Abstract 3342: A novel indigenous knowledge system based approach to study cancer health disparities in rural population of North East India
Authors: Pathak Lekhika , Pal Bidisha , Baishya Tutumoni , Sarma Anupam , Das Bikul 
Published: August 2019

Abstract
Background: India's North East is an economically deprived and politically unstable region inhabited by diverse groups of indigenous people. The incidence of cancer (mainly oral) is unusually high in the region. Through our KaviKrishna telemedicine care (www.kavikrishnalab.org) with collaboration of Thoreau Lab for Global Health (www.thoreaulab.org) we have initiated a longitudinal study in the greater Sualkuchi (50,000 population) area to identify different elements that underlie cancer health disparities. Specially, we wanted to develop an indigenous knowledge system (IKS) based approach (1) as an analytical tool to study cancer health disparities. IKS may be defined as a knowledge-emergence mechanism as a result of non-linear communication between an individual and his/her culture (1).
Methods: An IKS-based experimental approach was developed as follows. First, we identified 45 cancer patients (mostly oral cancer, age group- 30-65 years; 60% male) living in Sualkuchi. Second, we mapped out each patient’s social network/support system through regular home visit, interviews, focused group discussion, and visits to attending doctors. Third, one group of patients (n= 30 out of 45 patients) and relatives were empowered with basic knowledge about their disease and the available treatments needs through regular focused group meetings. After three months, we repeated interviews/group discussion to find whether they communicated their knowledge/experience to generate an IKS-based system (1). The data were then fed into the IKS-network analysis tool, which we developed partly, based on hub-system (3) and thematic network based approach (3). 10 patients from urban area served as a control population.
Results: We found that 40 out of 45 patients find it extremely difficult to navigate the complex cancer care system due to lack of communication with treating oncologists/surgeons as compared to urban patients. 15 patients discontinued follow up visit mainly for this reason alone. 25 patients showed evidence of communicating through a pre-existing IKS-based system. Surprisingly, these 25 patients were positively responding to our care services/group discussion and becoming emotionally and psychologically strong towards managing their self-care.
Conclusion: Our study indicates that lack of communication is a major cause of cancer health disparity. An IKS based approach may enhance communication, and contribute to cancer care in rural India.
1. Bikul Das. Globalization and Emerging Opportunities of Indigenous Culture. 2003. (www.academia.edu/ 7882695).2. Anita Kothari et al. Using an integrated knowledge translation approach to build a public health research agenda. Healthy Research Policy and Systems, 2014. (PMID: 24475759).3. Jennifer Attride-stirling: Thematic networks: an analytic tool for qualitative research. 2001. Qualitative Research.
Note: This abstract was not presented at the meeting.
Citation Format: Lekhika Pathak, Bidisha Pal, Tutumoni Baishya, Anupam Sarma, Bikul Das. A novel indigenous knowledge system based approach to study cancer health disparities in rural population of North East India [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3342.