Académique Documents
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Current Situation
Evlina Suzanna,MD
Coordinator Collecting and Data Analysis of Indonesia
National Cancer Registry. Department of Health
Number of Population and Province in
Indonesia.
(Sensus 2005)
33 Provinces
218.086.288 Population
M : 109.613.519
F : 108.472.769
Number
10,000,000
15,000,000
20,000,000
25,000,000
5,000,000
0
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Provinces
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Distribution of Population in Indonesia
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History of Cancer Registry In Indonesia
2006 Hospital Based Cancer Registry in
Jakarta as a model à Population Based
Cancer Registry.
Semarang, 1970
KLATEN,1998
The 10 Commonest Malignancy in Semarang,
1990 -1999.
Female Male
Topo
Skin 4.6 Nasopharyx 3.78
Unknown 3.26 Skin 3.62
Corpus Uteri 3.01 Lymphoma 3.62
Lymphoma 2.67
Unknown 2.82
Thyroid 2.05
Thyroid 1.18
0 5 10 15 20 25
0 2 4 6 8 10 12 14 16
ASR ASR
Prof Sarjadi,MD.
Pathologist.
1988 IAP Indonesia,
13 Centers Diagnostic of Pathology
1. Medan.
2. Padang
13 Manado
3.Palembang
4. Jakarta
5. Bandung
12 Makassar
6. Surakarta
7. Yogjakarta
8. Semarang 11 Bali
9. Surabaya
10. Malang
The 10 commonest cancer in Indonesia
13 Centers of Pathology 1990 – 1999.
4500
4000
Cervical cancer
3500 Breast cancer
Skin cancer
3000
NPC
2500 Ovarial cancer
Lymphoma malignum
2000
Rectal carcinoma
1500 Thyroid carcinoma
STSs
1000
Colon carcinoma
500
0
1990 1991 1992 1993 1994
The 10 Commonest Cancer in Indonesia
13 Centers of Pathology 1990 – 1999.
4500
4000
Cervical cancer
3500 Breast cancer
Skin cancer
3000
NPC
2500 Ovarial cancer
0
1995 1996 1997 1998 1999
THE TEN COMMONEST MALIGNANCY
in "DHARMAIS" NATIONAL CANCER CENTER 1995 - 2004
350
300
Cervical Cancer
Nodal Lymphoma
Nasopharynx
Leukemia
150
Bronchus and Lung
Soft Tissue Sarcoma
100 Bone Sar coma
Ca Corpus Uteri
Thyroid Gland
50
0
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
YEARS
GLOBAL DEATHS BY CAUSE, ALL AGES 2005
17.528.000
CARDIO-
VASCULAR
DISEASES
7.586.000
CANCER 4.057.000
2.830.000
1.607.000
883.000 CHRONIC
RESPIRATORY 1.125.000
HIV/AIDS TUBER- DISEASE
30
25
20
15
10
0
Inf & Par Sirkulasi Pernapasan Sal. Cerna Neoplasma Kecelakaan Perinatal
CLINICS
LABORATORIES
VITAL STATISTICS
DEATH CERTIFICATES
HOSPITAL
Case 61
PB
case 1 Hospital 1
HB1
Hospital 2
case 2
HB2
Hospital 6
case 6 HB6
Hospital 4
case 4
case 5 HB4 Hospital 3
HB3
Hospital 5
Case 3
HB5
Hospital n.. Case 31
Case n.. Hb n...
Case51
PB = case 1-6, n.. PB= population-based
HB3= case 3, 31 HB= hospital-based
Cancer Incidence in Indonesia
New cases of cancer
As
Absolute numbers
Proportion (percent) of total
Rate per (100.000) population at risk, per (year)
?
?
? ?
? ?
Measuring the Burden of cancer
in Indonesia
• Incidence
• Mortality
• Person-years of life lost (PYLL)
• Quality adjusted life years (Lost) (QALYs).
• Disability adjusted life years (Lost) (DALYs)
• Survival
• Prevalence
MOH of RI Organization Structure, 2006
Ministry of Health
Secretary General
DG of DG of DG of Disease DG of Inspectorate
Medical Pharmacies Public Health General
Control & EH
Services & med-supp
Secretary of DG of DC & EH
DIREKTUR DEWAN
UTAMA PENGAWAS SATUAN
PEMERIKSA
INTERN
KOMITE
KOMITE DIREKTUR
ETIK DAN DIREKTUR DIREKTUR
MEDIK HUKUM MEDIK DAN KEPERAWATAN SUMBER DAYA MANUSIA KEUANGAN
DIREKTUR
DAN PENDIDIKAN UMUM DAN OPERASIONAL
SUBBAGIAN SUBBAGI AN
SEKSI SUB BAGIAN SUB BAGIAN SUBBAGIAN SUBBAGIAN AKUNTANSI SUBBAGI AN SUBBAGIAN
SEKSI SEKSI SUB BAGIAN PENGEMBANGAN
CATATAN MEDIK ADM.INISTRASI PENGELOLAAN
PENYUSUNAN PERBENDAHARAAN KEUANGAN TATA USAHA PROMOSI
PELAYANAN -MED RAWAT JALAN PENELITIAN ANGGARAN SIM RS
KEPEGAWAI AN DIKLAT
MENTERI KESEHATAN,
Office space/
archives With special permit/restricted room.
11,370,615 5- 10,739,089
9,983,140 0- 9,608,600
-12,000, 0 2,000,000 4,000,000 6,000,000 8,000,000 10,000,00 12,000,00
12 -10,000,
10 -8,000,0
8 -6,000,0
6 -4,000,0
4 -2,000,0
2 0
0 0 2 4 6 8 10 12
000 000 00 00 00 00 0 0
366,009 5- 350,138
364,057 0- 350,508
-600,00 -500,00 -400,00 -300,00 -200,00 -100,000 0 0 100,000 200,000 300,000 400,000 500,000 600,000
600 500 400 300 200 100 0 0 100 200 300 400 500 600
0 0 0 0 0
9,000,000
8,000,000
7,000,000
6,000,000
5,000,000 Male
Number Female
4,000,000
Total
3,000,000
2,000,000
1,000,000
0
Jakarta Centrl East West North South
Region
Mortality in Jakarta in 2006
Cancer Mortality Among Total Death
in Jakarta in 2006 ( 4 Hospitals)
40 Hospitals in Jakarta Cancer Registry as a Model
National Cancer Registry PM.01.02/V/530/07
RSUPN Cipto Mangunkusumo RS ATMAJAYA
RSAL Mitoharjo RS Gading Pluit
RSPAD Gatot Subroto( Reg of Central) RS Fatmawati (Regional of South)
RSIslam Jakarta RS MMC
RS Tria Dipa RS Medistra
RS Carolus RS Pondok Indah
RS Keramat 128 RS Tebet
RS Husada RS Jakarta
RSB Budi Kemuliaan RS Pusat Pertamina
RS PGI Cikini RS Persahabatan (Regional of East)
RSK Dharmais (NCCPs), (Reg of West) RS POLRI Pusat
RSK RS Cengkareng RS Budi ASIH
RS Tarakan RS UKI
RSAB HarKit (Childhood Cancer Reg) RS Mitra International
RS Pluit RS Haji Jakarta
RS Sumber waras RS Dharma Nugraha
RS Pelni Petamburan RS Omni Medical center
RS Koja (Regional of North) RS Islam Jakarta Timur
RS Pantai Indah Kapuk RS Pasar Rebo
RS Mitra Klp Gading RS Sumber Waras
Cancer Registry Activities in 40 Hospitals
in Jakarta
RS Fatmawati (South Regional ) RSUPN Cipto Mangunkusumo
RS Pasar Rebo
REG RS Fatmawati
Dharmais NCC
REG RS Bone
RS Makassar
REG REG RS Bulu
Kumba
Monitoring
Evaluation Monitoring and Facilitate
Dissemination of Information
(2008- 2010)
Job Description
National Cancer Registry
Central National Cancer Data
“Dharmais” Data Collecting and Analysis
NCC Verify and Validate
Regional Cancer Data
Regional Data collecting and verify
Hospitals from Municipal govern and Private hospt
National/Regional Budget
Funding
WHO
Cancer Registry Software
No
New cancer patient New primary
New cancer patient
No
Check previous Yes
notification Yes Request notification or information Yes
from related persons
40
35
30 Hospital
Cancer Team Work
25
Number
Brainw are
20 Hardw are
Softw are
15
Room/office
10
0
Cntrl Jkt West Jkt East Jkt Sout h Jkt Nort h Jkt Tot al
Hospt
Area
Result in 12 Months
4600
4400
4200
Number
4000
3800
3600
3400
Verify1 Verify2 Verify3 Verify4
Activities
% Histology Verification, 2005
80
70
60
50
Percent
40
30
20
10
0
Clin Rad Surg Lab Cyt Hist MV Autop Unk
Only Metas
Basic Diagnosis
The Ten Commonest Malignancy in Female
in 31 Hospitals in Jakarta, 2005
Breast Ca
Cervix Ca
Ca Ovarium
Leukaemia
TOPO
Colorectal Ca
Thyroid Ca
Nasopharynx Ca
Lung Ca
Skin Ca
Liver Ca
Lymphoma 6.90
Prostate Ca 6.00
Liver Ca 4.70
Skin Ca 2.90
Brain Ca 2.60
Gaster Ca 2.00
5000
4900
4800
4700
4600
Number
4500
4400
4300
4200
4100
4000
Total Cases Enrty Data Verified Analysis
Data
The Ten Commonest Malignancy in Female
in 24 Hospitals, 2006
Breast 34.48
Cervix 16.13
Leukemia 5.99
Ovarium 5.11
Thyroid 3.39
Topo
Lymphoma 3.02
Nasopharynx 2.6
Lung 2.26
Skin 2.14
Colorectal 2.14
0 5 10 15 20 25 30 35 40
Percent
The Ten Commonest Malignancy in Male
in 24 Hospitals, 2006
Leukemia 13.91
Nasopharynx 12
Lung 11.67
Lymphoma 5.92
Tongue 5.36
Topo
Colorectal 5.28
Prostate 3.28
Mediastinum 3.28
Brain 3.12
Skin 2.8
0 2 4 6 8 10 12 14 16
Percent
Challenges and Obstacles
Fundamental Sustainability
development Strengthening
National Cancer Control Programmes
Environment
Conductor Impact :
Diet & Cancer
Program
Risk Factor
food
Hormonal
Colaborate with
Physical Activity • Professional Organization
• Indonesia Cancer Foundation
Behavior
• Board committee of NCCPs
Occupation • University Society network
Genetic/Screening • Others Foundation
MORBIDITY
Tobacco Control MORTALITY
Policy of NCCPs
Ca Patients
Vaccination
WHO 1982
1982,, “Do not put years but life into years “
THANK YOU