Early detection of cancer

Breast and cervical cancer are the most common cancers affecting Filipino women. They are highly amenable to early detection and cure, but women continue to die prematurely from these diseases.

Delaying screening and early detection programs is a substantial social and economic burden on individuals, families and the whole society. Effective screening programs drastically improve survival rates for women affected by breast or cervical cancer.

Cancer registration is necessary for cancer control, because knowledge of the country’s particular cancer situation and patterns is needed to make informed decisions on the targeted interventions to reduce incidence and death. High-quality population-based cancer registries at the national level are the ideal standard for cancer registration.

The National Integrated Cancer Control Act (NICCA) mandates the establishment of a national population-based cancer registry that covers all forms of cancer among adults and children and serve as a guide for the NICCA Council in policy development. This registry will collect data on all new cases of cancer by geographical region to provide a framework for assessing and controlling the impact of cancer on the community. Cancer registries will form part of the Electronic Medical Record requirement of the Department of Health (DoH), and must comply with the Data Privacy Act.

NICCA contains a comprehensive set of provisions that aims to enhance cancer screening, treatment and survivorship, especially for underprivileged and poor Filipinos. As the country observes National Cancer Awareness Month, the development of a national registry can help ensure the law’s full and effective implementation.

Like in the Philippines, breast and cervical cancer impose a heavy disease burden in many countries in the Americas, where cancer is the second leading cause of death. Each year, 400,000 women in the Americas are diagnosed with breast and cervical cancer, and 92,000 die from breast cancer and 36,000 from cervical cancer, according to the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA).

The IFPMA earlier formed a three-year partnership with the Pan American Health Organization (PAHO) Foundation to increase awareness of breast and cervical cancer and improve screening and earlier detection services. Initiatives under this partnership eventually helped build a cancer registry that saved lives.

There was great progress in three main areas in the first year of the partnership. The partnership produced a number of educational materials for the public on breast and cervical cancer prevention, detection and treatment to raise disease awareness and encourage women to go for screening and early detection services.

A pilot project with the Ministry of Health in Chile was implemented to strengthen national cervical cancer screening programs, as well as a series of policy workshops with government officials and health experts. Finally, a cancer registry training was held in 11 countries, in collaboration with the International Agency for Research on Cancer.

Health information, education and communication activities were developed to raise public awareness and to support an informed, empowered community of women.  A toolkit with educational messages on HPV, HPV vaccination, cervical cancer screening and treatment was also created and disseminated throughout the region. Spanish language guidelines for program managers and health professionals on how to design and deliver programs for comprehensive cervical cancer prevention and control were shared with the Ministries of Health in Latin America. English language guidelines have also been disseminated.

The partnership also offered healthcare provider training to strengthen the national cervical cancer screening program, focusing on HPV test-based strategies to improve screening coverage and pre-cancer treatment rates. The program likewise disseminated evidence on breast cancer screening and early detection, and trained providers at the primary healthcare level on the early signs and symptoms of breast cancer.

Training for primary health providers on visual inspection using acetic acid took place as well as a pilot screening program using HPV DNA testing for cervical cancer.

All these best practices can help inspire activities in the Philippines as both the national and local governments work on the implementation of the cancer law in communities. These efforts will be more successful if conducted in partnership with patients, the medical community and private sector.

Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines, which represents the biopharmaceutical medicine and vaccine industry in the country. Its members are in the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.