Dharmais National Cancer Center Indonesia

The role in National Cancer Control Program of Indonesia.

Sutoto MD, MHA

President Director of
Dharmais National Cancer Center Indonesia
Capital city of Indonesia : Jakarta

“Dharmais” National Cancer Center

Indonesia
 THE TEN COMMONEST MALIGNANCY
in "DHARMAIS" NATIONAL CANCER CENTER 1995 - 2004

350

300
Cervical Cancer
Nodal Lymphoma

250 Breast Cancer

Skin Cancer
Colorectal Cancer
200
Ovarial Cancer
NUMBER

Nasopharynx

150
Leukemia
Bronchus and Lung
Soft Tissue Sarcoma
100 Bone Sar coma
Ca Corpus Uteri
Thyroid Gland
50

0
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

YEARS
 The Most Common Malignancy in Male and Female
Dharmais National Cancer Hospital, Jakarta-Indonesia in 1997-1999

Ca. Pharynx 16.43%

Ca. Oral Cavity 2.40 %
Nodule Lymphoma 6.93 % 3.79 % Ca. Pharynx
2.62 % Ca. Thyroid Gland
3.12% Nodule Lymphoma

Ca. Bronchus and Lung 22.56 % 4.46 % Ca. Bronchus and Lung
27.05 % Ca. Breast
Ca. Hepar 4.97 %

Ca. Colorectal 7.55 %

3.96 % Ca. Colorectal

Ca. Prostate Gland 2.84 % 2.62 % Ca. Corpus Uteri

7.25 % Ca. Ovary
27.55 % Ca. Cervix Uteri

Leukemia 5.42 % 2.51 % Leukemia

Ca. Skin 2.58 %

Soft Tissue Sarcoma 3.02 %

Sub Division Cancer Registry

Research and Development
Department
Dharmais National Cancer
Hospital, Jakarta, Indonesia
Data unpublished
 The Most Common Mortality in Male and Female
Dharmais National Cancer Hospital, Jakarta-Indonesia in 1997-1999

Ca. Pharynx 11.66%

Ca. Oral Cavity 2.04 %
3.23 % Ca. Pharynx
Nodule Lymphoma 5.83 % 1.84 % Ca. Oral Cavity

Ca. Bronchus and Lung 29.74 % 2.07 % Ca. Thyroid Gland

3.00 % Nodule Lymphoma
8.53 % Ca. Bronchus and Lung
Ca. Hepar 7.87 % 27.42 % Ca. Breast
Ca. Pancreas 3.79 %
Ca. Stomach 3.21 %
Ca. Colorectal 8.45 % 4.38 % Ca. Colorectal

Ca. Prostate Gland 2.33 % 9.68 % Ca. Ovary

18.20 % Ca. Cervix Uteri

Leukemia 6.41 % 4.38 % Leukemia

Sub Division Cancer Registry

Research and Development
Department
Dharmais National Cancer Hospital,
Jakarta, Indonesia
Data unpublished
Site Specific Cancer Registry
(Breast Cancer)
in Dharmais NCC-Indonesia

Dharmais Hospital based Cancer Registry.

Department of Research and Development
 Breast Cancer by Age Group per year
in Dharmais NCC-Indonesia.

100

80
Frequency

60

40

20

0
15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94
Age Group

2000 2001 2002 2003 2004 2005 2006 2007

 Stage - No Stage in Bre ast Cancer Cases in 1993-1996
54.7%

know n

45.3% unknown

Stage of Ca.Mammae cases

in Dharmais Hospital 1993-1996

47.2%
50%
40% 32.0%
30%
18.4%
%

20%
10% 2.5%
0%
stage 1 stage 2 stage 3 stage 4

Stage
 Stage by Status 1993-1996

80%
67.52%
70% 59.04%
60%
% 50%
40%
23.08%
30%
15.64% 15.05%
20% 8.98% 5.98%
3.42%
10% 0.00% 1.28%
0%
Stage 1 Stage 2 Stage 3 Stage 4 Unknown

Stage
Dead Alive

Mortality Rate of The 10 Comm ones t Malignancy

in 1994-1998 in Dharm ais Cancer Centre
Jakarta, Indonesia

Cerv ix

Rectum

Lymphoma
Topography

Nasopharynx

Ovarium
% Dead
Breast % Alive

Colon

Leukemia

Hepar

Bronchus and Lung

0.00% 20.00% 40.00% 60.00% 80.00% 100.00%

Percent
 Breast Cancer Early Detection in
1000 Dharmais Hospital
936 2001 -2005

800
627

600
400
198
200 84
1 69 62 4
Courtesy 13 4 7 0
Kardinah, SpRad
0 US Mam mo Mamm o+US

BIRADS 1 627 936 69

BIRADS 2 198 84 62
BIRADS 3 0 3 1
BIRADS 4 1 4 4
BIRADS 5 7 33 1
0thers 13 7 0
 Implementation Screening Mammography in Jakarta
‘Modified’ screening
• Primary health care • The goal : Early detection
awareness promotion: nurses (tumor less than 3 cm/Stage II)
/ midwives • Identified High risk
• Risk Factors population
• Familial cancer : pedigree • Introducing Familial cancer
• Education : CBE and BSE • Promote Awareness
• Ultrasound Examination : cyst • To build easy access to care
or solid lesion
• Mammography (mobile unit)
• Referral system

Courtesy Kardinah, SpRad

 EDU : Early Detection Unit
YKPJ: Jakarta Breast Health Foundation

Result Value in percentage

100 97.4
90 91.5
87.7
80 KECAMATAN KOJA – JAKARTA UTARA
74.2
70
60
Normal
50 Cyst
40 Malignant
30
20
9.9
10 4.4 3.5
3.5
0.9 0.9 1.5
0 0
YKPJ US EDU US YKPJ Mamo EDU Mamo

Profile
Population : 592.586
Male : 308.957
Female : 283.626
Primary Health Care : 6 Units
Courtesy Kardinah, SpRad
Terima Kasih
Thank You