BPKMCH | ANNUAL REPORT - 2018
DEPARTMENT OF CANCER
PREVENTION, CONTROL & RESEARCH
Introduction
According to est mates from the Internat onal Agency for Research on Cancer (IARC), in 2018 there were 18.1
million new cancer cases and 9.6 million cancer deaths worldwide. By 2040, the global burden is expected to
grow to 29.5 million new cancer cases. The increase in burden of cancer is due to increase in life expectancy,
changes in lifestyle related factors like diet, physical act vity, sexual habit, tobacco and alcohol use and
environmental pollut on due to industrializat on.
However, a substant al proport on (30-50%) of cancers could be prevented. All cancers caused by tobacco use
and heavy alcohol consumpt on could be prevented. In 2010, almost 1.5 million of the est mated 8 million
cancer deaths in the world were caused by tobacco smoking. In addit on, the World Cancer Research Fund has
est mated that between one-fifh and one-fourth of cancers worldwide are related to overweight or obesity,
physical inact vity, and/or poor nutrit on, and thus could also be prevented. Many of the cancers related to
infect ous agents, such as human papillomavirus (HPV), hepat t s B virus (HBV), hepat t s C virus (HCV), human
immunodeficiency virus (HIV), and Helicobacter pylori (H. pylori), could be prevented through screening and
early diagnosis, behavioral changes, infect on control procedures, vaccinat ons, or treatment of the infect on.
Many cases of skin cancer could be prevented by protect ng skin from excessive sun exposure and avoiding
indoor tanning. Screening can detect cancer early, before symptoms appear, which usually results in less
extensive treatment and beter outcomes. Screening can prevent cancers by allowing for the detect on and
removal of precancerous lesions. Screening is known to reduce mortality for cancers of the breast, colon,
rectum, cervix, and lung (among long-term and/ or heavy smokers). A heightened awareness of changes in
the breast, skin, test cles, or oral cavity may also result in the early detect on of cancer. Cancer is the second
leading cause of death in developed countries and the third leading cause of death in developing countries.
In Nepal, cancer morbidity and mortality is increasing day by day. GLOBOCAN est mated that there are 26,184
new cancer cases in Nepal with age-standardized incidence rate of 103.7 per 100,000 populat on in 2018.
Similarly, it is est mated that there were 19,413 cancer deaths with age-standarized mortality rate of 77.8 per
100,000 populat on for the same year.
With the moto of “Prevent on is beter than cure” Cancer Prevent on, Control & Research Department in
BPKMCH is working to increase awareness in the general populat on, conduct screening and research act vit es.
Services
The Department of Cancer Prevent on, Control and Research is responsible to conduct Primary prevent on
(Cancer awareness and educat on), Secondary prevent on (Cancer screening and early detect on) and Cancer
control and research act vit es at nat onal level. It has conducted the following program in the year 2018:
1.
Cancer Awareness/Education Program:
a.
Hospital based cancer awareness/educat on program:
This program is a regular act vity to create awareness among pat ents, atendants and visitors in
OPD. A total of 10,000 persons atended this program. The awareness were provided with Lecture,
demonstrat on, audiovisual aids and street dramas. More than 10,000 Printed materials like pamphlets,
leaflets, and posters were distributed for cancer educat on.
b.
Community Based Awareness Program:
Community-based awareness program were organized in different parts of the country to create
awareness on cancer prevent on and control. The programs were mainly focused on tobacco control,
diet modificat on, self-breast examinat on, regular cervical cancer screening and warning signs of
cancer. A total of 70 events were organized at different level. A total of 10,000 populat on atended the
program.
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BPKMCH | ANNUAL REPORT - 2018
c.
School Cancer Educat on Program (SCEP):
The object ve of this program is to reduce the exposure of risk factors causing cancer and control the
use of tobacco by ut lizing the students and teachers in community setup. Eight events were conducted
in different schools.
d.
Primary health workers:
The primary health care workers part cipated the training program in the co-ordinat on with district
health/public health office/local authority. The training was focused on primary prevent on, tobacco
control, oral, head and neck screening, cervical cancer screening(VIA/Pap smear) self breast examinat on
and early referral.
Table 1 : Orientat on, Training and Screening Program conducted in 2018:
Districts
Health workers trained
Training program
Kapilvastu
19
Head and Neck cancer screening
Morang
20
Head and Neck cancer screening
Dhanusha
21
Head and Neck cancer screening
Morang
20
Cervical & Breast cancer screening
Dhanusha
20
Cervical & Breast cancer screening
Lamjung
20
Cervical & Breast cancer screening
Sindhupalchowk
22
Cervical & Breast cancer screening
Total
142
-
e.
Cancer awareness through mass media:
Local FM radio and newspaper is used to broadcast the message on risk factors of cancer, general
signs and symptoms. Medical doctors and other health professionals part cipated in these programs to
educate public. Several events were conducted this year.
f .
Celebrat on of “Nat onal Cancer Awareness Day”:
To make people aware of cancer in Nepal, the government has declared 10th Asoj every year as
“Nat onal Cancer Awareness Day”. On this day; talk program were organized and IEC materials were
distributed to create awareness among the general people.
g.
Celebrat on of “World No Tobacco Day”:
This program highlighted the adverse effects of various form of tobacco use. More than 20,000
pamphlets on adverse effects of tobacco were distributed to the peoples.
Ant tobacco rally - Part cipants 500 with play card, banner, and leaflet organized in co-ordinat on with
the Bharatpur Sub metropolitan City Office, Cancer Relief Society and DPHO.
School health program on tobacco awareness: 2 schools
Tobacco awareness programs to police officers and other general populat on
Drama on Tobacco awareness at BPKMCH premises
h.
Celebrat on of “World Cancer Day”:
World Cancer Day is celebrated every year on 4th February to aware about cancer prevent on and
control to the general public. Last year it was celebrated through media and printed educat on materials.
2.
Cancer Screening and Early Detection Program:
The object ve of this program is to reduce the morbidity and mortality by detect on of precancerous
lesions through screening services at hospital and in the community. At present screening program for
uterine cervical, breast and oral cancers is going on.
a.
Cervical cancer early detect on program:
This program is organized for healthy women’s at BPKMCH and in community set ng. Trained nursing
personnel are providing these services where they provide awareness regarding cervical cancer
and breast cancer. The program was successfully conducted in 70 different communit es which
included Morang, Dhanusha, Makwanpur, Chitwan, Nawalparasi, Tanahun, Arghakhachi, Kaski and
Sindupalchowk districts.
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BPKMCH | ANNUAL REPORT - 2018
Table 2: Month wise cervical cancer screening (FY 2075/76)
Total screened
Months
Negat ve
Posit ve
Community
Hospital
Total
Shrawan
Bhadra
75
8
83
81
2
Ashwin
267
3
270
266
4
Kart k
510
4
514
507
7
Mangsir
91
18
109
107
2
Poush
403
82
485
478
7
Magh
473
10
483
480
3
Falgun
269
140
409
399
10
Chaitra
666
36
702
693
9
Baishakh
846
20
866
855
11
Jestha
625
372
997
985
12
Asar
472
29
501
489
12
Total
4697
722
5419
5340
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Table 3: Results of Cervical Cancer Screening (VIA) (FY 2075/76)
Site
Total screened
Negat ve
Posit ve
% VIA posit ve
Community
4697
4627
70
1.49%
Hospital
722
713
9
1.24%
Total
5419
5340
79
1.46%
b.
Breast cancer screening:
This screening service is available in the OPD every day. This screening program is conducted
simultaneously with cervical screening program in the community. Self-breast examinat on procedure
was taught and demonstrated in the community.
Table 4: Act vit es of breast cancer screening (FY 2075/76)
Act vit es
Total no. of clients
Findings
Advice
Breast examinat on with I-breast scanner
107
Clinical Breast examinat on
1614
Discharge=24, Lump,
USG breast=124
Fibroadenoma=417
Mammogram=124
Cytology=24
Breast cancer awareness and Self-breast
8148
examinat on training
c.
Oral, Head and Neck Screening Program
Screening events - 7
Screening Program organized at - 4 districts, 792 people were screened. Examinat on kits and protocols
were distributed during training. The screening program is going on smoothly by the trained health
workers in the respect ve health inst tut on.
3.
National Cancer Registry
Hospital based Nat onal cancer registry program with collaborat on of 7 major hospitals in Nepal started
at 2003 supported by WHO Nepal. Currently, data of all cancer diagnosed cases are collected from 12
collaborat ng hospital for data analysis in BPKMCH. From this year, data collect on will be undertaken
from 17 hospitals. It has also started populat on-based cancer registry in 15 districts since 2013.
4.
Cancer Research Program
A Case-Control Study of Environmental Risk Factors of Oral, Head and Neck Cancer in Nepal has been
completed and it is in the process of data analysis. Similarly, various other studies are being undertaken
by the department this year:
Study on community -based screening of precancerous lesions of cervical cancer and oral cancer
Experiences of Cervical Cancer Survivors in Chitwan, Nepal: A Qualitat ve Study Ant biot c resistance
patern among cancer pat ents
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BPKMCH | ANNUAL REPORT - 2018
5.
Cancer Education Materials Development and Distribution:
Different types of Cancer educat on materials like leaflets, pamphlets, booklets, digital flex and flip
charts, calendar were developed in Nepali language and were distributed to the government and non-
governmental organizat ons, general public and health workers.
Academic Activities
Medical/Nursing students from different Colleges visited this department for academic purpose. Two PhD
Researchers ( Dr Disha Shinde and Dr Mohammad Adnan Shahid) from University of New Mexico completed
their dissertat on on “Health, Wellness and Quality of Life Choice Preference Study of the Cancer Pat ents
of Nepal” in collaborat on with department. Two MPH students from University of Gothenburg, Sweden
(Johan Hellman and Sameul Ferm) conducted researches on “Knowledge, at tude, pract ce of Nepalese
Female Community Health Volunteers in the area of non-communicable diseases” and “Qualitat ve study on
perspect ves of non-communicable diseases among FCHVs”. A total of 19 groups of nursing students - MN,
BSc, BN and Staff Nurse visited the department for the academic purpose.
Kishore Kumar Pradhananga, Manju Sharma and Tara Dawadi atended Screening and Colposcopy training at
China on August 2018.
Ayodhya Pathak, Manju Sharma and Tara Dawadi atended Colposcopy Training at Dhulikhel on December
2018.
Published articles in 2018
Reproduct ve and hormonal factors in relat on to lung cancer among Nepali women
Cancer Registrat on in Nepal: Current status and way forward
Comparat ve Analysis of Cancer Incidence by Dual Cancer Registry in Nepal 2013-2015
Populat on based cancer incidence in various geographical regions of Nepal - 2015
Human Resources
Mr. Bhola Siwakot , Head of Department
Mr. Kishore Kumar Pradhananga, Deputy Chief Public Health Officer
Dr. Gambhir Shrestha, MD Registrar
Mrs. Ayodhya Pathak, Senior Sister
Dr. Krishna Prasad Subedi, Public Health Officer
Mrs. Rashmi Mulmi, Public Health Officer
Mrs. Manju Sharma, Senior Staff Nurse
Mrs. Tara Dawadi, Senior Staff Nurse
Mrs. Kamala Adhikari Senior Administrat on Assistant
Mr. Gopal Bhat rai, Support Staff
Mrs. Kalpana Neupane, Support Staff
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