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Ranjeeta Subedi Nepal Health Research Council

Population Based Cancer Registry in Nepal. Ranjeeta Subedi Nepal Health Research Council. 13 June, 2019 Vancouver, Canada. Federal Democratic Republic of Nepal. An overview. Established in January 2018 Led by Nepal Health Research Council

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Ranjeeta Subedi Nepal Health Research Council

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  1. Population Based Cancer Registry in Nepal Ranjeeta Subedi Nepal Health Research Council 13 June, 2019 Vancouver, Canada

  2. Federal Democratic Republic of Nepal

  3. An overview • Established in January 2018 • Led by Nepal Health Research Council • PI : Prof. Dr. Anjani Kumar Jha • Reached up to 9 districts (Out of 77) with three registries of the country (Kathmandu, Bhaktapur, Lalitpur in province 3, Siraha, Saptari, Dhanusha, Mohattari in province 2 East and West Rukum in province 5 and 6) • Population coverage by PBCR: 20.3%

  4. PBCR Established Districts in Nepal China India Kathmandu Bhaktapur Lalitpur India West Rukum East Rukum India Mahottari Dhanusha Saptari Siraha

  5. Why PBCR in Nepal ? • Absence of routine surveillance and national PBCR in the country • Disease burden estimates so far depend upon small scale data sources and data from neighboring countries

  6. Why PBCR in Nepal … • Nepal government invest huge amount of money ( NRS. 93,04,09,118 in 2016/17) for cancer treatment • PBCR supports for the country to measure Global NCD Target endorsed by WHO Member States in 25% reduction of premature mortality from the four major NCDs by 2025

  7. PopulationBased Cancer Registry Program Methodology of PBCR Population Based Cancer Registry Steering Committee TWG Facility Based Approach Community Based Approach Cancer hospitals /General Hospitals/ Hospices Gathering of collected data from various sources Municipality ; Health sector coordinator (Focal contact person) Pathology Laboratories Residence Confirmation, Checking and verification of information Civil Registration / Bipanna Service Health post in- charge Data entry and analysis at CanReg5 Software FCHVs Collect household information

  8. Collaborations • IARC Regional Hub Mumbai • WHO Country Office, Nepal • Private/Public Health Facilities • Pathology Laboratories, Hospice, Civil Registration, Wards/Deprived Section of Department of Health Services within Kathmandu Valley • Local Authorities: Metropolitan city, rural/municipalities and their ward offices

  9. Major Progress/Achievements • Establishment of Steering Committee, Technical Working Group • Oriented around 2000 (doctors, health in charges/ coordinators and FCHVs) • MoU signed between B.P Koirala Memorial Cancer Hospital, Bharatpur & Nepal Health Research Council for PBCR • Published PBCR Interim Report 2018 • PBCR fully established at 9 districts

  10. Major Progress/Achievements…. Total new cancer cases until May 31st2018 Kathmandu Valley: 702 Siraha, Saptari, Dhanusha and Mahottari: 256 East and West Rukum: 23

  11. Findings: Interim Report 2018; Kathmandu Valley Cancer Registry Fig. 1: All Sites Cancer Incidence Rate by Sex (N=702)

  12. Findings … Fig.2: Cancer Incidence by Age (N-702)

  13. Findings … Fig.3: Cancer Incidence Rates by Age and Sex Male (n=323) Female (n=379)

  14. Findings … Fig.4: Cancer case distribution among districts of Kathmandu valley (N=702)

  15. Findings … Fig.5: Cancer Cases Distribution by Ethnicity (N-702)

  16. Findings … Table 1: Cancer cases distribution by marital status

  17. Findings … Fig.6: Leading cancer sites N=702

  18. Findings … Fig.7: Leading Cancer Sites in Males (n=323)

  19. Findings … Fig.8: Leading Cancer Sites in Females (n=379)

  20. Findings … Table 2: Other and unspecified cancer sites

  21. Findings … Table 3: Pediatric cancer cases

  22. Findings … Table 4: Most Valid Basis of Diagnosis among Male and Female

  23. Challenges • The data collection method is primarily active. • No dedicated staff at data source locations; difficult to obtain data on periodic basis • Hard to keep exact record of cancer cases within registry area as cancer patients visit other country (India) • Limited human/financial resources • No PBCR coordinating bodies at the respective provinces.

  24. Way forward • Meaningful participation of key stake- holders at planning & implementing PBCR • Increment in human/financial resources • Increase collaboration with hospitals outside the country and make coordination to obtain data on regular basis from there. • Utilizing the information obtained in cancer control strategies.

  25. Thank You

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