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Date : 23/01/2006
Source: Department of Health
Title: Tshabalala-Msimang: Meeting of Stakeholders on Cancer Surveillance


  Speech by the Minister of Health at Meeting of Stakeholders on Cancer Surveillance in South Africa, Johannesburg International Airport

Distinguished guests,
Members of Witwatersrand University Research Ethics Committee,
Members of University of Cape Town Research Ethics Committee
Members of the Medical Research Council’s Working Group on Research Ethics,
WHO and International Agency Research for Cancer Representatives
Members of Cancer Association of South Africa
Members of National Health Laboratory Service
Members of the Academia,
Ladies and Gentlemen

I hope you had a good festive season and you were able to regain the energy that is needed to continue our endeavour to improve the health of South Africans.

I would like to thank you for inviting me to this important meeting. I am glad that you have convened this consultative session right at the beginning of the year so that we can have adequate time to consult and to implement the decisions that come out of this consultation.

As you know, cancer is major health challenge facing health systems in both developing and developed countries. The World Health Organisation (WHO) estimates that globally, more than 10 million people are diagnosed with cancer every year and projects that if we do not make the necessary interventions, these cases will increase to 15 million each year by the year 2020.

There is therefore a need to strengthen our surveillance systems and research in this area to ensure that we fully understand the challenge facing us and to inform the necessary policy interventions.

South Africa has the largest national cancer registry system in Africa and is one of the world leaders in the research of cancer. Although registry in South Africa provides valuable data for planning and for informing policy, the data underestimate the magnitude of the prevalence of cancer, with probably gross underreporting in the African population. We have been informed that the Cancer Registry is experiencing special challenges with data that is currently being collected.

It is common knowledge that in the previously disadvantaged communities of South Africa, awareness about cancer is insufficient and there is lack of information about the incidence and implications of cancer. This often results in people from these communities seeking medical intervention when their cancer is already at an advanced stage, making a successful outcome of treatment less likely. This is also exacerbated by the fact that there is a disparity in the provision of services for diagnosis and treatment between urban and rural, high and lower income communities.

Population based cancer registries provide a comprehensive data collection system from all possible cancer diagnosing facilities and are the standard cancer data collectors that are recommended by the World Health Organisation.

Cancer - a group of diseases characterised by the unrestrained growth of cells - poses a lifetime risk to all South African men and women.

A total of 30 480 new cancer cases amongst women and 29 428 men were reported in the National Cancer Registry in 1999, and these figures were similar to the cases reported in 1998. Cancers of the prostate, lung, oesophagus colorectal and bladder, in that order, were the five leading cancers amongst men. Cancer of the breast, cervix, colorectal, oesophagus and uterus, were the five leading cancers in females. Although cancer is a condition of great public health concern, it is not a notifiable or a reportable condition. As such, it becomes difficult to collect data relating to the conditions for purposes of research to inform policy interventions. There is therefore a need to discuss options to improve reporting.

As we take this direction, we need be conscious of the fact that patients have a right to consent to the collection, use and disclosure of, and access to their health information. Health practitioners also have an obligation to protect their patients and to maintain confidentiality. We also need to address the challenges relating to the use of codes for patients that can be linked with laboratories and the use of unique identification numbers as unique identifiers in the health system

I hope that through this consultation, firm proposals and agreements will be made on the use of data with laboratories as a medium term measure within the limitation of the principles of privacy and confidentiality.

Consultation on this critical issue in our efforts to address the major challenge of cancer in the country should not end today. We should strive to get input of most stakeholders and ensure that we agree on an appropriate approach as early as possible.

Programme Director, cancer will continue to become an increasingly significant contributor to the burden of diseases if we do not intensify the implementation of preventative interventions we have put in place. Many cancers are preventable through avoiding tobacco use, eating healthy food and having clean environment.

We have included these messages as main elements of our Healthy Lifestyle Programme which we will be intensifying its implementation this year. Working together with various partners, we want to ensure that our people:
* Eat nutritious food,
* They exercise regularly
* They do not smoke or abuse alcohol
* And that they adopt safe sexual behaviour

We have also put in place legislation and policies in an effort to reduce cases of cancer. This includes the Tobacco Control Amendment Act, cervical cancer screening programme and Hepatitis B immunisation. Effective implementation of these programmes should have an impact in reducing cancers associated with these factors.

We have to have to raise awareness amongst our people about how some of the cancers can be prevented. We have to highlight the fact that early detection, prompt treatment and effective monitoring are critical in the management of cancer.

I would like to recognise the good work that is done by the National Cancer Registry of South Africa in maintaining and developing national awareness of the growing problem of cancer in the South African population. The government has been supporting the Cancer Registry for many years and will continue to work together with you and all other partners in addressing this challenge.

I wish all of us a fruitful discussion.

Issued by: Department of Health
23 January 2006
   

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