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CERVICAL & BREASTCERVICAL & BREASTCANCER SCREENINGCANCER SCREENING
PROGRAMPROGRAM
DIRECTORATE GENERAL OFDIRECTORATE GENERAL OF
DISEASE CONTROL AND ENVIRONMENTAL HEALTHDISEASE CONTROL AND ENVIRONMENTAL HEALTH
MINISTRY OF HEALTH, REPUBLIC OF INDONESIAMINISTRY OF HEALTH, REPUBLIC OF INDONESIA
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Data SIRS 2005Data SIRS 2005--2008200810 JENIS KANKER TERBANYAK DI INDO NESIA TAHUN 2004-2007
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
JENIS KANKER
JUMLAHKASUS
2004
2005
2006
2007
SUMBER : SIRS 2005-2008
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10 Leading Cancers among women in 3110 Leading Cancers among women in 31Hospitals in Jakarta (Cancer Registry) 2005Hospitals in Jakarta (Cancer Registry) 2005
0.00 5.00 10.00 15.00 20.00 25.00 30.00 35.00
Liver Ca
Skin Ca
Lung Ca
Nasopharynx Ca
Thyroid Ca
Colorectal Ca
Leukaemia
Ca Ovarium
Cervix Ca
Breast Ca
TOPO
Percent
32.0
21.5
8.0
6.5
5.0
3.8
3.6
2.7
2.7
2.0
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MOH of RI Organization StructureMOH of RI Organization Structure
DG of Disease
Control & EH
Directorate
VBDC
Directorate of
NCDC
Directorate
of EH
Directorate
of SESPIM
Secretary of DG of DC & EH
SubditCardiovas
Subdit. DM &Other Metabolik
SubditCancer
Subdit.Chronis &
degeneratif
Subdit.Violence &
Injury
Directorate
of DCDC
Ministry of Health
DG of
Public Health
Inspectorate
General
DG ofMedicalServices
Secretary General
DG of
Farmacies&med-supp
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Pilot Project of Cervical & Breast Cancer Screening-- Goal : Increase ccoverage of cervical cancer & breast cancerGoal : Increase ccoverage of cervical cancer & breast cancer
screeningscreening-- Target : woman age 30Target : woman age 30--50 yrs50 yrs-- Coverage target: 80% from target population in 5 yearsCoverage target: 80% from target population in 5 years-- Location : 8 Districts @ 8 Primary Health Center (2008)Location : 8 Districts @ 8 Primary Health Center (2008)
-- Method :Method : single visit approachsingle visit approach with Visual Inspection withwith Visual Inspection withAcetic acid/Acetic acid/VIAVIA & Cryotherapy (for VIA+), and& Cryotherapy (for VIA+), and Clinical BreastClinical BreastExamination/CBE + Breast Self Examination/BSEExamination/CBE + Breast Self Examination/BSE
-- Provider : well trained MD & midwives in PHCProvider : well trained MD & midwives in PHC-- Supervisor: 1. Clinician (Obsgyn & Surgeon)Supervisor: 1. Clinician (Obsgyn & Surgeon)
2. Management: District & Provincial health officer2. Management: District & Provincial health officer
National Program, 21 April 2008
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1)1) Need Assessment in districtsNeed Assessment in districts
2)2) Socialization & advocacy in MoH, provinces,Socialization & advocacy in MoH, provinces,districts, & subd distristrictsdistricts, & subd distristricts
3)3) Training of Trainier for managers of cancerTraining of Trainier for managers of cancer
controlcontrol4)4) Training of Trainers (TOT) for obsgyn, GP, &Training of Trainers (TOT) for obsgyn, GP, &
midwivesmidwives
5)5) Training for providers (GP & midwives)Training for providers (GP & midwives)
6)6) Training for cadresTraining for cadres7)7) Promotion, information, education to peoplePromotion, information, education to people
8)8) ScreeningScreening
9)9) Technical AssistanceTechnical Assistance
10)10)Monitoring & EvaluationMonitoring & Evaluation
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Screening of Cervical & Breast Cancer in
Pilot Projects (8 Districts of 6 Provinces)
2007-2008
% ('08) % % %
1 Deli Serdang 27,597 5,519 4,510 16.34 109 2.42 0 1 0.02
2 Karawang 45,793 9,159 3,698 8.08 103 2.79 16 0.43 31 0.84
3 Kebumen 15,540 3,108 5,692 36.63 205 3.60 11 0.19 23 0.404 Gresik 34,572 6,914 3,394 9.82 221 6.51 2 0.06 24 0.71
5 Gunung Kidul 35,711 7,142 2,176 6.09 106 4.87 4 0.18 28 1.29
6 Gowa 16,846 3,369 1,019 6.05 18 1.77 13 1.28 7 0.69
7 Pekalongan 23,627 4,725 943 3.99 58 6.15 5 0.53 2 0.21
8 Malang 17,425 1,000 467 2.68 32 6.85 4 0.86 - 0.00
TOTAL 217,111 40,937 21,899 10.09 852 3.89 55 0.25 116 0.53
Breast tumorTARGET
1 year
Screened VIA (+)Suspect Ca
CervixNO DISTRICTSTARGET 5
years
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RESULT OF THE SCREENING IN 8
DISTRICTS 2007-2008
Benar
IVA
positif
IVA tnyt
negatif % %
1 DELI SERDANG
2 GOWA 2 0 0 7 3 0
3 KARAWANG 37
4 GUNUNG KIDUL
5 KEBUMEN 84 48 1 0 61
6 GRESIK 98 375 6 4 196 140
7 PEKALONGAN
8 KOTA MALANG
TOTAL 184 423 7 0.028 11 0.044 297 140
Benar
CaCervix
Benar Kanker
Payudara
DILAKUKAN
KOLPOSKOPIKABUPATEN
DIRUJUK KE RSDATA DASAR
Dilakukan
Krioterapi
Follow up
pasca krio
NO
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Source: Max Parkin, IARCSource: Max Parkin, IARC
KEY OF SUCESSFUL PROGRAMKEY OF SUCESSFUL PROGRAM
KeterkaitanDeteksi Dini
dan PengobatanEfektivitas
Pengobatan
KonselingPromosi
& Awareness
CakupanDeteksi Dini
Min 80% WUS
(30-50 TH)
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Thank You