Bringing cancer screening program at your doorsteps

The team for the comprehensive cervical cancer screening camp in Bumthang in January this year (Photo: MoH)

Some 2,600 people, reportedly infected with H. pylori bacteria, are on treatment

Lhakpa Tshering

With doctors at your doorsteps, the most convenient and fast access nationwide mass screening program for cervical, breast, and gastric cancer under the health flagship is seeing massive turnouts.

Through the screening, some 2,600 people reported having been infected with H. pylori bacteria and were put on treatment. Of the 64 stomach cancers reported till July, eight were early gastric cancer or non-invasive gastric carcinoma.

Over 12,000 endoscopies have been performed since implementing institutional-based screening programs and camps from July 2020 in nine districts currently offering in Punakha.

Punakha district health officer Namgay Dawa said the camp has been receiving good community support. “For instance, if we call 60 people to come for the services in a day, the turnout is some 80 people,” he said. “We had to send them back home telling them to come on the next day.”

“We are targeting to screen over 8,000 people for gastric cancer with over 95 percent coverage of the target population,” he said. “We have completed most of the gewogs and currently it is ongoing in two gewog.”

However, despite awareness programs at all levels, he said, there are still a few people who are not forthcoming to avail themselves of the services. “We aim to have 100 percent coverage of the target population,” he said.

For those who could not make it to the facilities because of various reasons, the dzongkhag is planning for a day-long brush-up camp for each gewog after the completion of the program in all gewogs. 

“We will offer them the second opportunity following the awareness program through local government,” he added. “So we want everyone who has not yet been screened to come forward and avail themselves of the service.”

The ongoing campaign in Punakha, he said, is carried out by a doctor from Thimphu during the weekends and a doctor from Wangdue hospital for two days a week. “With the completion of gastric cancer screening, cervical and breast cancer for women will start together,” he added.

Namgay Dawa said that such programs will benefit in many ways at the national level, society and family. “We can save many lives at the early stage and also, we can cut down the cost of the treatment,” he said.

He said, for instance, if a stomach cancer patient has to be referred abroad, each patient would cost a million at the minimum. “So if this one million is invested for the endoscopies, it will save many lives. Otherwise, it is a heavy cost to the government,” he added.

The program includes mass H. pylori eradication program for all populations aged 18 to 75 years with rapid stool H. pylori antigen test and endoscopy services to aged 40 to 75 years with risk factors for gastric cancer to provide continuum care for cancer through prevention, early detection, and treatment.

Also, it screens all women between the age group of 30 to 65 years for cervical cancer with a human papillomavirus (HPV) test and aged 40 to 65 years with risk factors for breast cancer by mammography clinical breast examination.

Health Minister Dasho Dechen Wangmo said that this is a huge shift in delivering health services. “Now doctors are no longer waiting in the endoscopy room for patients to come. We are actually going and looking for patients and doing endoscopy,” she said.

With excitement, she says, the fundamental healthcare has been changed. “This will benefit our people who have no resources to come to the hospital and poor people who have no connections and also people who are busy taking care of their farms, but yet, they get quality health services,” Lyonpo added.

“Today we are able to take the endoscopy services to the doorsteps that were not even available in the dzongkhag hospital a few years back,” Lyonpo said. “Usually people come to the national referral hospital (JDWNRH) for endoscopy where they have to wait in the line for hours. Now they are waiting in their villages for the endoscopy.”

Meanwhile, health officials say, the cases are expected to increase after the nationwide screening with the access of services at the doorstep. However, they say it would drastically reduce because of the active surveillance after a few years.

The health flagship programs are interventions to address top priority national issues that require multi-sectoral collaboration and coordination in a concerted manner. It focuses on three cancers namely stomach, cervical and breast cancers. 

The program is being implemented through a separate Project Management Unit (PMU) in the Ministry of Health with a budget outlay of Nu 1.109-billion. 

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