The News International
‘Pakistan must form National Cancer Registry’
Shahina Maqbool
ISLAMABAD: Neither a national cancer control programme, nor any cancer surveillance project can effectively prevent and control cancer in the absence of a population-based National Cancer Registry. Prime Minister Imran Khan has already devoted over two decades of his life to cancer treatment; it’s now time to walk the extra mile and move to proper cancer control.
Talking to ‘The News’ here on Monday, eminent Public Health Specialist Dr. Ghulam Nabi Kazi expressed the above views while highlighting the imperative of a fully functional National Cancer Registry in Pakistan.
Such registries collect, analyze and interpret data on all cancer cases in a country through an ongoing systematic effort, not merely for epidemiological research, but also to evaluate health services in terms of prevention, diagnosis and treatment. A hospital-based registry records all cases reporting to that institution with an emphasis on clinical care and management. “All such institution-based registries need to submit data to the national registry,” he stated.
Cancer registries, Dr. Kazi added, play a major role in providing data to justify the establishment and implementation of national cancer control programmes. “An erroneous assessment of the cancer burden can have long-term negative implications for the health resources of a resource constrained country like Pakistan. A mission to Pakistan from the International Agency for Research on Cancer (IARC) four years ago pledged technical support in this regard. It is high time Pakistan appears on the world map in terms of its demonstrated commitment to cancer control,” he highlighted.
While Pakistan has approved the establishment of a National Cancer Registry in principle and has mandated the Pakistan Health Research Council (PHRC) with this task, the project has yet to really get underway, Dr. Kazi flagged. “Previously, the Sindh government approved the project for a cancer registry in the southern business district of Karachi that was financially sustained from 1995 till 2003. I personally remember presenting that case before the Departmental Development Working Party of the Sindh Health Sector in 1995. It, however, suffered from lack of commitment following the sad demise of Dr. Yasmin Bhurgri, the leading pathologist and crusader of this task,” Dr. Kazi lamented.
A modest start, Dr. Kazi maintained, has however been made by the PHRC in collating and analyzing quarterly facility-based data from eight major public-sector hospitals since 2015.” The database does not however contain either the state-of-the-art Shaukat Khanum Memorial Cancer Hospital (SKMCH) Lahore or the several other excellent facilities affiliated with the Pakistan Atomic Energy Commission encompassing thousands of cases,” he pointed out.
The hospital-based cancer registry of the SKMCH has been functioning since December 1994. Over the last 23 years till 2017, as many as 89,629 neoplasms were registered at SKMCH&RC and Karachi Diagnostic Center, of which 4,825 were benign and 84,803 malignant. The distribution amongst males and females was 48.44% and 51.56%, respectively. About 89.95% tumors were found in adults and 10.05% in children. The top three malignancies in all age-groups, both sexes combined, were breast cancer, leukemia, and lip/oral cavity cancer. The top three malignancies amongst adult females were cancers of the breast, ovary/uterine adnexa, and lip/oral cavity, while in adult males, prostate, colon, rectum, anal canal and anus, and lip/oral cavity cancers.
What does cancer prevention planning involve, Dr. Kazi was asked. “The initiative requires an assessment of cancer risk factors for priority-setting and evidence-based allocation of scarce resources. Around 40% of all cancers are preventable; early diagnosis and treatment can further help in saving and improving quality of lives. These factors combine to make cancer control and prevention mandatory in every country,” Dr. Kazi stated.
Cancer prevention can also be integrated with other prevention programmes as the predominant risk factors for cancer include tobacco use, unhealthy diet, physical inactivity and obesity.
Posted by Doc Kazi on 2018-11-20 02:19:00
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