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Department of radiotherapy. University Hospital Ibn Rochd Casablanca – Morroco

Cancer Control Resources in Maghreb countries. Pr. BENIDER. Department of radiotherapy. University Hospital Ibn Rochd Casablanca – Morroco. Marrakech June 19th 2010. Maghreb map. INTRODUCTION. MAGHREB Epidemiologic transition - Demographic transition

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Department of radiotherapy. University Hospital Ibn Rochd Casablanca – Morroco

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  1. Cancer Control Resources in Maghreb countries Pr. BENIDER Department of radiotherapy. University Hospital Ibn Rochd Casablanca – Morroco Marrakech June 19th 2010

  2. Maghreb map

  3. INTRODUCTION MAGHREB Epidemiologic transition - Demographic transition - Transformations of the environment - Change of the way of life Non transmissible chronic diseases Health priorities Cancer = Major problem of public health

  4. Historical • 1929-1980 • 1929: Bergonié Centre -Casablanca Ibn Rochd Oncology Center 1947: Casablanca Mayor inaugurating the hospitalization of the Bergonié center

  5. Historical • 1929-1980 • Treated cancers in Cancer Centre bergonié

  6. Historical • 1980-2005 • 1980: First two radiotherapy specialists (Pr.Gueddari - Pr.Kahlain) • 1985: National Institute of Oncology-Rabat • 1989: First private center - Casablanca • After 2005 • 2005: Lalla Salma Association Against Cancer • 2010: Cancer Plan (2010 - 2019)

  7. Epidemiological Data

  8. Cancer Standardized Incidence In Maghreb All Sites • * Registre des Cancers de la région du Grand Casablanca Edition 2004 • ** Registre des tumeurs d’Alger Edition 2003 • *** Registre des Cancers de Nord Tunisie 1999-2003 • **** Benghazi Cancer Registry 2004

  9. Cancer Standardized Incidence In Maghreb All Sites

  10. COMMONLY CANCERS IN MALE • * Registre des Cancers de la région du Grand Casablanca Edition 2004 • ** Registre des tumeurs d’Alger Edition 2003 • *** Registre des Cancers de Nord Tunisie 1999-2003 • **** Benghazi Cancer Registry 2004

  11. COMMONLY CANCERS IN FEMALE • * Registre des Cancers de la région du Grand Casablanca Edition 2004 • ** Registre des tumeurs d’Alger Edition 2003 • *** Registre des Cancers de Nord Tunisie 1999-2003 • **** Benghazi Cancer Registry 2004

  12. Breast Cancer Comparison of standardized incidence of other countries

  13. Health facilities

  14. Cancer facilities in Morocco • Before 2005 • Casablanca Public (1) Private (2) • Rabat Public (1) Military (1) Private (2) • Oujda Public (1) • Total: 8cancer centers Al houceima

  15. Cancer facilities in Morocco • After 2005 Functional • Casablanca (4) • Rabat (4) • Agadir (1) • Oujda (1) • Al Houceima (1) • Marrakech (2*) • Fes (1/1*) • Total: 12 (3*)cancer centers Al houceima Planned • Tanger • Meknes (2) • Safi • Laayoune *Functional soon

  16. Cancer facilities in Algeria . . . • Algiers . Oran . • Constantine . • Blida Ain Misserghin • Ain-Naadja • ALGERIA • 6 centers

  17. Cancer facilities in Tunisia • - 3 functional centers: Tunis Sousse Sfax • Jendouba - 3 planned centers: Gafsa Gabes Jendouba

  18. Radiation Therapy Equipment in Morocco • * Planned

  19. Radiation Therapy Equipment in Algeria

  20. Radiation Therapy Equipment in Tunisia • * Planned

  21. Comparison of Radiation Therapy Equipment in Maghreb countries • * Planned - No data available

  22. Human resources in cancer centers in Morocco • Radiotherapy Specialists: 82 Residents: 61 Medical Oncology Specialists: 20 Residents: 51 Surgical Oncology Specialists: 16 Total: Specialists: 118 Residents : 112 22 22

  23. Human resources in cancer centers in Algeria • Medical Oncologists: 250 • Radiation Oncologists: 50 • Surgeons: 100 23 23

  24. Human resources in cancer centers in Tunisia 24 24

  25. Comparison of Human resources in cancer centers in Maghreb countries 25 25 - No data available

  26. Moroccan cancer Plan 2010-2019 Conceptual Framework National and international mobilization Communication Legislation Prevention Palliative cares Early diagnosis Detection Diagnosis and treatment Social support Research / Training

  27. Moroccan cancer Plan 2010-2019 Health facilities organization • Level 1: Basic health centers, General practionners • Level 2: Provincial hospitals Diagnosis centers Clinics • Level 3: University hospitals, Regional cancer centers Private cancer centers

  28. Tunisian cancer Plan 2006-2010 • In collaboration with the Institut National Français du Cancer (INCa) • Piloting comittee and sub-commissions : - Formation/Research - Epidemiology - Primary Prevention - Screening/Early Diagnosis - Management

  29. Recommendations

  30. International Resources Standards in Radiotherapy EQUIPMENT • 1 device / 250 000 - 500 000 inhabitants. • OMS/AIEA recommendations for developing countries : 1 device for 1 million inhabitants.

  31. International Resources Standards in Radiotherapy HUMAN RESOURCES • 1 Radiation Oncologist / 300 - 400 annual treatments • 1 Radiation Physicist / 350 - 500 annual treatments • 2 therapy radiographers / each treatment device • At least 1 therapy radiographer / simulator • At least 1 dosimetrist.

  32. Moroccan equipment Requirement in Radiotherapy (cancer Plan 2010-2019) For each cancer center • 2 LINACs with MLC • 1 Simulation system (standard or CT) • 1 TPS with network link • HDR Brachytherapy

  33. Moroccan Human Resources Requirement in Radiotherapy (cancer Plan 2010-2019) For each cancer center • At least 2 radiation oncologists, and above depending on the center activity: 1 radiation oncologist / 400 - 500 patients treated per year • At least 2 Radiation Physicists , and above depending on the center activity: 1 radiation Physicist / 600 - 700 patients treated per year • At least 12 radiation therapy radiographers • At least 2 Brachytherapy radiographers • At least 1 dosimetrist, and above depending on the center activity

  34. Conclusion • Cooperation Governments - NGOs would allow: * Cancer prevention * Cancer treatment * Palliative care * Better quality of life

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