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No nat’l database of cancer prepared

Ershad Kamol

No central database of cancer has been maintained in the country so far, which is an essential part of any cancer control programme.
But, the countries which have prepared the population-based cancer registry have achieved success in controlling the problem as the database contains statistics on the cases of cancer in a certain population and provides a framework for controlling cancer and assessing its impact in the family and community, health experts say.
The population-based registry further reflects the understanding that most cancer cases are, directly or indirectly, linked to food habit, lifestyles and environmental factors and thus are preventable, the experts say.
‘Cancer can be controlled through preventive measures and awareness campaigns in one third cases and early diagnosis can cure another 30 per cent cases,’ said, Golam Mohiuddin Faruque, associate professor at the radiotherapy department of Dhaka Medical College.
An estimated 122,000 new cancer cases are diagnosed and over 91,000 patients die every year in Bangladesh, according to the global database on cancer GLOBOCAN12 developed by the International Agency for Research on Cancer, a specialised cancer agency of the World Health Organisation.
The IARC believes the number of people suffering from cancer in Bangladesh could be 12-13 lakh. It came to the conclusion analysing the data of Cancer Registry Report of the National Institute of Cancer Research and Hospital and population-based cancer records in the South Asian region. 
‘Our cancer registry does not give a complete picture of the situation in the country, since it has been developed based on the records of the patients who came to this hospital,’ Dr Md Johirul Islam, an analyst of the department of cancer epidemiology at the National Institute of Cancer Research and Hospital, told New Age.
 Cancer epidemiology department initiated the cancer registry project in 2004 with support from WHO and has published three cancer registry reports since then.
But the department failed to incorporate records from the 20 cancer centres. ‘An Initiative was taken in 2008 to expand hospital-based registry to Bangabandhu Sheikh Mujib Medical University and 14 public medical colleges. Unfortunately, the outcome is not satisfactory so far due to some constraints,’ said Habibullah Talukder, head of the cancer epidemiology department of the NICRH.
Talukder further said that approaching the other possible sources of data also did not work. ‘The local government bodies have no data of death cases and causes of deaths, though death registration is mandatory in the country. Even, the doctors do not go by the guidelines of the International Classification of Diseases’ 10 codes while writing death certificates,’ Talukder said.
Referring to the success achieved in India through prevention programmes, Talukder said, ‘At least three types of common cancer – breast, cervical and oral – can easily be mitigated through preventive and awareness programmes such as community based oncology.’
The health rights activists observe it is not an isolated problem. ‘Although there are a lot of government organisations, we do not have any dependable national-level database on any non-communicable diseases such as cancer, heart disease, and diabetes, to take policy in the interest of public health,’ said professor Mahmudur Rahman, coordinator of Dhaka Community Hospital trust.
‘The government employees are not accountable and the policymakers do not behave responsible,’ professor Rahman added.
The chairman of Health Rights Movement, professor Rashid-e-Mahbub said, ‘The rates of non-communicable diseases are increasing in the country with the increase in the average life expectancy. The health management system must address this fact and function accordingly.’
Additional director general of the Directorate General of Health Services professor Md Abul Kalam Azad, who is line director of management information system, said that the directorate had initiated a project to collect data using the health assistants working in the rural areas.
‘We have also instructed the government hospitals and medical colleges and registered private hospitals to provide data to develop a national registry,’ professor Azad said. 

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