This document discusses cancer incidence in Jaffna, Sri Lanka and the need to improve cancer care services there. It finds that breast and cervical cancer have the highest incidence. While a cancer center was begun in Jaffna in 1981, radiation services were not consistently available until 2004. The author calls for building a new comprehensive cancer center in Jaffna to better treat and prevent cancer through multidisciplinary care and early detection programs. Support is needed from foreign organizations to help the region's cancer patients.

1. By Dr.N.Jeyakumaran. MBBS(SL), MD(SL). Teaching Hospital. Jaffna Cancer Incidence In Sri Lanka And The Needs for Improving Cancer Care Services In Jaffna

2. Introduction. Cancer….. Is a major source of disease burden in Sri Lanka. Is the second leading cause for death. Number of cases are expected to increase. Growth of aging population.

3. The pattern of cancer incidence in Sri Lanka is totally different to that of Western countries. Introduction .( cont…) No Set National Screening Programme available in all over Sri Lanka. At present Hospital based Cancer Registry is available. Study of cancer incidence in Sri Lanka will help to set up our own prevention and screening guidelines to control the cancer burden.

4. During 1985 - 1995 Period, cancer cases from Jaffna District would have been missed ! Introduction .( cont…) Jaffna population has been subjected to migration and displacement several times due to the conflict. Therefore actual population is more likely to be lesser than the estimated population.

5. Cancer Incidence 43.5 37 31.5 Females 37.3 34.4 31.8 Males 1995 1990 1985 Incidence : Per 100,000 Population. Year

11. Highest Incidence - Breast Cancer 45 – 49 52.4 65 - 69 35.4 45 - 49 32.3 65 - 69 Incidence Age Group Incidence Age Group Incidence Age Group 1995 1990 1985 Year Age Group - Incidence (per 100,000)

13. Highest Incidence - Cervical Cancer 60.0 65 - 69 51.8 65 - 69 40.8 65 - 69 Incidence Age Group Incidence Age Group Incidence Age Group 1995 1990 1985 Year Age Group - Incidence (per 100,000)

15. Highest Incidence - CA Oropharynx 47.1 70 - 74 33.7 70 - 74 36 70 - 74 Females 109 > 75 104.9 > 75 118.3 70 - 74 Males Incidence Age Group Incidence Age Group Incidence Age Group 1995 1990 1985 Year Age Group - Incidence (per 100,000)

17. Highest Incidence - CA Oesophagus 45.5 65 - 69 33.1 65 - 69 23.6 70 - 74 Females 33.8 > 75 28.6 70 - 74 19.2 70 - 74 Males Incidence Age Group Incidence Age Group Incidence Age Group 1995 1990 1985 Year Age Group - Incidence (per 100,000)

24. Females Males

27. Discussion Data were collected from NCI - Maharagama. Cancer Unit - Kandy. Cancer Unit - Galle. Population Extrapolation. Diagnostic Facilities. Radiology. Pathology. Treatment of Selected Patients.

28. ONCOLOGY UNITS IN SRI LANKA - ONCOLOGY UNIT NCI MAHARAGAMA BADULLA Sri Lanka

29. Cancer Treatment Centre In Northern Region of Sri Lanka.

30. Cancer Treatment in North. 1981 March - Foundation Stone was laid down for a Cancer Centre at Tellipallai. 1983 - A Cobalt Unit was installed. 1983 - Again Source was removed !. Machine - as a museum object. 2004 - 5 : World bank Project!

31. Patients has to travel to NCI Maharagama. By…. Land Route. Land and Sea Route. Again by Land Route. Faced Problems Related to ??????? Earlier…..

32. Year 2000 Onwards….. Only Cancer Clinics….. Oncology registrar’s Visit. Oncology team Visit. Oncology Consultant’s visit. World Health Organization (WHO) Health is a complete state of Physical , Mental and Spiritual well-being and not merely the absence of disease or infirmity.

33. From 14 th of December 2004….. A permanent Consultant Oncologist. An Inward Treatment. Chemotherapy. Pain Management.

34. Present Cancer Ward.

35. From 9 th of June 2004. Radiation Rx. External Beam Radiation. Cobalt Unit.

36. FIRST RADIATION TREATMENT IN TELLIPALLAI CANCER UNIT

37. Clinics in Various places….. TH Jaffna. DH Tellipalai. BH Point Pedro. DH Chavakacheri. PU Chankanai & Karainagar. DH Kilinotchi. From 14th of December 2004(Cont.)

38. Clinics in Various places…..

46. Future Plan….. To have a Multidisciplinary Approach of Treatment. A Land - available at Pannai. To Build a Cancer Ward Complex… Medical Oncology Unit. Radiation Oncology Unit. Surgical Oncology unit.

47. Who has to DO ???????? Foreign Governments. NGO. Other Organizations. Individuals.

48. Pray for quick restoration of Peace in the Political Atmosphere of Sri Lanka! Declare a War Against the cancer!! How Can You Help Us????????? Contribution to… North Lanka Cancer Patients’ Welfare Fund. Support Cancer Prevention and Early Detection Programme. Mammography. Colposcopy. Build Part of New Cancer Ward complex In Jaffna.

49. President and Members of IMHO. Prof N.Suntharalingam. Acknowledgements

50. FIRST RADIATION TREATMENT IN TELLIPALLAI CANCER UNIT CEREMONIAL OPENING OF CANCER UNIT. Thank U