Cancer Awareness Should Still be Needed in Community

Cancer, according to medical professionals, is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body.

It can start almost anywhere in the human body which is made up of trillions of cells! Normally, human cells grow and multiply through a process called cell division to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.

There are about 100 types of cancer, which include bladder cancer, breast cancer, colorectal, kidney cancer, lung cancer-non-small cell, lymphoma (non-Hodgkin), melanoma and oral and oropharyngeal cancer just to mention a few of them.

Cancer, according to medical experts, can cause many symptoms, but those symptoms are most often caused by illness, injury, benign tumour or other problems.

A person who suffers from the disease can experience bladder changes, bleeding or bruising for no reason, bowel changes, cough or hoarseness that does not go away, eating problems, thickening or lump in the breast or elsewhere, indigestion or difficulty in swallowing and obvious change in a wart or mole, to mention a few.

Cancer as one of the non-communicable diseases (NCDs) is a global health issue with its burden projected to increase in least developing countries. Its mortality rate is estimated to increase by over 70 per cent worldwide by 2050, where the most diagnosed cancer types are breast, lung, colorectal, stomach, colon and prostate cancers.

According to the World Health Organisation (WHO), cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020, or nearly one in six deaths.

According to WHO, around one-third of deaths from cancer are due to tobacco use, high body mass index, alcohol consumption, low fruit and vegetable intake and lack of physical activity. It causes infections such as human papillomavirus (HPV) and hepatitis, which are responsible for approximately 30 per cent of cancer cases in low- and lower-middle-income countries.

According to cancer doctors, many cancers can be cured if detected early and treated effectively, so there is a paramount need for people to go for medical checkup at least once a year. In 2018, according to the researchers’ findings, cancer incidences in Africa were estimated to be 5.8 per cent while the mortality rate was estimated at 2.7.

For Tanzania, according to the available official data, the country is experiencing rising cancer incidences and mortality and is increasing the number of cancer treatment centres. Cancer is ranked in the top three of the NCDs in the country and falls among the top ten diseases, where its health behaviour is challenging.

Owing to that, the Aga Khan Health Service Tanzania through the Tanzania Comprehensive Cancer Project (TCCP) in April last year conducted a baseline survey to assess the current capacity of 58(Dar es Salaam 30, Mwanza 28) selected implementing health facilities to collect, report quality data in District Health Information system (DHI2) and use for decision making.

Another objective, according to TTCP Project Manager Dr Harrison Chuwa, was to strengthen the capacity of health care providers to collect, report in DHIS2 and use quality cancer data, determine data quality status in health facilities, develop recommendations for improving cancer indicators and interventions,

“Another objective was to assess data collection and management systems at health facility level to meet the data quality main standards which are accuracy and reliability”,

he explained, adding that the survey was basically conducted in two regions of Mwanza and Dar es Salaam on baseline knowledge, attitude and practice survey on cancer among community members and health providers.

According to Dr Chuwa, another aim of conducting a survey of those three areas which was submitted recently at a stakeholders’ meeting in Mwanza city was to determine the level of knowledge, attitude and practice among community and health providers in Dar es Salaam and Mwanza regions.

“The aim was to assess the knowledge and attitude towards cancer related issues among adult men and women at community level”,

he said, adding that another objective was to identify knowledge gaps, cultural beliefs or behavioural patterns and practices that create barriers to utilisation of cancer services in the country.

Another objective for the qualitative gender assessment was to understand key gender barriers related to women and men’s access and use of cancer care to inform the underlying key gender barriers and root causes in relation to women, youths and men to access and use cancer services in Mwanza and Dar es Salaam.

Presenting the result of the baseline knowledge survey, attitude and practice survey on cancer among community members and health providers for Mwanza and Dar es Salaam regions, on behalf of Praxis (For Health and Development) during the data dissemination meeting in Mwanza city recently, Ms Eveline Mcharo said health seeking behaviour for cancer in the country is challenging, with over 80 per cent of cancer cases diagnosed at advanced stages.

Dr Mcharo said during the survey those who were interviewed, over 50 per cent (622) of the community respondents were female and 44.2 per cent (492) were male at the mean age of 38.8 years, with the majority 58.1 per cent being young adults of the age below 30 years, equal to 32.5 percent and between 30 and 39 years (25.6 per cent).

Others interviewed were the middle aged people (40- 59) who constituted 29.2 per cent while the ones above 60 years made up 12.8 per cent of the study participants.

On community awareness on cancer and cancer care services, she said over 90 per cent of people interviewed had heard about cancer and the majority (75 per cent) were aware of breast cancer (73.1 per cent), cervical cancer (58.2 per cent) and esophageal cancer (26.4 per cent).

According to her, the less known cancer was prostate, liver, lymphoma, lung and blood cancers (leukemia) although they are also common in the country.

Presenting his research findings on TCCP baseline survey findings on the same meeting, the TCCP Consultant Prof Twalib Ngoma said the survey was conducted in ninety-nine (99) out of 100 TCCP facilities in Dar es Salaam and Mwanza regions.

One TCCP facility in Mwanza was not surveyed due to logistical reasons and the total number of participants interviewed was 450, 270 females and 180 males.

He said they found that there is no reliable local data on cancer due to lack of population-based cancer registry, cancer related services are not available in dispensaries, health centres and district hospitals.

In his recommendation, Prof Ngoma said cancer control in the country should have strong national leadership and coordination structures and public private partnership should be encouraged by creating an enabling environment.

“Cancer centres should be given incentives to develop outreach services and collaborations with health facilities in the regions and districts”,

he said, adding that establishment of population-based cancer registries should be given top priority while the National Cancer Control Strategy and Action Plans should be visible in the National Health Plan and national five years development plans. Prof Ngoma who is also the Muhimbili University of Health and Allied Science (MUHAs) Lecturer said sustainable approaches of cancer information dissemination and social mobilisation should be developed to disseminate correct cancer information.

“Lessons learned from other programmes like HIV should be implemented,”

he said, adding that community awareness and education programmes on cancers should be conducted in health facilities.

He said messages that reinforce the need to avoid common risk practices such as multiple sex partners and insertion of herbs in the vagina for sexual pleasure should be broadcasted in the media.

He clarified that more social workers and community health professionals should be trained so that they can conduct cancer information, education and social mobilisation.

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