Developing countries: an evolving opportunity for oncologic research.
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Biomedical Research↗
Biomedical subjects
Surendra Shastri
Publications and source records attributed to Surendra Shastri.
Cervical and oral cancer screening in India.
Incidence of both cervical and oral cancer are high in India. Although there are no organized cervical or oral screening programmes in the country, a number of research projects are ongoing or recently completed. In cervical screening, a number of studies of visual inspection with various aids and studies of human papillomavirus (HPV) testing are in progress. Long-term follow-up of these will inform policy on cervical screening in limited resource countries. A randomized trial of oral visual inspection for cancer or premalignant lesions in 192,053 subjects has been conducted in Kerala, South India. In the trial population as a whole, the study group showed a non-significant 21% reduction in mortality from oral cancer compared with the control group. In users of alcohol, tobacco or both, in which more than 90% of oral cancer deaths occurred, the reduction was a significant 34% (relative risk = 0.66, 95% confidence interval 0.45-0.95). On the basis of these results, screening for oral abnormalities has the potential to prevent 37,000 deaths per year worldwide.
Adult↗
Teacher tobacco use and tobacco use prevention in two regions in India: qualitative research findings.
BACKGROUND: This paper uses qualitative data to explore differences in tobacco use patterns and tobacco use prevention efforts among teachers in two Indian states with high versus low prevalence of tobacco use. METHODS: We conducted a series of 12 focus groups with teachers in 12 schools in Maharashtra and Bihar following a standardized script, and analyzed data using standard qualitative methods. RESULTS: Teachers in Bihar reported higher levels of tobacco use and stronger social norms promoting tobacco use compared to those in Maharashtra; nonetheless, teachers in both states reported strong social prescriptions about teachers' not using tobacco. Few supports were available for cessation. Although focus group participants were generally aware that tobacco use has deleterious health effects, not all were knowledgeable of specific health consequences, in particular resulting from the use of smokeless tobacco. Key barriers to teaching about tobacco use prevention were reported, including the lack of its inclusion in standard curricula and large class sizes; these results also underscore the importance of support for tobacco control policies. CONCLUSIONS: These findings point to the need for a multi-pronged approach to tobacco use prevention that involves the government, school administration, as well as teachers, parents, and the broader community, and including support to tobacco use cessation.
Adolescent↗
Teacher tobacco use and tobacco use prevention in two regions in India: results of the Global School Personnel Survey.
BACKGROUND: This paper compares tobacco use patterns and tobacco use prevention efforts among teachers in two Indian states with high versus low prevalence of tobacco use. METHODS: Data from the Global School Personnel Survey compared tobacco use patterns and tobacco use prevention activities among teachers from the Indian states of Maharashtra (N = 954) and Bihar (N = 524). RESULTS: 78% of teachers in Bihar and 31% from Maharashtra were current tobacco users. Tobacco control policies were virtually non-existent in schools in Bihar, while in Maharashtra, over one-fourth of teachers reported that tobacco use was prohibited among both students and teachers. Few teachers in Bihar taught their students about tobacco use prevention, while such teaching was more common in Maharashtra. In Maharashtra, teaching about tobacco use prevention was significantly associated with not currently using tobacco (P < 0.0001), having a policy specifically prohibiting tobacco use among students (P < 0.0001), and having a policy specifically prohibiting tobacco use among school personnel (P < 0.0001). CONCLUSIONS: This study has clear implications for implementation of tobacco control policies in Indian schools and further underscores the need for infrastructure support for tobacco use prevention in developing countries such as India, where tobacco use threatens to contribute to a growing proportion of the burden of disease worldwide.
Adolescent↗