Increase Coverage Cancer Registry by Strengthening and Improving the Reporting of Breast Cancer Screening Program in Jakarta as One of Data Source
Authors: Sinulingga D.T. , Kadir A. , Purwanto D. , Kardinah K. , Suzanna E. , Khairina D. , Ramadhania F. , Rahayu P.S. , Septiawati S. , Julyanti J. , Yulianita R. , Kartikawati A. , Gumelar L. , Anhar N. 
Published: September 2018

Background and context: Breast cancer screening programs by mobile mammography have been done since 2005 for Jakarta and around by collaboration of Dharmais National Cancer Center with The Indonesia Breast Cancer Foundation and Jakarta Health Department. Every activity, mobile mammography has been examined 50 persons for 60-80 times yearly. For 2015 there were 3493 examinations with 529 cases (15.1%) were abnormal which 43 from that cases (8.1%) are suspect malignancy. All that data were compile with early detection and cancer registry data to know the real cancer, but there were no malignancy and only 15 benign cases had come to follow-up to Dharmais NCC. The result is no malignancy. To compile the mobile mammography data with detection unit and cancer registry data were difficult because of the difference terms of the variables. National Cancer Registry of Indonesia has been announced by Ministry of Health since 2016. The coverage of cancer that diagnosed in 2008-2012 in Jakarta just 30.7%. One of the sources of data are screening data. In Indonesia, screening programs for breast and cervix cancer have been done sporadically, including at Jakarta. Unfortunately for 2008-2012 diagnose year, there were no data can compile to cancer registry because there were no address data and name. So we collaborate to improve the data variables for cancer registration system. Aim: To conduct the mobile mammography screening data as one of the sources data for cancer registration to improve the coverage in Jakarta and to prepare the breast specific cancer registry system. Strategy/Tactics: Cancer Registry, Early Detection, Radiology and Pathology Unit was collaborating with The Indonesia Breast Cancer Foundation to improve the variables. Program/Policy process: We to improve the variables and their operational definition especially for name, address and birth date include risk factors and physical examinations variables. The palpations of breast was conduct by midwives or doctors before the examination with mammography. Cancer registration variables definition is the standard, so the name variable is the name that written in the National Identity Card, include the birth date and address. Information system department in Dharmais NCC has made the program to this data system and have been take place since July 2017. Outcomes: There were 1462 data that have been in hospital data based for mobile mammography with 237 cases (16.2%) were abnormal which 14 cases (5.9%) are suspect malignancy. Only 5 suspect malignancy cases had more examination in Dharmais NCC and all of them were diagnosed breast malignancy. What was learned: Standardization of variable definitions is very important for cancer registry data source to improve the coverage especially for early stage finding cases. But to know the standard diagnose and to follow the cases real conditions, we have to make a good and clear referral system networking.