Public Health Oncology in Practice

Rampal Health Database Program

The science-grounded goals for public health oncology—cancer medicine for populations—across the prevention, early detection, diagnosis, treatment and palliative care spectrum, are well-described. How to optimally address these goals, particularly in populations where cancer morality is high, is poorly defined.

We propose creation of a 160,000 population-targeting “laboratory” in a rural Bangladeshi upazila in which to develop, introduce, carefully analyze and modify based on data, strategies and models for implementing public health oncology in practice. Critical activities of this project are: (1) strengthening the local primary health care system using a community and allopathic and traditional medicine health care worker relationship-building and social mobilization model. (2) Establishment in the upazila for all inhabitants of a longitudinal database of (i) demographic characteristics; (ii) health status and major risk factors for disease; (iii) disease episodes and their treatment; (iv) a cancer registry; (v) recording of deaths and cancer-cause-specific deaths; and (vi) numbers and types of traditional medicine practitioners. (3) Complete population coverage with interventions addressing major avoidable risk factors for cancer. (4) Development of affordable cancer diagnosis and treatment facilities, for example with extensive use of point-of-contact ultrasound for cancer diagnosis and basic staging; and innovative business models to allow affordable care. (5) Tele-home hospice-regular symptom and performance status reporting, and management using a cell phone application for palliative care patients.

The goal of this project is to demonstrate that optimal cancer health for local circumstances as a human right can be achieved sustainably and affordably.

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Sreefoltola, Rampal, Bagerhat
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