In the Philippines, cancer ranks third in leading causes of morbidity and mortality after communicable diseases and cardiovascular diseases (Department of Health–Health Intelligence Service or DOH–HIS, 1992, 1996) (1). Over the period 1942–96, communicable disease mortality has shown a gradually decreasing trend, in contrast to the increasing trends of heart disease and cancer (non-communicable diseases).
In the Philippines, 75% of all cancers occur after age 50 years, and only about 3% occur at age 14 years and below. If the current low cancer prevention consciousness persists, it is estimated that for every 1800 Filipinos, one will develop cancer annually. At present, most Filipino cancer patients seek medical advice only when symptomatic or at advanced stages: for every two new cancer cases diagnosed annually, one will die within the year.
The Philippine Cancer Control Program, begun in 1988, is an integrated approach utilizing primary, secondary and tertiary prevention in different regions of the country at both hospital and community levels. Six leading cancers (lung, breast, liver, cervix, oral cavity, colon and rectum) are discussed.
The top cancer sites in the Philippines include those cancers whose major causes are known (where action can therefore be taken for primary prevention), such as cancers of the lung/larynx (anti-smoking campaign), liver (vaccination against hepatitis B virus), cervix (safe sex) and colon/rectum/stomach (healthy diet). Except for the liver, the top Philippine cancer sites are also the top cancers worldwide.
Survival from Cancer in the Philippines
The survival experience, regardless of treatment, of patients with top cancer sites diagnosed in 1987 and included in the DOH–RCR was evaluated as the first population-based survival data for Filipinos (5). Lung cancer had the lowest survival and breast cancer had the highest (Table 4). Five-year survival in excess of 40% was observed for only three cancer sites: oral cavity, colon and breast. For all other sites, survival was less than 30%. Owing to the small number of cases in each category, no distinct impact of age on relative survival could be perceived for most cancer sites. However, both observed and relative survival rates were low for breast cancer patients less than 35 years old.
A study in 1999 (11) estimated 17.9 million Filipinos to have a history of smoking (46.5% of the adult population). At least another 26.4 million are passive smokers. The economic burden resulting from lung cancer, chronic obstructive pulmonary disease, coronary artery disease and cerebrovascular disease adds up to approximately US$ 1 billion (59% from health care costs, 39% from premature deaths and 2% from productivity loss).
Second-hand smoking, effects to non-smokers
The group renewed its call for stricter implementation of tobacco control measures in the country that will address the many dangers of smoking, including its effect on non-smokers.
The call comes as the World Health Organization (WHO) on Friday, February 27 celebrated the 10th anniversary of the Framework Convention on Tobacco Control (FCTC), of which the Philippines is a signatory.
Among other tobacco control measures, the FCTC calls for protection from exposure to tobacco smoke.
Yet despite the Philippines’ Tobacco Regulation Act of 2003 (Republic Act 9211), the figures are still alarming: 24 million Filipinos are exposed to tobacco smoke every day, with 66.7% inhaling second-hand smoke at work, and 75.7% in places without an anti-tobacco policy.
Citing the Philippine Cancer Society, NVAP said 3,000 Filipinos die of lung cancer each year because of second-hand smoke. Lung cancer is the leading cause of cancer deaths in the Philippines and worldwide. (READ: What you should know about lung cancer).
Air pollution in Manila
Lung cancer – top cancer in the Philippines