District cancer control program: A white paper to optimize cancer care in rural India by developing a uniform, modular, and multi-tier system.

PURPOSE: In India, less than 10% of cancer care is accessible to the country's 70% of rural residents. Providing all-encompassing cancer care in a remote setting with limited resources is a difficult undertaking. Despite having the best of intentions, many centers struggle to treat patients in accordance with current standards because they lack the necessary resources and guidance. This leads to a worsened prognosis for millions of cancer patients, with detrimental effects on the person, the family, and society at large. The situation is presumably similar in other developing countries. The purpose of this article is to identify challenges and try to find their solutions that suits practical situation.

METHODS: The contents of this article were the result of deliberations in a recently concluded Indian Cancer Congress 2023, Mumbai, which was one of the largest conglomerations of around 6000 oncologists across India and the world. The session included clinicians and other stakeholders with years of experience working in rural India. The contributors worked in groups based on their strengths and experience for the past few months to develop appropriate recommendations for each section.

SUMMARY: The ideal system to deliver comprehensive cancer treatment should include various aspects like prevention, early detection, protocol-based treatment, rehabilitation, palliation, data collection, and research. As of now, there are no clear guidelines or structure available for stakeholders in rural areas to build their care delivery. This article proposes a district-based cancer control program that covers all aspects of cancer care using available resources, with the aim of creating a uniform, modular, and multi-tier structure to establish a care delivery pathway for districts that can be replicated in any region.