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JOURNAL OF SCIENCE, Hue University, N
0
61, 2010 CANCER CONTROL PROGRAM IN THUA THIEN HUE, VIETNAM,
2008 - 2009
Nguyen Dinh Tung
Oncology Department of Hue Central Hospital
Lecturer of Hue College of Medicine & Pharmacy
SUMMARY
Thua thien Hue is one of three biggest networks for Cancer Control Program in
Vietnam. The first phase of program implementation

was conducted in 2008, providing the
cancer burden and assessement the abilities of the cancer screening in breast and cervix,
improvement the facilities in diagnosis and cancer treatment. Methods: Cancer patients was
registered in 14 hospital in Thua thien Hue from 2008 January to 2009 December.Women of 4
districts was attended the screening program of breast and cervix cancer was taken by study
forms and analysed in SPSS 16.0. The other informations for cancer patients almost was
collected from Hue Central Hospital and Thua thien Hue Health Office. Results: There is 2,641
cancer cases was registered in this province periode 2008, 2009; males 56.94%, females
43.06%. Order Prohibiting

Smoking in public places for tobacco control, improving

the cancer
treatment net, mass media education in television, publishing the discs and brochures for cancer

and mortality in Vietnam.The first phase of program implementation

was conducted in
2008 in six main cities of Vietnam, providing the guidelines for

specifying program
policy, components, implementing guidelines

and timetable.
512
Viet Nam has proposed a National Strategy for Cancer Control up to 2010 and
2020 with the following objectives:
1. Reduce the incidence of tobacco related cancers by 30%, compared to the
year 2000.
2. Ensure HBV vaccination coverage for all newborns.
3. Reduce breast, cervix, mouth and rectum cancers mortality rates.
4. Decrease the proportion of advanced stage cancers from 80 to 50%.
5. Establish a community-based terminal care system for cancer patients and
ensure enough supplies of essential drugs.
Thua Thien Hue is one of province was chosen in performing this program.
The Cancer Control Programme begun in 2008, is an

integrated approach utilizing
primary, secondary and tertiary

prevention in different regions of province at both
hospital

incidence and to provide the public, health professionals and scientists with statistical
information for education and research.
Table

1 and figures 1& 2 shows the age-standardized rate of leading cancers of
this registry in recent years and comparison with the data

from some other registries . 513
Table 3.1. Cancer incidence of Thua Thien Hue 2008, 2009
Years 2008 2009 Total %
Males 745 759 1,504 56.94
Females 573 564 1,137 43.06
Both 1,318 1,323 2,641 100.00
34.8
31.3
24.6
11.5
7.5
6.4
5
4.2
3.9
3.8
0
5
10
15

oral cavity are the most frequent in females. The difference between

the Midle and the
North is in lung cancer (in the North is highest in lung cancer while the Middle is liver
cancer) and the South is in cancer of the cervix: the incidence

of this cancer in the South 514
is almost several times higher than

that in the Middle ( ASR 26 : 5.8). In periode 2008,
2009, the cancer incidence in Thua thien Hue is ASR 173.5 for males and 103.9 for
females. Based on the estimation of the International Agency for Research on Cancer
2008 for Vietnam, the cancer incidence is ASR 154.4 for males and 127.7 for females.
3 2. Cancer Control Activities
3.2.1. Tobacco Control Program
Vietnam is a country with a very high

level of tobacco production and
consumption. The cultivated

surface for tobacco plants was about 24 000 ha

and tobacco
production represented about 2 billion packs of

cigarettes.In a disigned survey, 70%
smokers began before 25 years old and "water pipe"smoking was strongly related to

realistic and
sustainable. Since 2000, this vaccine was included

in the extended program of
immunization for newborns and pupil Hue City. In a report, 75% liver cancer was
living in the rural location of Thua thien Hue, coast and moutain areas.There is over
10,000 pupil was injected for prevention Hepatitis in Thua thien Hue.
3.2.3. Breast Cancer Screening
Implementation of breast cancer screening program has a nationwide anti-breast
cancer

scheme: public information and health education, case finding

and treatment
integrated into the community health structure

and equipped to control breast cancer in a
systematic sustained

manner. There is over 14,000 women in 35 to 60 years old was
attended this program by Breast Selft Examination . The suspected cases was refered to
Hue Central hosptal to confirm diagnosis. There is 5 cases breast cancers among 68
suspected cases in 2008, 2009.
In the observation of 6617 women from 35 to 60 years old for knowledge in
breast cancer and understanding about breast cancer screening, the result as table 2: 515
Table 3.2. Observation the understanding on breast cancer
Question Answer %

a cervix. The interval of Pap smear
testing for each patient

should be recommended by the physician based on risk factors

(e.g. early onset of sexual intercourse, history of multiple

partners, low socioeconomic
status). Patients

at increased risk due to unprotected sexual activity or multiple

partners
should receive appropriate counseling about sexual

practices.

There are 196 has been
high risk for cercical cances including 6 cases was confirmed as cancer .
Lessons learned from successful Papanicolaou cytology cervical cancer
prevention in Thua thien Hue are: IF our ideological commitment is to improve health
outcomes as quicky as possible among many women as possible THEN Papanicolaous
screening services ( with or without HPV/VIA testing services) should be provided
without further delay in any setting where cervical screening is appropriate but
unavailable, with consideration given to HPV vaccination after, rather than before, the
possibility has been excluded that HPV vaccination may be ineffective for cervical
cancer prevention and/or full coverage of target demographic groups by screening
services has been achieved, whichever comes first.
5 Breast cancer 21
6 Digestive Organ 26
7 Lymphoma 07
8 Others 44
Total 273
The National conference on cancer control ,National conference on breast
cancer , Pathology symposium, Radiation symposium, was organized in Thua thien
Hue in the last 2008, 2009. However, the knowledge of general practitioners

on new
concepts in pain relief is still very limited while requirement of palliative care has just
centralised in hospital ( see Table 3). Still

no facility for hospice care exists in Thua
thien Hue as well as Vietnam. Terminal care

for cancer patients still relies on their
family.
The cancer control program in Thua thien Hue is also received support from
Ministry of Health, UICC, IARC in sharring experience, medical staff training and
others.
Hue College of Medicine and Pharmacy is training for medical staffs in the
Middle and Highlands with specialized oncology in general level and level I. 517
Another Activities : Mass media in cancer prevention on television in Hanoi and
Hue( 102 times), vaccination for cervical cancer, publishing document for cancer
prevention ( 152 discs , 40.000 brochures )
4. Conclusions

9. Vietnam Cancer Control :
10. Cancer Control: Knowledge into action, WHO guide for effective programmes: