Cancer Control Program in Indonesia

Cancer Control Program in Indonesia

Cancer control programs are well organized recently conducted since about 5 years in Indonesia, in line with the established and active Controlling Directorate Directorate General of Communicable Diseases in P2PL. On the other hand, control of infectious diseases is far longer much done extensively since Indonesia's independence.

Prof. Tjandra deliver cancer control activities carried out in Indonesia covers many important aspects, as listed below:

1) Promotion and Prevention

Cancer risk can occur throughout the life span, from the fetus in the womb to senior citizens. Risk factors for cancer can be found everywhere, whether consciously or not. Therefore, the goal of controlling cancer risk factors applicable to all age groups. The Ministry of Health has strengthened the dissemination of cancer control in different areas. Guidelines for the control of risk factors for cancer have been developed for health workers, volunteers, school-age children and high-risk communities. Promotion and prevention campaigns cancer risk conducted by the Ministry of Health, who also worked with cross-program, cross-sector, government organizations, private and public.

Efforts to control smoking, increasing physical activity and increased consumption of fruits vegetables have been integrated in the program PHBs (behavior and healthy). The program is implemented through a variety of priority national campaigns. No Smoking Policy advocacy Region (KTR) has been conducted by the Ministry of Health to local government. Each region is expected to have policies KTR in health care facilities, schools, children's playground and a place of worship. At this time 43 regencies / cities in 21 province has had KTR implementing regulations in their respective areas.

2) Early Detection and Follow-up

Early detection programs implemented for some cancers can be detected early, such as cervical cancer, breast cancer, colorectal cancer, oropharyngeal cancer, and retinoblastoma. Cancer early detection programs can be developed based on the prevalence of cancer in each region and the availability of resources.

Program early detection and follow-up of breast cancer and cervical cancer has been developed by the Ministry of Health in collaboration with a variety of professions and others. Technical guidelines including a handbook for volunteers have been prepared. The goals of these were women aged 30-50 years. Since 2004, Female Cancer Program (FCP) has run this event in 7 provinces. Since 2007, the Ministry of Health in collaboration with the local government has developed a program of breast cancer screening and cervical cancer are integrated in the 10 provinces. This program has been launched by the First Lady of Indonesia as a national program on 21 April 2008. Until the year 2011 the program has been developed in 310 health centers in 84 districts / cities in 17 provinces, namely North Sumatra, West Sumatra, South Sumatra, East Java, Central Java, Yogyakarta, West Java, Jakarta, Bali, Kaimantan West, East Kalimantan , South Kalimantan, South Sulawesi, North Sulawesi, Central Sulawesi, Lampung and Banten.

Early detection and cervical cancer screening was conducted by Visual Inspection Acetic Acid (VIA) and if found positive IVA then do cryotherapy, a single visit method. Consideration IVA method, based on the efficiency, effectiveness and feasibility of the implementation of cervical cancer screening in the entire country, which is generally not affordable anatomic pathology testing facilities. In the urban areas that have / close anatomic pathology testing facilities, most of the people doing the early detection of cervical cancer with a Pap smear.

Early detection of breast cancer using clinical breast examination by trained / Clinical Breast Examination (CBE) and breast self-exam. The event was held at the health center, private practice doctors and midwives, and hospitals. Provider activities are general practitioners and midwives. Mammography is used for further investigation of breast cancer is higher in fasilaitas Health (Hospital).

3) Surveillance and Cancer Registration

Cancer registration began in the 1970s. The first time, conducted a survey of cancer frequency in Semarang in 1970. Then, develop a population-based cancer registration in the city of Semarang until 1989. There are also some hospital-based cancer registry that has the means of anatomical pathology. In 2006, ICF worked with the Association of Anatomical Pathology Indonesia developing cancer registration data based anatomic pathology obtained from 13 hospitals in Indonesia, which has a cancer unit. Dharmais Cancer Hospital, has developed Heroine (Cancer Registration System in Indonesia), but it applies only in Jakarta. In 2007 the Ministry of Health in collaboration with WHO Indonesia to develop a model of cancer registration, hospital-based and population, in Jakarta. For the sake of comprehensiveness valid and cancer data, the activities of hospital-based cancer registry and population need to be conducted continuously. The data will be a source of information to develop and evaluate cancer control programs. These activities need to get support from the relevant parties.

4) Diagnosis and Treatment

At this time various hospitals in Indonesia have the ability to diagnosis and treatment of various types of cancer. Definitive diagnosis of cancer by anatomic pathology examination can be conducted in many laboratories in our country. Cancer surgery and chemotherapy have also been carried out in our hospitals. Indonesia also had 21 radiation centers, with 16 linac, 17 telecobalt, and 45 radiological cancer, which spread across several hospitals that have cancer unit. Of course we still need more complete facilities for diagnosis and treatment of cancer and human resources to deal with cancer in many hospitals, especially outside Java. Improving the quality and quantity of resources and the diagnostic and treatment facilities still need to be improved.

5) Palliative Care

Palliative care is necessary because most patients with cancer (in advanced stages) and thus it is difficult to cure and overcome the symptoms meet the needs of patients and families in the terminal phase is important. At the end of his life, suffering the pain (pain) or other matters need to be addressed. The Ministry of Health has developed guidelines for palliative care in the hospital. Ties that contribute to palliative care in palliative care has been established, but palliative care. To continue to enhance the activities will require both the development of palliative care programs in hospitals and in the community.

Sources: Sub Surveillance and Outbreak Response