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Fact Sheet of Population-Based Cancer Registry and Cancer Incidence and Mortality in Nepal

by Public Health Update

Population Based Cancer Registry (PBCR)

Nepal Health Research Council (NHRC) published four different reports on Cancer Incidence and Mortality in Rukum Districts in 2018, Cancer Incidence and Mortality in Kathmandu Valley in 2018, Cancer Incidence and Mortality in SSDM Districts in 2018 and Population Based Cancer Registries at Kathmandu, Bhaktapur, Lalitpur, Siraha, Saptari, Dhanusha, Mohattari, West Rukum and East Rukum Districts, Nepal, 2018. According to summary report Nepal Health Research Council (NHRC) has started Population Based Cancer Registry (PBCR) since January 2018. Currently, three PBCRs have been established in 9 districts out of 77
districts of the country. The districts are Kathmandu, Bhaktapur, Lalitpur, Siraha, Saptari, Dhanusha, Mohattari and East and West Rukum.

Related: Quality of Essential Medicines in Public Health Care Facilities of Nepal, 2019

Objective

The objective of the registry is to generate evidence on cancer incidence, patterns and trends and mortality related to cancer in the given territory and defined population, and to enhance national capacity for sustainable PBCR in the country. The registry data are useful to plan cancer control activities as well as to strengthen cancer care services by the government of Nepal.

Study highlights and results

  • The Kathmandu Valley incidence rate is higher for males and lower for females than the GLOBOCAN estimated incidence rate for Nepal, however comparable with many of the urban registries in India.
  • In Rukum registry, cancer incidence rates are lower than the Kathmandu Valley Cancer registry, however it is comparable with other rural registries in India.
  • In Siraha, Saptari, Dhanusha, Mohattari (SSDM) registry, incidence rates are lower compared to the urban and rural registries in Nepal and India.
  • Lungs cancer is high in all the geographical areas of Nepal, the AAR ranging from 2.6 to 23.7 per 100,000.
  • Cervical cancer is high in rural part of Nepal but less in urban region. In urban area breast cancer is higher.
  • Within Kathmandu Valley though lungs cancer is common, the rates of lungs cancer are much higher in Lalitpur and Bhaktapur compared to Kathmandu. Similarly in Bhaktapur district the cancer of mouth and larynx is more common in contrast to other 2 districts.
  • Gallbladder and stomach cancer are found to be common in all the districts among both the sexes. Within the districts, the incidence rate of gallbladder is very high in Bhaktapur and Lalitpur district and comparable to the urban areas of India.
  • In the SSDM the incidence of mouth cancer is the commonest among males which was not found as common in other two registry area in the hill and mountain.
Recommendations from this study
  • Researchers suggest and recommend Ministry of Health and Population (MoHP) to develop the National cancer control strategy which is an urgent and important need of the time.
  • Based on the findings of the PBCR data, intervention programs should be planned and launched in various regions of the country focusing on the special cancer site for that region. Concerned Provincial and local government authority should be engaged in planning and intervention of the programs.
  • Establishment of a separate cancer wing in the MoHP to look after all the issues related to cancer.
  • As Lung cancer is commonest in all the areas of Kathmandu valley, existing awareness program needs to be strengthen to encourage smoking/tobacco cessation. Information Technology (IT) based and community based interventions for “quit tobacco” is a good tool for this.
  • Kathmandu Valley and SSDM PBCR shows Breast cancer as the most common cancer in female, thus government of Nepal as well as concern authority should need to give priority for the breast cancer awareness,screening and early detection to reduce the future burden of breast cancer in Nepal.
  • In SSDM and Rukum, cervical cancer is the commonest in females. Cervical Cancer is one of the Cancer amenable for all level of prevention and is the priority of Nepal Government. Activities like awareness, screening, vaccination, prevention, early detection and treatment to be carried out in a systematic manner to cover the maximum population across the country.
  • Establishment of early detection centers are highly recommended in the semi urban and rural areas like SSDM and Rukum.
  • It is necessary to conduct the risk factors study of the common cancer like Lungs, head and neck, stomach, gallbladder, urinary bladder, colorectal cancer in order to strengthen cancer prevention strategies and activities.
  • Government should need to focus towards digitalization of uniform medical recording system with some mandatory variable in all government and private health facilities. This will help to minimize work duplicate and save both human and financial resources at nation level.
  • Death is one of the vital statistics, which is also linked with human development index of the country, however, collecting death information is quite challenging in Nepal. Thus government should need to give emphasis towards strengthening the death recording system including cause of death.
  • Cancer survival studies to be undertaken. Similarly, it is recommended to do a cross sectional survey in order to check the completeness of registry data especially in the SSDM districts.

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