New patient registrations at cancer treatment centres have risen during the past 10 years. While cancer detection has increased due to the wide spread of information, doctors warn that modern lifestyles are also significantly contributing to this increase.
The rise in cancer is not unique to Sri Lanka, explained National Cancer Control Programme (NCCP) Strategic Information and Management Unit Head Dr. Suraj Perera.
Growing awareness among the public on cancer has increased detection, according to Dr. Perera. “Tomorrow’s cancers are being detected today.”
He said that as people’s awareness increased, they tended to opt for more self-testing than they did before, which resulted in early detection. However, he also cited the increase in population ageing as a reason for the increase in cancer cases.
According to the ‘Cancer Incidence and Mortality Data’ report from 2021, 103 patients are diagnosed with cancer each day. The 2022 report is to be released in the near future, Dr. Perera said.
The new patient registration numbers from Government cancer treatment centres in 2024 amounts to 40,421, marking yet another step in a steady increase seen since 2008. For 2023, this number was 39,115. However, it is to be noted these numbers include duplicates, where some patients may have registered at more than one centre.
The most prominent cancers among men are oral, lung, colorectal, oesophageal, and prostate cancers, while leading cancers among women are breast, thyroid, colon, ovarian, and cervical cancers.
Impact of lifestyle
Sri Lanka Medical Association (SLMA) President Dr. Surantha Perera pointed to the lifestyles of today that were outside of the circadian rhythm or the body’s biological clock, noting that these patterns were contributing towards cancer and other Non-Communicable Diseases (NCDs).
“In the evening we are supposed to slow down and from midnight to 6 a.m. our bodies are purified; even abnormal cells are fought against at this time,” he said.
Stressful patterns in a fast-paced life, such as resorting to eating from outside instead of cooking meals at home, irregular sleep, and oral gratification through tasty meals when one is pressed for time contribute to many NCDs, including cancer.
Environmental causes of cancer include those such as pollution, water contamination, pesticide use, and the use of microplastics.
“This is a planetary health problem. When the planet is sick we are sick,” Dr. Perera said.
Cancer control
Cancer control is practised under various domains. The first domain is primary prevention, which is done alongside efforts at preventing all NCDs such as diabetes and hypertension or high blood pressure.
Warning messaging on cigarette packets and school immunisation programmes against hepatitis B and human papillomavirus (HPV) are also parts of prevention care.
While the hepatitis B vaccination intends to prevent cirrhosis while also providing protection against hepatic (liver) cancer, HPV immunisation is against a virus that can cause cervical cancer.
In order to support the prevention of the occurrence of NCDs including cancer, the NCCP’s Dr. Perera said that 1,000 healthy lifestyle centres had been established islandwide. While noting that these centres were also meant to support people to break away from unhealthy habits, he said there was not a significant participation in them.
However, according to him, with the prohibition of public smoking, the tendency to smoke indoors has increased, exposing non-smokers such as family members, including children, to these toxic fumes.
Early detection, the second domain, is also carried out through these clinics where cases are noted. They are subjected to confirmatory tests and if a positive diagnosis is made, early treatment is initiated.
“There are more than 1,000 Well-Woman Clinics where self-examination is taught in order to identify suspicious breast lumps. In addition, grassroots healthcare providers also conduct pap smears to detect cervical cancer.
“In addition, five cancer early detection centres with walk-in clinics and 25 breast clinics with consultant surgeons and nursing teams are operational around the country,” he said.
“We say one-third can be prevented, one-third can be detected early, and one-third can be given quality care to ensure cure, or if cure is not possible, palliative care; therefore no one should be left behind.”
Challenges in cancer control and care
Based in main hospitals around the country, 25 cancer care centres are operational. However, Dr. Suraj Perera of the NCCP said that the waiting lists and medicines shortages were affecting the care provided.
“Cancer medicines are very expensive and patients cannot be expected to buy them on their own. I believe the Government is expending the highest effort into procuring the necessary medications,” he said.
In 2019, according to the most recent published data, 15,598 have died of cancer. He noted that late detection, inconsistent treatment, and the absence of a follow-up system for patients who are missing treatment were some of the issues that required addressing.
SLMA President Dr. Perera also said that there were issues encountered when it came to accessing current data. He said that while data was available in separate departments, it was compartmentalised and therefore not freely shared.
“The Ministry of Health also runs into issues due to problems in data sharing,” he added.