Workshop on breast cancer

Cairo, December 17th, 2008

Rachid BEKKALI

Executive

Director

Population: 31.3 million

Urbanisation rate: 55 %

Population growth rate: 1.4 %

Brief history of ALSC

a

Kingdom of Morocco

Bass

in B

oujd

our-

Laay

oune

Morocco Population

Evolution of the female population

40,3

48

11,7

36,3

52

12,9

32,2

54,5

13,3

28,2

57,1

14,7

26,2

57,2

16,6

24,5

56,1

19,4

1988 1994 1999 2004 2009 2014

0-14 years 15-49 50 and more

2008 : 2 214 000 women between 45 and 65 years

Cancer registry (RCRC 2004)◘ First population registry in Morocco

◘ Taking place in Casablanca region ◘ Data of the year 2004 ◘ 30 500 new cases of disease are recorded each year*

* Registre des cancers du Grand Casablanca Année 2004, ALSC 2007

Cancers of womenRCRC 2004

36,1%12,8%

5,3%

5%

4%

2,8%

2,7%

2,5%

2,3%

2,2%

1,7%

1,6%

1,2%

1,1%

16,7%

Breast

Cervix

Thyroid Gland

Ovary

NHL

Rectum

Corpus uteri

Stomach

Skin

Colon

Lung

LH

Bladder

Œsophagus

Others

0 20 40 60 80 100 120 140

0-4

05-09

10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75 et +

Tranches d'âge

Effectif

Mean age

48,1 years

Breast cancer by age RCRC 2004

36,12%Percentage of cases / total

35,04Standardisedincidence

36,14Brut incidence

662Number of cases

RCRC 2004

Morocco: RCRC => 5250 new cases / year

Breast cancer

• Morocco : 35 F / - M

• Tunisia : 25.6 F / - M

• Algeria : 17 F / 0.5 M

• USA : 129.4 F / 1.8 M

• France : 109.8 F / 0.8 M

• Canada : 95.5 F / 1 M

Breast cancerAge standardised incidence

rates (world standard)

Breast cancer screening : pilot project

• Telemammography project – screening by numerical mammography with second reading

• After 1 year : 2200 women screened

• For 1000 first women, 5 cases diagnosed

Decision of scientific board Screening by Clinical Breast Examination

Early detection Breast cancer model

ScreeningPrimary health care

systemAge : ≥ 45 years

Diagnosis

Secondary health care

system

Treatment

Tertiary health care

system

Info

rmati

on

syste

m f

or

con

trol an

d e

valu

ati

on

Patients referenced

Patients referenced

Primary health care system : screening• Reception, information, recruitment, clinical breast

examination• General practitioner or nurse

Secondary health care system : diagnosis• Reception, clinical breast examination, mammography,

ultrasound, biopsy, pathology • Specialist practitioner

Tertiary health care system : treatment• Reception, treatment (surgery, chemotherapy, radiation

therapy)• Specialist practitioner

Early detection Breast cancer model

• National breast cancer campaign

• Training of general practitioners and nurses

• Early detection program by region

• Building centers for diagnosis in each region

• Continuing Training for specialist practitioners

Diagnosis center for breast and cervical cancer Rabat

Early detection Breast cancer Actions

National Breast cancer campaign May 2008Early detection saves lives

Together against breast cancer

2 TV spotsConsult your doctor

8 different stories

200 000 leaflets Posters Video clip

Socia

l fi

eld

National breast cancer campaign (May 2008) Assessment of the Campaign : June 10 2008

• # trained doctors : 2300

• # briefings: 25 692

• # women who attended the meetings: 314 253

• # women have been examined : 120 654

• # women highly suspected with breast cancer :

1 284establishing a program of systematic detection of breast cancer by clinical examination in the public health system

Thank you for your attention

www.contrelecancer.ma