1
HEALTH SERVICES DELIVERY
1.4
DISEASE CONTROL PROGRAMME
1.4.1.g
Non-Communicable Diseases Control:
Cancer Control Programme (as of March 2008)
A
B
C
Focal Point
Implementing Agencies
Target Areas & Beneficiaries
DDG/ LS
National Cancer Control Programme
Especially the Medical Officers of Health Areas,
Plantation Sector, Rural and urban Middle and
Low income population group, Migratory workers.
In general, all the Groups at risk of getting cancers in Sri
Lanka.
Project Summary:
The WHO developed Cancer Control Programs in various countries starting 1980 in order to
reduce Morbidity and Mortality of cancers in the world. National Cancer Control Programme of
Sri Lanka is one such organization developed with the support of the WHO by the Ministry of
Health in Sri Lanka. It works under a Director and has a Field staff including Doctors. One of
the main functions is Surveillance and Monitoring of the disease burden. It maintains a cancer
registry data base of Pathology, Epidemiology and Public Health Related data. Times to time
publications are released from these.
The second aspect of cancer control is primary health care with health education, tobacco
control
within the island, and the Advisory committee on Tobacco control to the MoH monitors these
activities and the director of the National Cancer Control Programme is the Secretary of this
committee, EX - Officio. Other Health Education work is done with the collaboration of Health
Education Bureau, Family Health Bureau, UNFPA, Ministry of Education, Rotary Club and
other
non- government organizations.
Secondary prevention of early detection and screening is carried out for most common
malignancies and Mobile Clinics, Local Health Personnel Training, Development of Health
Care volunteers and Management of Project Based Screening Campaigns are carried out with
the Plantation Health Trust, UNFPA and with other NGOO. Tertiary Care Management and
Palliative Care Planning are done through the advisory committee for cancer control where the
Secretary is the Director, National Cancer Control Programme. Rehabilitation work and hospice
care is promoted through various NGOO. Research and development activities also are
promoted by the NCCP. The following project proposal for the next 06 years will be mainly
centered around the Guide lines by the WHO to increase the Monitoring and Surveillance of
cancer burden in the country by developing the databases in Pathological Diagnosis, Initial
Registration at Treatment, Monitoring of Follow up of cases and Mortality due to cancer.
Health Education Programme will be local area based with the development of local resource
personnel and volunteers. Early detection programmes will center on development of a central
referral screening laboratory and clinics centre. Mobile clinics will be conducted and peripheral
cancer control units will be developed to promote screening facilities.
1.
Justification:
60% of the Cancers prevalent in this country are primarily preventable. Mainly through control
of tobacco usage and prevention of viral infections. E.g.:- Oral and Lung
cancers and Carcinoma of Cervix uteri.
Other major cancers like breast cancer and colonic cancers will be controlled by early detection. The strategies
for these are simple and cost effective while the increased disease burden and the late disease will need a huge
amount of public health sector funds with very low quality results as the out come. The Health Education with
regard to prevention of tobacco usage, healthy life styles and diet patterns, proper hygiene and the regular
monitoring of health status with surveillance of occupational risks will not only result in the control of
cancers but also will give significant benefits in various other disciplines too.
2.
Important Assumptions/Risks/Conditions:
Important Assumptions is that Medical Officers of Health will be available for dissemination of
knowledge and early detection at local peripheral levels.
At present, most of the funds for cancer control are obtained from various projects. To be
sustainable, the flow of required funds should be from a permanent and consolidated source.
3.
Project Objective:
Objective
To increase the knowledge with
regard to prevention of cancers
and increase facilities for early
detection methodology, in order
to reduce the cancer disease
burden
4.
Indicators
 Down staging of
detected Cancers
 Reduction of Smokers
and Tobacco usage in the
country
 No of asymptomatic
clients attending for
Screening
 Increased detection of
pre- malignant lesion
Means of Verification
 The cancer registry
database
 Hospital patients
databases
 Spot surveys and
periodical surveys
 Screening clinic databases
 Pathological registry
database
Project Output/Product:
Outputs
Grass root level health care
workers trained in Cancer
prevention and Screening
Central and provincial screening
clinics and reference laboratory
established
Mobile cancer screening
programmes organized by the
Central Unit as well as the
peripheral organizations
Smoking and Tobacco usage
reduced through public awareness
Indicators
 All Public health staff
trained on awareness of
cancer control
 A functioning central and
provincial screening clinic
and reference laboratory
 Increased early detection
of asymptomatic cancer
patients
Means of Verification
 Staff assessment
reports
 Reduction of smoking
related and tobacco related
 Tobacco sales data,
spot surveys internal
 Work performance of
the central screening clinic
and reference laboratory
 Screening clinic data
and referral data to
treatment centres
and cessation work
5.
cancers and other diseases
Mortality and Morbidity
rates
Related Projects:
Project No.
1
2
6.
Re- Productive Health
UNFPA /
WWC
programme
Country project of Rotary Club of Colombo on Early Detection of Cancers
Relevant Agencies to be Coordinated:





7.
Project Title
Development Programme with
Ministry of Health
Ministry of Education
United Nations Fund for Population activity
Rotary Club of Colombo
Provincial Health Sector Administration
Monitoring & Evaluation:
1. Who?
a National Cancer Control Programme
b. Family Health Bureau
c. Working group on Well Women Clinics
2. When? a. Annual report
b. Periodical Surveys -Quarterly
c. Inspection Visits regularly
d. Database Analysis- routine
3. What actions to be taken based on results of monitoring & evaluation?
a. Re- Assessment and regulate the training for peripheral health staff
b. Increase awareness programmes
c. Using Media Campaigns for promotional work
d. Further training for clinic staff
e. Publications on disease burden status and preventive / preclinical diagnosis
methods
f. News letters to be circulated
g. Health regulations to be formulated and circulated
8.
Activities:
Activities
Expected Results
1
Appoint an advisory committee on
cancer
control and control of
tobacco usage
Health related
policies developed
2
Establishment of Central and
Provincial screening clinic and
reference laboratory
Training of peripheral health workers
Good quality
screening
programme in place
HCWs capable of
3
Process Indicators
Availability of control
measures of tobacco and
facilities for detection of
cancers
Increase number of
early detection
Peripheral Cancer
and volunteers
4
Establish tobacco control, smoking
prevention and cessation units
5
Re-establish cancer registry database
health education and
counselling with
regard to cancers
developed in the
peripheries
Increased awareness
of tobacco hazards
and reduction of
users
Timely updated
publications from the
registry
Control Unit / cells start
functioning
Number of smokers
reduced tobacco removed
from beetle chewing
cessation unit established
Accurate and timely
collection
of required data