District chemotherapy centres to enhance accessibility
In a significant move aimed at bridging the gap between rural and urban healthcare delivery, the Karnataka government is rolling out(DCCC) across the state under a hub-and-spoke model. The initiative seeks to decentralise cancer care and improve accessibility, particularly for patients in remote areas.As per the latest report by the Indian Council of Medical Research–National Cancer Registry Programme (ICMR-NCRP 2023), Karnataka records nearly 70,000 new cancer cases annually. The most common types include breast cancer (18%), cervical cancer (14%), oral cancer (12%), lung cancer (8%), and colorectal cancer (6%). Alarmingly, the incidence rate of oral cancer in the state stands at 12 cases per one lakh population, surpassing the national average. Similarly, breast cancer incidence among women is 35 per lakh, and cervical cancer affects 15 per lakh women.However, access to chemotherapy remains a challenge. According to Health Department officials, nearly 60% of cancer patients in Karnataka are forced to travel over 100 km, often to major cities such as Bengaluru, Hubballi, or Mysuru, for chemotherapy sessions. This not only causes logistical strain but also leads to high dropout rates of up to 30%, as patients struggle with the costs and effort involved in repeated hospital visits.An official said that the DCCC project has been conceptualised to address these challenges and deliver equitable, cost-effective, and continuous cancer care at the district level. 'The model involves establishing district-level 'spoke'centres connected to tertiary 'hub' hospitals via Memorandums of Understanding (MoUs), allowing for shared resources, referrals, and training,' said the official.Under this framework, hub hospitals, which are tertiary cancer centres, will continue to provide advanced clinical services such as complex treatments, specialised diagnostics including PET-CT scans and molecular profiling, as well as training and telemedicine support. They will also monitor treatment quality and guide spokes in clinical decision-making.The spoke centres, or DCCCs, will focus on delivering outpatient chemotherapy to stable patients, particularly adjuvant and palliative chemotherapy. These centres will also conduct basic pre-treatment diagnostics, maintain a drug inventory, and provide essential support services such as pain management, counselling, and palliative care. Each unit will have a dedicated medical team, including a visiting medical oncologist, trained nurses, a physician, a pharmacist, and a counsellor.With treatment available within home districts, travel time and expenses will reduce drastically, significantly benefiting patients. The out-of-pocket expenditure is expected to decline by up to 40%, and the convenience of local treatment is likely to enhance adherence and reduce dropout rates.Additionally, the DCCCs are expected to help decongest tertiary care centres, allowing them to focus on complex cases. The district-level centres will also integrate with national screening programs like the National Programme for Prevention and Control of Non-Communicable Diseases (NPNCD) to ensure early detection and timely intervention.Each DCCC will function according to pre-approved treatment protocols aligned with the essential medicine list of the Suvarna Arogya Suraksha Trust (SAST). The performance of these centres will be closely monitored using key indicators such as patient turnout, treatment completion rates, adverse event tracking, and cost comparison with private sector benchmarks, said a Health Department official.
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