Cancer in Sri Lanka; trends, care and outcomes

Abstract

Introduction
The burden of cancer is increasing rapidly in Sri Lanka. However, limited data are available on incidence trends, diagnosis, treatment or outcomes of cancer in Sri Lanka. This oration encompasses a series of studies undertaken,

•     To describe the trends in incidence
•     To analyse stage at diagnosis, treatment and outcomes
•     To describe the long-term quality of life [QOL] after completion of treatment of cancer in Sri Lanka

Methods
Three different strategies were undertaken.  

• Incidence and trends - based on data published by the Sri Lanka National Cancer Registry [SLCR] during 2001-2010 for breast, thyroid and colorectal cancers. Joinpoint regression analysis was used to calculate changes over time.
• Diagnosis, treatment and outcomes – patients with breast and colorectal cancer registered between 01/01/2016 and 31/12/2019 for treatment at the Apeksha hospital, Maharagama were included.
• QOL – analysed using validated EORTC QLQ-C30 and QLQ-BR23 questionnaires in a cohort of women who have completed treatment for breast cancer.

Results
Significant increases in incidence were observed for all cancers which ranged between 2.5% to 8.5% per annum.
Apeksha hospital data included 4,185 breast and 1,985 colorectal cancers. While most of the cancer therapies appeared to have followed accepted guidelines, lower use of some of the adjuvant therapies is concerning.

The QOL mean scores for sexual functioning, sexual enjoyment, systemic therapy, breast symptoms, arm symptoms, and hair loss assessed by the QLQ-BR23 were found to be poor with scores of 18.3, 33.3, 30.5, 16.2, 23.4 and 32.7 out of 100, respectively.