was found to be INR 12.8 (USD 0.21) and INR 2528.8 (USD 41.4) respectively. Cost per confirmed case under the campaign was INR 447081 (7328 USD). Outcomes/What was learned:
Campaign was able to create awareness to a reasonable extent and helped in early detection of cancer cases in Punjab state. However, high economic cost points towards the fact that the opportunity cost of campaign put a significant burden on health system and other programs.