Title: Challenges involved in conducting training courses in cervical cancer prevention, early detection and management in Barshi; a rural town in India. 
 
Background: The Nargis Dutt Memorial Hospital (NDMCH) in Barshi, is a rural outreach centre of the Tata Memorial Centre (TMC) in Mumbai. It was set up in the year 1982 by the then director of the TMC Dr. Praful Desai and Dr. B. M. Nene, the founder of the NDMCH.
In 1987, the well-known epidemiologist Kasturi Jayant was appointed by the ICMR and the TMH as the as Head of the first Rural Cancer registry which was also set up at the NDMCH. Barshi.
The work being done at Barshi, came to the attention of IARC and in 1999, Dr. R. Sankmaranarayanan spear headed the landmark collaborative study (TMC, NDMCH and IARC)
(Sankaranarayanan et al; Int. J Cancer 2005; 116 (4) 617-23)
 
This study resulted in establishing a very efficient laboratory for Cytology, Histology and HPV testing, and expertise in VIA.
 
Subsequently Dr. Sankar, designated the NDMCH as a training centre in cervical cancer prevention, early detection and management.
 
Over the years around 20 courses have been conducted and more than 200 doctors and nurses from several countries in Africa and Asia have been trained. Master trainers from different parts of India and a few from France have carried out the training.

Objectives: Imparting quality training in alll aspects of cervical cancer prevention
 
Methods: This presentation discusses the work that goes into the selection of women who are the proper candidates for early cancer detection, the selection criteria; and the challenges faced in convincing the women to give their consent and attend.
 
Barshi has no airport and collecting and transporting the medical personnel who attend the workshop and the faculty from the nearest cities (Mumbai and Pune) needs to be planned.
 
Results and Conclusions: The trained medical personnel return home and successfully carry out the procedures they have learnt.
Numerous women from a number of countries benefit and a large number of cancers of the cervix are prevented.

Implication for practice or policy: India has a very high incidence of cervical cancer (around 123000 new cases anually as of 2020) The choice of the correct candidates for screening and follow up with colposcopy, and the methods for the treatment of precancerous lesions when put into practice will go a long way in the prevention of cervical cancer.

Training in progress