Chimi Dema

At least one in three cancer cases registered between 2014 and 2018 in the country resulted in death, according to a population based cancer registry report.

A total of 2,744 new cancer cases, 1,205 among men and 1,539 women were registered in the last five years.

The registry report, maintained by Thimphu referral hospital was launched yesterday in the capital coinciding with the 20th observance of World Cancer Day by Bhutan Cancer Society.  

Given the need for reliable data to understand the true burden of cancer in the country as well as to facilitate in developing cancer control strategies and other researches, the population based cancer registry was initiated in 2014 with technical support from Tata Medicine Center in Mumbai, India.

According to the report, stomach cancer is by far the most common cause of cancer deaths in the country. This could be due to advanced stage at diagnosis, the report stated.

In the last five years, the country saw high stomach cancer incidence among men with age-adjusted incidence rate (ARR) of 16.6 per 100,000 men and AAR of 11.7 per 100,000 women.

Paro saw the highest cases of 47 followed by Wangdue which saw 42 cases.

However, esophagus, liver and lung cancers were also found to have contributed to the high death rate among men.

In female, cervix, thyroid, breast and ovary cancers were common besides stomach.

Bhutan has high cervical cancer incidence with AAR of 20.5 per 100,000 women, and mortality rate of 5.3 per 100,000 women.

Between 2014 and 2018, the country saw 313 cervical cancer cases and 82 deaths.

Although the cancer incidence rate is higher in women with the cumulative risk of getting cancer at 11 percent against nine percent among men, cancer deaths were found more in men, the report stated.

Going by the report, the mortality to incidence ratio is 0.4 in males and 0.3 in females.

Among regions, the report found more cases of upper aero-digestive cancers including head, neck and esophagus and stomach cancers in the western districts.

Consumption of betel nut, dried meat and vegetables and butter tea were a few associated risk factors, according to the report.

In the east, cervical and thyroid cancers were found to be common.  Between 2014 and 2018, Trashigang alone saw a total of 32 cases of cervical cancer.  

While risk factors for thyroid cancers were not known, the prevalence of cervical cancer were attributed to poor screening coverage as well low socio-economic factors going by the report.

Meanwhile, southern districts had more lung and breast cancers prevalence. According to the report, smoking habits among the residents was presumed as a risk factor of the cancer.

While the first registry report served its purpose, Principal Investigator of the report and also Gynecologist, Dr Ugyen Tshomo said challenges in establishing and sustaining the registry remain in the absence of separate programme for cancer control and financial resources.

To sustain the registry, Dr Ugyen Tshomo urged the health ministry to take ownership.

In the future, it is expected to publish subsequent reports every two years.

On creating a separate cancer control programme, Health Minister Dechen Wangmo said that the ministry would be able to come up with one within a month.

With the cancer control programme in place, Lyonpo said quality treatment services would be made available for the people.

“I hope that within three years, most of our cancer patients would be able to get quality treatment without having to travel abroad,” Lyonpo said.

She said that the ministry is also working on implementing stomach cancer screening which would be followed by other cancers screening.

Meanwhile, the first phase of the comprehensive cervical cancer screening camp which started in three dzongkhags – Punakha, Bumthang and Mongar since the first week of January this year covered about 7000 women.

While cervical cancer is the number one killer among Bhutanese women, Lyonpo said that it is a disease that can be prevented, treated and cured. “And therefore, not taking bold steps towards elimination of cervical cancer is unacceptable.”

 “We must collectively come together to save our women and girls from dying prematurely from this disease,” she said.

Realising that the system and institution must evolve with epidemiological data, science and with time, Lyonpo said that the government is on the journey to eliminate the cervical cancer.