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  `