Perú 42,284. new cancer cases in 2008 living with cancer 100,000. How many new cancer cases are diagnosed? (INEN, EsSalud, FFAA, Private)

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2 100,000 Perú 42,284 new cancer cases in 2008 living with cancer How many new cancer cases are diagnosed?. 17,000cases (INEN, EsSalud, FFAA, Private)

3 and 85% advanced cases, diagnosis is often too late

4 Second cause of general mortality. Diagnosis: Advanced illness Lack of coodination between organizations DALYs = Disability Adjusted Life Years The sum of years of potential life lost due to premature mortality and the years of productive life lost due to disability. Peru=900 millons $ (2004) 42,000 new cases are waiting. Diagnosis: 17,000 cases 85% advanced illness Lack of access to: diagnosis, treatment and information

5 Multisectorial Coalition Perú against Cancer September 3rd 2005 Luis Pinillos-Ashton MD President of the Coalition

6 Participating Institutions American Cancer Society. Naval Medical center CMST. National Permanent Commission Against Tobacco - COLAT. Sanitary Services of the Armed Forces and National Police. Social Security Service - ESSALUD. Peruvian Cancer Foundation. Instituto Nacional de Enfermedades Neoplásicas National Institute of Health. Asociación de Clínicas Privadas. Dirección de la Policía Nacional. Peruvian League of fight Against Cancer. Ministry of Health - MINSA. Municipalities San Borja. OPS/OMS. Peruvian Cancerology Society. Medical Oncologyc Society. A volunteer s representative ALINEN. Dirección Nacional de la Fuerza Aérea. Colegio de Enfermeros del Perú. UICC. Washington Cáncer Institute. Technical Support Team. PATH.

7 New participating institutions Colegio de Obstetras del Perú. Municipalidad del Callao. Municipalidad de Carmen de la Legua. Municipalidad de Miraflores. Gobiernos Regionales: Lambayeque, La Libertad, Ancash, Ayacucho, Callao. Asociación de Pacientes. Asociación de Voluntarios. Patronato de Lucha Contra el Cáncer de la Región Huancayo. Comisión Nacional para el Desarrollo y Vida sin Drogas - DEVIDA. Hospital Militar Central. Colegio de Psicólogos del Perú.

8 Estrategic Plan National Cancer Control and Prevention Plan

9 Priorities According to the Strategic Plan: Breast cancer. Cervical cancer. Stomach cancer. Lung cancer. Prostate cancer. Skin cancer. Mouth cancer.

10 Strategy Strategic Lines Promotion and Prevention Regulation Accessibility Active Surveillance and Research Strengthening of organized groups Volunteerism Resources development Information and Communication Strategic Objectives Strengthen primary, secondary and tertiary prevention. Emphasize early detection and treatment of lesions. Oversee the execution of current norms and create the necessary norms to achieve the objectives and goal. Strengthen the decentralization process for oncological attention Implement active epidemiological surveillance and promote cancer research. Support the creation of cancer survivor groups. Support volunteer activities in all the institutions. Seek and incorporate financial resources, develop and promote an effective use of human potential and an efficient use of the infrastructure of services. Create a National Program of Cancer Education and Communication which involves the mass media with multisectorial and civil society participation.

11 Strategic Objectives Strengthen primary, secondary and tertiary prevention. Emphasis on early detection and treatment of lesions. Ensure that existing norms are met and create necessary norms. National Plan Objectives Promoting healthy lifestyles among the Peruvian population, linking these lifestyles to other factors and health promotion agents, and preventing cancer by controlling for risk factors. Conduct early detection/diagnosis of the 7 main neoplasms, following the current Technical-Oncological norms. Favoring decentralization * Treat the different types of cancers detected, utilizing the best available and most adequate methods in Oncology Units or Specialized Centers. * Ensure the best quality of life for oncology patients through rehabilitation and pain management treatments.

12 Strategic Objectives Implement VEA and promote research Satisfy patient group needs. Support volunteer activities. Gain financial resources, develop human potential and improve use of services. Create a National Program of Education and Communication. National Plan Objectives Standardize Cancer Registries in Peru. Boost development of human resources, infrastructure, equipment and financing in the Oncology Units or Centers throughout the country. * Promoting healthy lifestyles among the Peruvian population, linking these lifestyles to other factors and health promotion agents, and preventing cancer by controlling for risk factors. * Boost development of human resources, infrastructure, equipment and financing in the Oncology Units or Centers throughout the country.

13 Budget Specific objective Cost (US$) 1) Promotion and Prevention 7 402,800 2) Detection (Seven priorities) ,300 3) Treatment of cancer ,000 4) Palliative rehabilitation and cares 7 949,000 5) Unified registries 4 901,125 6) Research 502,000 7) RRHH, infraestructura, equipos ,925 Total cost by Objectives ,150

14 PROGRESS BY OBJECTIVES

15 Objective 1 Promote healthy lifestyles among the Peruvian population and prevent cancer by modifying the risk factors Reduce alcohol consumption by 15% among youths under 18 years of age and by 10% among adults. Reduce exposure to environmental agents associated with carcinogenesis. Increase, by 30%, the number of Peruvians, over the age of 2, that consume 5 servings a day of fruits and vegetables. Reduce the number of obese adults by 10% and of obese children and adolescents by 5%.

16 ACTORS COLAT MUNICIPIOS ORGANIZACIONES COMUNALES DIRESAS GOBIERNOS REGIONALES SOCIEDADES CIENTÍFICAS Expected result: Healthy lifestyles and prevention activities adopted by the peruvian population MINISTERIOS DE EDUCACIÓN, AGRICULTURA LPLCC INEN MINSA ASOCIACIONES DE PACIENTES

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19 Nursing Counseling in Cancer Prevention and Detection

20 Justification Cancer prevention counseling is personalized and founds the adoption of healthy life style and to practice cancer screening and early detection.

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25 To do theorical and practical meetings. All the nurses were selected of the differents centers and they are working in primary care of health

26 First phase: Theorical meeting

27 Principaly, nurses who works in health primary level

28 First Day: Cancer definition Epidemiology of Cancer Tobacco and its actual legislation Diet, physical activity and cancer Genetics and Cancer Counseling in Cancer Prevention Second Day: Breast Cancer. Prevention and Detection Cervical Cancer. Prevention and Detection Lung Cancer. Prevention and Detection Gastric Cancer. Prevention and Detection Prostatic Cancer. Prevention and Detection

29 Second phase: Workshop and practical meetings

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32 WORKSHOP TO TRAIN NURSES TO BECOME COUNSELORS IN BREAST CANCER PREVENTION AND DETECTION

33 WORKSHOP TO TRAIN NURSES TO BECOME COUNSELORS IN BREAST CANCER PREVENTION AND DETECTION Learning Counseling Examining and teaching

34 After the Intervention 2600 nurses who works in primary health care level in Lima and 9 provinces into our country. Counselor Nurses in Cancer Prevention chain in Peru

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