FATUM BASALAMA, MD, MPH HEAD OF SUB DIRECTORATE CANCER DISEASE CONTROL
NCD
MINISTRY OF HEALTH, THE REPUBLIC OF INDONESIA DIRECTORATE GENERAL DISEASE CONTROL AND ENVIRONMENTAL
HEALTH
33 Provinces 497 District 218.086.288 Population M : 109.613.519 F : 108.472.769 F F 66.326.200 Target ( VIA target FF 29%=192,234,54 NCD, moH Ind --. 2006 Cancer Priority Breast & Cervical
Trend proportion of Death by Disease Group
10.16 65.9 7.3 6.5
59.5
49.9
41.7
28.131.2
44.2
0
10
20
30
40
50
60
70
HHS 1995 HHS 2001 BHR 2007
Perinatal/Maternal NCD Accident CDC
Data HIS 2005-‐2008
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
Kanker payudara
Kanker serviks uterus
Kanker hati & saluran empedu
intrahepatik
Leukemia Limfoma Non Hodgkin
Kanker bronkhus &
paru
Kanker ovarium
Kanker kolon Kanker daerah rektosigmoid &
anus
Kanker nasopharink
Top 10 cancer in INDONESIA 2004-2007
2004200520062007
: HIS 2005-2008 1.41
1.61
1.72
1.76
2.21
2.40
3.15
4.27
9.25
18.58
0.00 5.00 10.00 15.00 20.00
Hepar
Leukemia
Pharynx
Corpus Uteri
Thyroid Gland
Bronchus and Lung
Colorectum
Ovary
Cervix Uteri
Breast
Crude Rate (per 100.000 person-‐years)
1.08
1.23
1.36
1.86
1.88
2.82
3.65
4.01
4.13
5.81
0.00 1.00 2.00 3.00 4.00 5.00 6.00 7.00
Central Nervous System (CNS)
Skin
Renal Pelvis -‐ Bladder
Lymph Nodes
Leukemia
Prostate Gland
Pharynx
Hepar
Colorectum
Bronchus and Lung
Crude rate (per 100.000 person-‐years)
Top 10 Jakarta Cancer Incidence 2005-2007 (Coverage 4,17% Pop of Urban Area)
Submit to CI5 volume X
Data January 2010 Hospitals with Radiotherapy : 21 (20 ac=ve) Linear accelerator : 16 Telecobalt : 17
Policy on Cancer Control • Based on social par=cipa=on and community empowerment through local
enhancement • Developing collabora=on and partnership networking
• Integra=ng program of primary, secondary and ter=ary preven=on. • Performing services delivery by professionals and qualified healthcare providers • Developing surveillance of risk factors and cancer registry • Quality Assurance
STRATEGIES Social mobiliza=on and community empowerment for healthy living Encouraging health service development Encouraging and facilita=ng community par=cipa=on Developing early detec=on program Improving health services access Developing risk factors surveillance and cancer registry Proposing cancer treatment in the compulsory health insurance for the poor payment scheme
-‐ Method : single visit approach with Visual
Inspec=on with Ace=c acid/VIA & Cryotherapy (for VIA+), and Clinical Breast Examina=on/CBE + Breast Self Examina=on/BSE
-‐ Provider : MD & midwives in HC well train
-‐ Supervisor: 1. Clinician (Obsgyn & Surgeon) 2. Management: DHO & PHO
Cancer Screening Program
-‐ Goal : Increase coverage of cervical cancer & breast
cancer screening -‐ Target : woman age 30-‐50 yrs -‐ Coverage target: 80% from target popula=on in 5
years -‐ Loca=on :
Recent : 2011 17 PROVINCES (82 DISTRICT) AT 192 PHC è MoH +
FCP + JHPG
Result of Servical & Breast Cancer Screening Program 2007-‐2011
0
500000
1000000
1500000
2000000 2007
2008
2009
2010
2011
Series 3
Series 2
Series 1
Result of Servical & Breast Cancer Screening Program (17 Provinces & 84 Districts)
2008-‐2011
Year Sreening
VIA + %
2008 51.713 2318 4,48%
2009 114.608 1872 5,73%
2010 119.157 8458 3,16%
2011 602312 25.800 4,12%
Total 893785 38448 4,3%
CBE for Breast Cancer à 2880 suspect (0,48%)
PROSENTASI VIA POSITIVE WITH CRYO PROSENTASI VIA POSITIVE WITH CRYO
No Cryo-‐
lndonesia Cancer Control Program ICCP
PrevenTon Public awareness :RF ,promoTon, public educaTon
Screening VIIA, (30-‐50 y)CBE ,( PHC) 5 % -‐ Hsp,ICF, Pap Smeer
treatment PHC(Cryo) -‐ Hsp Komperhenship treatment 11 prov in 33
Surveillance Registry Cancer (Jakarta )
Pallia=ve 6 Prov in 33 (Inpa=ent, one day care, homecare, clinic
Research NRDC, MoH
PLAN 2014
PrevenTon Total area coverage, develp Lung Ca, Colorectal Ca Propose VACCINE PROGRAM ( High Risk Area)
Screening 2014 : VIA, CBE 80% PW every 5 Y/1x
Treatment 25% PHC Cryo, Kompr
Surveillance Registry Cancer ( all Prov priority Medical Faculty area )
Pallia=ve Total Prov
SupporTng Govrm Central, Prov/Distr, WHO, Inst, Proff, NGO Nat/Int
CURRENT
TERIMA KASIH `