{
  "abstract": "Introduction Despite implementation of the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD), screening coverage for oral, breast and cervical cancers remains below 2%. Screening quality is inadequately addressed and delays in diagnosis and treatment initiation continue to persist. This multisite implementation research aims to improve district-level coverage and quality of screening, early diagnosis and timeliness of treatment initiation through a model co-developed within the NP-NCD context.Methods and analysis The study will be conducted in three phases across seven districts in diverse regions of India. In phase I (formative), the current status, barriers and facilitators of cancer screening, diagnosis and treatment initiation under NP-NCD will be assessed. In phase II (optimisation), a model (package of implementation strategies) will be co-developed and iteratively optimised with multistakeholder engagement at the subdistrict level to improve screening coverage and quality and strengthen the referral system for early diagnosis and treatment initiation. In phase III (scale-up and evaluation), the model will be implemented at the district level and evaluated for improvements in screening, early diagnosis and treatment initiation. A convergent mixed-methods design will be used, incorporating household surveys, facility assessments and stakeholder interviews. Implementation Research Logic Model will guide planning, execution and evaluation in the present study. Determinants of screening coverage and quality, early diagnosis and treatment initiation will be assessed using the Consolidated Framework for Implementation Research. Implementation strategies for the model will be finalised using the Expert Recommendations for Implementing Change framework. Implementation and service outcomes will be evaluated using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework.Ethics and dissemination Ethical approval has been obtained from all study sites. The study findings will be disseminated at the state, national and global levels through meetings and conferences and submitted to a peer-reviewed journal for publication.Trial registration number CTRI/2025/08/092672.",
  "authors": [
    {
      "affiliations": [
        "Community Medicine & School of Public Health, PGIMER, Chandigarh, India"
      ],
      "name": "Ankita Kankaria"
    },
    {
      "affiliations": [
        "Preventive Oncology, AIIMS, New Delhi, India"
      ],
      "name": "Pallavi Shukla"
    },
    {
      "affiliations": [
        "Department of Surgical Oncology, Yenepoya (Deemed to be University), Yenepoya Medical College, Mangaluru, India"
      ],
      "name": "M Vijayakumar"
    },
    {
      "affiliations": [
        "IGMC, Shimla, India"
      ],
      "name": "Amit Sachdeva"
    },
    {
      "affiliations": [
        "Preventive Oncology, Cancer Institute-WIA, Chennai, Tamil Nadu, India"
      ],
      "name": "Malliga J Subramanian"
    },
    {
      "affiliations": [
        "ICMR-RMRC, Dibrugarh, India"
      ],
      "name": "Prasanta Kumar Borah"
    },
    {
      "affiliations": [
        "Department of Community & Family Medicine, All India Institute of Medical Sciences, Bathinda, India"
      ],
      "name": "Soumya Swaroop Sahoo"
    },
    {
      "affiliations": [
        "Department of Community Medicine, Yenepoya (Deemed to be University), Yenepoya Medical College, Mangaluru, India"
      ],
      "name": "Abhay Nirgude"
    },
    {
      "affiliations": [
        "Biostatistics & Socio Behavioral research, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India",
        "Faculty of Medical Research, AcSIR, Ghaziabad, India"
      ],
      "name": "Ranjan Kumar Prusty"
    },
    {
      "affiliations": [
        "Department of Public Health and Preventive Services, Tamil Nadu, India"
      ],
      "name": "Selvavinayagam T S"
    },
    {
      "affiliations": [
        "Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India"
      ],
      "name": "Krishna Asuri"
    },
    {
      "affiliations": [
        "Indian Council of Medical Research, New Delhi, India"
      ],
      "name": "Pulkit Verma"
    },
    {
      "affiliations": [
        "Division of NCD, Indian Council of Medical Research, New Delhi, India"
      ],
      "name": "Jyoti Sharma"
    },
    {
      "affiliations": [
        "Division of NCD, Indian Council of Medical Research, New Delhi, India"
      ],
      "name": "Rupinder Singh Dhaliwal"
    },
    {
      "affiliations": [
        "Biostatistics & Socio Behavioral research, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India",
        "AcSIR, Ghaziabad, India"
      ],
      "name": "Shahina Begum"
    },
    {
      "affiliations": [
        "Division of NCD, Indian Council of Medical Research, New Delhi, India"
      ],
      "name": "Tanvir Kaur"
    },
    {
      "affiliations": [],
      "name": "ICMR-NHRP Cancer Screening Group"
    }
  ],
  "title": "Enhancing screening, early diagnosis and treatment initiation of oral, breast and cervical cancer in selected districts of India: an implementation research protocol",
  "uid": "40a5e8e7-5abb-57f0-9acc-580b32c40c6f"
}