The population-based cancer registry maintained at JDWNRH recorded 2,648 cancer cases from 2014-2017 and 954 individuals died from cancers during the same period (unpublished data). The cervical and stomach cancers constituted the majority of the cancer burden in Bhutan. The average annual incidence of cervical cancer is 25 per 100,000 population with similar incidence of stomach cancer at 24 per 100,000 population. Stomach cancer causes the highest mortality amongst all cancers with 12 deaths per 100,000 population. Currently most stomach cancer cases are detected at late stage thus majority of cases ends up dying.
Evidence from other countries suggests that major proportion of stomach cancer is attributed to infection by Helicobacter pylori. Studies in Bhutan suggests the prevalence of H. pylori infection ranges from 66% in children to 80% in patients presenting gastric problems. In addition, the H. pylori bacteria isolated in Bhutan is known to be the most carcinogenic strain in the world.
Therefore, there is good opportunity to prevent large proportion of gastric cancer cases through effective screening and eradication of H. pylori.
This pilot project is initiated by KGUMSB, MoH, JDWNRH and HIGAN (Zero Helicobacter IGAN Network of Japan). This project will be funded by JICA and HIGAN. The project will be implemented at Dawakha BHU catchment areas as it has reported high stomach cancer rate in Bhutan. This project will be implemented from October 2019 to September 2022.
The objective of the project is to reduce the incidence and mortality of gastric cancer in Bhutan through effective screening and eradication of H. pylori, and improving the early detection of gastric through endoscopy. As a part of this project, 8 medical doctors are being trained to conduct advance endoscopy to detect early gastric cancer taking Train-the-Trainer approach. The project will also strengthen laboratory capacity of Bhutan to detect H. pylori infection and assessment of efficacy of H. pylori treatment.
The project is also exploring fund to procure latest ad high-end endoscopy machine that can improve the detection rate of early gastric cancer.
The findings from this project will be used to guide and support development of national gastric cancer control program and roll-out nationwide program to reduce incidence and mortality of gastric cancer.

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