Pathologist’s role in Non Communicable Diseases

Abstract

With the control of communicable diseases by improved health care facilities, non communicable diseases (NCD) have surpassed communicable diseases in morbidity and mortality in Sri Lanka. Among these, cardiovascular diseases have the highest mortality with respiratory diseases, trauma, poisoning, diabetes, kidney, liver diseases followed by cancers showing an upward trend. Although there is an increase in incidence of cancer from 1990 to 2007, cancer related deaths remain static due to early detection and better treatment modalities provided by health care services. However, malignancies had the highest mortality in 2009 followed by deaths related to cardiovascular causes. Cancer is a major component of the non communicable disease burden in Sri Lanka with an increase in incidence of 31.6 in 1995 to 71.6 in 2007 per 100,000 population. Cancer detection and management constitute a major component of the health care system in Sri Lanka. Therefore pathologists play a crucial role in diagnosis of malignancy. Among the Sri Lankan males, the common sites of malignancy are lip, oral cavity and pharynx, trachea, bronchus, lung and oesophagus, followed by colorectum, lymphoma, leukemia, larynx, prostate and stomach; commonest three cancer sites among females are breast, cervix uteri and thyroid followed by oesophagus, ovary, colorectum, lip, oral cavity, pharynx, leukemia, uterus and lymphoma. The five most common malignancies without gender consideration are breast, lip and oral cavity, pharynx, cervix uteri and oesophagus. Leukaemias, lymphomas and brain tumours are the common malignancies among children (Source: National Cancer Control Programme data).