PAN-CANCER ANALYSIS OF WHOLE GENOMES (PCAWG)
Context: According to the new papers the most comprehensive gene map ever of the genes whose departures from normal behaviour — mutations — trigger a cascade of genetic misbehaviours that eventually lead to cancer.
WHAT IS THIS NEW STUDY?
In a major international collaboration called the Pan-Cancer Analysis of Whole Genomes (PCAWG), researchers has published a series of papers after analysing 2,658 whole-cancer genomes and their matching normal tissues across 38 tumour types. After their studies, they have arrived to a conclusion that “On average, cancer genomes contained 4-5 driver mutations when combining coding and non-coding genomic elements; however, in around 5% of cases no drivers were identified, suggesting that cancer driver discovery is not yet complete.” HOW IS THIS STUDY IMPORTANT? This is certainly the largest genome study ever conducted of primary cancer. There is a need of separate study of various kinds of cancers because cancers of different parts of the body often behave very differently from one another; so much so that it is often said that cancer is not one disease but many. As per the previous studies, focus was only on the 1% of the genome that codes for proteins. The Pan-Cancer Project explored, in considerably greater detail, the remaining 99% of the genome, including key regions that control switching genes on and off. The researchers identified 16 types of structural variation signatures in the genes ultimately leading to cancer. The study holds a significance as it allows doctors and researchers from all over the world to look things up, consult and find information about the cancer of a given patient. WHAT IS THE STATUS OF CANCER BURDEN IN INDIA? According to the recent WHO report, approximately, 1 in 10 Indians will develop cancer during their lifetime, and 1 in 15 Indians will die of cancer. Cancer is the second most-frequent cause of death worldwide, killing more than 8 million people every year; incidence of cancer is expected to increase by more than 50% over the coming decades. According to a recent analysis, published in The Lancet Global Health, that looked about 9.7 million deaths that happened in India in 2017, the Northeastern states, Uttar Pradesh, Rajasthan, West Bengal, Haryana, Gujarat, Kerala, Karnataka and Madhya Pradesh account for 44% of the cancer burden in India. TREATMENT OF CANCER IN INDIA
- The Government is implementing National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), with a focus on strengthening infrastructure, human resource development, health promotion & awareness generation, early diagnosis, management and referral to an appropriate level institution for treatment. In order to tackle the challenge of Non Communicable Diseases (NCD), including cancer, a total of 616 NCD Clinics at District level and 3,827 NCD Clinics at Community Health Centre level have been set up under NPCDCS.
- Population level initiative for prevention, control and screening for common NCDs (diabetes, hypertension and common cancers viz. oral, breast and cervical cancer) has also been rolled out under the National Health Mission (NHM) in over 215 districts. Under NHM support is provided to States/UTs to provide free essential medicines and diagnostic services for primary and secondary health care needs.
- Screening of common NCDs including three common cancers i.e. oral, breast and cervical is also an integral part of service delivery under Ayushman Bharat – Health and Wellness Centres.
- Strengthening of Tertiary Care for Cancer Scheme, in order to enhance the facilities for tertiary care of cancer, is setting up of 19 State Cancer Institutes and 20 Tertiary Care Cancer Centres.
- Further, Oncology is also one of the focus areas in case of new AIIMS and many upgraded institutions under Pradhan Mantri Swasthya Suraksha Yojana (PMSSY). Setting up of National Cancer Institute at Jhajjar,Haryana and strengthening of Chittaranjan National Cancer Institute, Kolkata, are also steps in the same direction.
- In Government hospitals, cancer treatment is either free or highly subsidized. Treatment of cancers is also available under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PMJAY).
- Besides this, Affordable Medicines and Reliable Implants for Treatment (AMRIT) Deendayal outlets have been opened at 195 Institutions/Hospitals with an objective to make available Cancer and Cardiovascular Diseases drugs and implants at discounted prices to the patients.
- Under the umbrella scheme of Rashtriya Arogya Nidhi, financial assistance is provided to families living below threshold poverty line for their treatment, including treatment of cancer, in Government hospitals.
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