Purpose: According to GLOBOCON 2018, in India oral cancer is the most common cancer among men while breast and cervical cancers are the most common cancers in women. Tobacco is a common and significant risk factor. This study was conducted amongst garbage cleaners of Bangalore, India. This population represents one of the lowest socio-economic classes in India due to poor health literacy and financial poverty. The objectives of this study were to identify the risk factors for oral, breast, and cervical cancer in this population and to identify premalignant and malignant lesions.

Methods: A cross-sectional descriptive study was conducted in Bangalore, India. Validated questionnaires were used to assess risk factors. Over a period of one year, screening programs were conducted once a week in the municipality clinics. The screening included a visual exam of the oral cavity and exfoliative cytology of lesions, clinical breast exam (CBE), and pap smears. Follow up of suspected lesions were referred to higher centers for further management.

Results: Of the 1123 attendees, 81.5% were women, 85% were illiterate. 68 oral premalignant lesions were identified on clinical exam and all of them underwent tobacco cessation counselling. 913/915 women underwent CBE, of which 23 were abnormal and were referred for mammogram. 28 abnormal pap smears were detected; 16 underwent biopsy:1 SCC (treated), 3 HSIL (1 treated/1 refused/1 under follow up), 2 LSIL (under follow up), 10 normal. Multiple logistic regression was done to assess the impact of risk factors on the oral pre-malignant cases. The intercept/constant was statistically significant with tobacco having a positive relationship while gender and age had a marginally positive relationship.

Conclusion: Garbage cleaners represent a high-risk population due to poor health literacy, limited access to health care and hazardous working conditions. This program not only helped to create awareness about these cancers and the implications of tobacco use but also provided opportunity for screening. Imparting knowledge about oral and self-breast exams will help to create a sustainable model. Implementation of tobacco cessation programs would be beneficial.

Citation Format: Chethana T, Punith Shetty, Radhika Kulkarni. Screening and Risk Factor Analysis for Oral, Breast and Cervical Cancer amongst Garbage Cleaners of Bangalore, India; An Underserved Community. [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 66.