Philippine Cervical Cancer Prevention and Control Program

1. Philippine Cervical Cancer Prevention and Control Program MS. REMEDIOS V. NIOLA National Center for Disease Prevention & Control Department of Health

2. THE SITUATION • Cervical Cancer is one of the major public health problems in the Philippines • Cases and deaths accounted for about 4,812 and 1,984 (2010 Cancer Facts & Estimates) • Incidence rate starts rising steeply at age 30 • National incidence rate of 11.7 per and mortality rate of 5.3 per 100,000 - One out of 100 women would have died from cervical cancer before age 75.

3. THE SITUATION

4. THE SITUATION

5. THE SITUATION

6. THE SITUATION

7. Vision, Mission and Goal Vision : Improve quality of life for all Filipino women Mission : To provide quality, effective and accessible services for the prevention and control of cervical cancer Goal: Reduce morbidity and mortality due to cervical cancer

8. Objectives 1. To reduce the exposure of population to risk related factors primarily smoking, unhealthy diet, physical inactivity, and HPV infection through multiple sexual partners, early sex and others. 2. To increase the number of patient given appropriate screening, diagnosis and treatment 3. To increase the number of patient given appropriate pain relief and support care services with cervical cancer

9. Strategies • Promotion of Healthy Lifestyle including HPV Vaccination • Improve screening/diagnosis • Improve treatment • Improve Rehabilitation and Palliative care • Strengthen Cervical Cancer Registry

10. Accomplishments Policy, Guidelines Formulation • AO 89-A s, 1990 creation of Phil Cancer Control Program dated Apr 18, 1990 • AO #3-B s, 1997 – DOH Guidelines on Papanicolaou Smear Procedure dated March 18, 1997 • AO # 19-A s, 1998-National Policy on Cyto-Screening in the Cervical Cancer Control Program, designating Med.Tech as cyto-screeners • AO 2005-0006 Establishment of a Cervical Cancer Screening Program dated Feb 10,2005 • Dept Memo #0126,2009,DM # 0077, 2010, DM # 0128, 2011 on Free Cervical Cancer Screening in DOH Hosp

11. Accomplishments • Service Delivery • Free Cervical Cancer Screening in 58 DOH Hospitals • Some local government units and district hospitals provide cervical cancer screening services

12. Accomplishments • Program Management • - Created a multi-agency technical working group for the program - UNFPA - World Health Organization - Womens Health Project II - Phil Health Insurance Corporation - Society of Gynecologic Oncologists of the Phils - Phil Obstetric and Gynecologic Society - Merck Sharp & Dohme - National Center for Pharmaceutical Access & Mgmt - Cervical Cancer Prevention Network Program - Philippine Charity Sweepstake Office - National Center for Health Promotion - Food & Drug Administration - Bureau of Health Devices & Technology - Dangerous Drug Abuse Prevention & Treatment Program - national Center for Health Facilities and Development - National Epidemiology Center - Bureau of International Health Coopertion - UP-NIH - Phil. Medical Oncology Society - Phil. Pediatric Society - National Hospice & Palliative Care Council of the Phils. - Phil. Cancer Society - Carewell

13. Accomplishments • Capacity Building • Drafted Training Module on Cervical Cancer Prevention and Control • Conducted Orientation/training of health workers on the conduct of Free Cervical Cancer Screening in regional hospitals • Conducted orientation training on Integrated NCD Registry (includes cancer registry) in pilot hospitals • Awareness Campaigns/Advocacy • Use tri-media for advocacy • and information campaign • - Fora on cervical cancer prevention • - Building partnerships

14. Accomplishments • Health Information System - Established Hospital-Based NCD/Cancer Registry • - Provided support to Phil. Cancer Society for Strengthening Population-Based Cancer Registry • Procurement & Provision of Supplies - Developed and Issued Guidelines on the Distribution of supplies for VIA

15. Issues and Challenges • Lack of funds for the sustainability of the Cervical Cancer Prevention & Control of Program and introducing HPV vaccination • Lack of supplies & equipment for screening, diagnostic &treatment of cervical cancer (i.e. 7 units of cryo therapy and colposcopy available in 22% of tertiary hospitals; 11% of hospitals had treatment facilities) • Lack of pathologist in hospitals (available in 45% of hospitals) • Lack of cytology technician (available in 21% of hospitals) • Health workers at RHUs have no proper training on cervical cancer screening • Scale-up of population-based and hospital-based Cancer Registries

16. Next Steps • Intensify advocacy and information campaign and promotion of healthy lifestyle - Yearly Celebration of Cervical Cancer Awareness Month • Continue Tri-Media campaigns and development of appropriate IEC Materials • Improve Cervical Cancer Screening, Diagnosis and Treatment • - Finalization of training Module on Cervical Cancer Prevention and Control • - Provision of Supplies & equipment • - Development of Updated Clinical Practice Guidelines to include HPV Vaccination

17. Next Steps • Strengthen capability building - Training of HW and Regional Hospitals on Cervical Cancer Prevention and Control among HWs - Cascading of training to province/city/municipality • Strengthen Health Information System • Scale up of cancer registries • Institute monitoring program implementation

18. Next Steps • Plan for possible introduction HPV Vaccination - Plan and secure funds for the introduction of HPV vaccination • Develop guidelines on HPV Vaccination: targets age-group, immunization strategy, scope of implementation, training of vaccinators, vaccine management, delivery and cold chain system • Explore inclusion to the Phil. Health Insurance package

19. THANK YOU!!