April 2024
Focus Area 1: Healthcare Access and Outcomes
India is a vast country with a population of 1.4 billion, the largest in the world. Even as India undergoes rapid economic development, there is an extreme shortage of infrastructure for cancer screening and treatment. In an effort to provide a partial solution to this issue, Olympus created the Outreach Screening Program, which installs endoscopic screening equipment in a vehicle that travels to small villages. The head of the medical business in India discusses the certain results observed from this program and the substantial expansion to be pursued in the future.
General Manager, Medical Business, Olympus Medical Systems India
Joined Olympus in 2010 as a Product Manager in the gastrointestinal and respiratory medical field. Later served as a Marketing Manager and General Manager of Sales, and was appointed General Manager of the Medical Business in 2020.
There are 282 endoscopists per million people in Japan, 47 in the United States, but only 7 in India.1 This figure may be very telling about the state of cancer treatment in India.
Many people develop oral cancer, esophageal cancer, and stomach cancer, accounting for about 35% of all cancer cases. In addition, due to the growing population, changes in lifestyles resulting from economic development, and other factors, it is projected that the number of cancer patients will increase in the future. It is said that in general, early detection and treatment through periodic screenings are important for the treatment of cancer. Despite this, India has few facilities that can conduct cancer screenings, and there is also a shortage of specialist doctors who can perform screenings and treatment.
As a result, it is not at all uncommon that people who live in rural areas have to travel seven or eight hours to undergo screenings. Even the existence of these screenings is not very well known. Against this backdrop, a common pattern is that when people experience some physical ailment, they try only folk remedies such as ayurveda and adopt a wait-and-see attitude, and it is only when their condition deteriorates that they undergo testing.
As a result of these circumstances, some 60% to 80% of patients who are diagnosed with cancer through screenings already have advanced cancer. Cancer survival rates are also lower than in developed countries. For example, the five-year survival rate for esophageal cancer patients is 47.8%2 in Japan, but is only 10.8%3 in India.
To address these issues, Olympus is collaborating with local academic societies and hospitals to support the development of endoscopists by providing opportunities for training on endoscopic equipment. However, it takes 10 or more years for a physician to become an endoscopic specialist. As a result, three years ago, Olympus launched a project for traveling endoscopic screenings as a more direct solution.
1 Compiled by Olympus using publicly available data
2 National Cancer Center Japan, Cancer Information Service, Aggregation of Hospital-based Cancer Registry Survival Rates
https://hbcr-survival.ganjoho.jp/graph?year=2014-2015&elapsed=5&type=c10#h-title (in Japanese, accessed March 15, 2024)
3 World Health Organization. (n.d.). GCO-Observed survival (%), 5-year, cases diagnosed 2008–2012: https://gco.iarc.fr/survival/survcan/dataviz/table?survival=5&populations=0&cancers=60
This program is conducted in collaboration with hospitals that want to perform endoscopic screenings for people who are unable to undergo testing due to access and other issues and with medical institutions with which Olympus has discussed possible solutions for these social issues. The hospitals provide the vans on which the equipment is installed, communications equipment, the personnel who perform the screenings and so on, and Olympus provides the endoscope screening equipment.
One measure that has already started is an initiative with the Asian Institute of Gastroenterology (AIG), a leading medical institution in Hyderabad, India. Under this initiative, a van travels one to two times each month to distant villages located up to 100 km from the base hospital and performs endoscopic screenings as well as basic blood screenings. The screening data is transmitted via satellite communications to the AIG main hospital in Hyderabad the same day for diagnosis. The following day, the physician who traveled to the site can prescribe therapeutic drugs.
One thing that surprised us about this program was that 60% of the patients who undergo screening have some type of medical condition such as peptic ulcers, varices, or malignancies. We believe that the main reason for this is that the endoscopic screenings are performed on patients who were screened in advance, but even so, the numbers are very high.
Another hospital participating in this program in a different region, Galaxy Hospital (located in Naded, Maharashtra), made the following comment: “By using the endoscopic van, we are able to reach even those places where people are not aware of the concept of endoscopy or for that matter any reasonable healthcare, and we can provide screenings to patients who need them. This year, we have traveled more than 9,000 km with the van and saved many lives. We not only conduct screenings, but also conduct educational programs on the importance of endoscopy for local general practitioners. I am certain that this program will have a major impact on awareness of endoscopic screening for many years to come.”
A traveling endoscopic screening van
An endoscopic screening
The Outreach Screening Program is currently being operated with total of four hospitals in the southern and central regions as bases, and so far, more than 2,000 endoscopic screenings have been performed. Based on the results from the past two to three years, it has become clear that this type of infrastructure enables people to undergo screenings in a timely manner, and hospitals are able to identify patients and detect cancer at an early stage.
However, when the vans are able to make only a few trips each month, the number of visits and the number of people who undergo screenings are unavoidably limited. It is our hope that this program will serve as motivation for clinics in the areas where the vans travel to start endoscopic screenings and that it will help collaborating hospitals establish new clinics that have endoscopic capabilities at the van destinations.
We aim to begin collaborating with a minimum of 20 additional hospitals in the next two years. To achieve this, we established a specialized organization in April 2023 to be involved in this solution. We are already collaborating with three new medical institutions in the northern region and are currently making preparations.
As the program expands, we will also face challenges including resource issues relating to the collaborating hospitals and doctors. We hope to engage in close communication with them and actively address these types of issues in order to increase colleagues who are in agreement with the objectives of these activities. In addition, by leveraging the experience, data, and expertise gained through these outreach screenings, we hope to contribute to the launch of a screening program on the nationwide level in India in the future.
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