Lung Cancer

Lung Cancer Control Program is a systematic, organized, and integrated approach towards
the control of lung cancer. It aims to reduce the mortality and morbidity of lung cancer through
the use of various primary, secondary, and tertiary prevention.

Focus: Anti-smoking campaign that covers 85% of all cancer site control campaign.

The specific objectives of the program are:

To inform/ educate school children and adults on the hazards of smoking and its known risk of
developing cancer
To prevent the onset of smoking and decrease the number of smokers
To identify among Filipinos those at high risk of developing lung cancer (40 years old and above
smokers)

These are carried through the following components:

1. Public Information and Health Education

This component aims to increase the public awareness on the hazards of smoking and
changing the attitude and behavior among primary and secondary school children.
Individualized process or group activities are being held to facilitate interpersonal
communications to reach out to specific target audiences. Social mobilization is an important
part to generate and sustain participation from all sectors of society, namely the governmental,
professional organization, religious and industrial establishments.

2. Legislation Measures

This has a critical role in the elimination of smoking habit, elimination of advertisements and
promotion of tobacco products, sales to minors, with labeling, tax and price policies on
cigarettes. An initial measure is started through local ordinances that is acceptable to policy
makers and public at large.

Some regulations that were written are the following:

 DOH Administrative Order No. 8 s. 1993 (January 28, 1993): Prohibited Smoking in
the Department of Health and its premises
 The Department of Interior and Local Government prohibited smoking in its offices
and premises in 2001. They also implemented this specific campaign in government
hospitals wherein hospitals with active implementation of the no smoking drive
received incentives or awards. In addition, job applicants are required to include
information on his smoking habits
 DOH Administrative Order No. 10 s. 1993 (March 22, 1993): laid out the rules and
regulations on labeling and advertisement of cigarettes.
Republic Act No. 9211: Tobacco Regulation Act of 2003

Prohibition of smoking in the following public places: centers of youth activity, elevators and
stairwells, location in which fire hazards are present, within buildings and premises of public and
private hospitals, medical, dental, and optical clinics, health centers, nursing homes,
dispensaries and laboratories, public conveyances and public facilities, and food preparation
areas

Designation of smoking and non-smoking areas wherein visible signs shall be posted to indicate
these areas

Vending machines or self service facilities are prohibited for sale of cigarettes unless they have
mechanism for age verification

Minimum age sales: 18 years old

The sale or distribution of tobacco products is prohibited within 100 meters from any point of the
perimeter of a school, public playground or other facility frequented, particularly by minors.

Warning on Cigarette Packages and Advertisement

Restriction on Advertising, Print Media Advertising, Outdoor Advertising, Cinema, Television,

and Internet

Ban on Advertisement starting on January 2007: all tobacco advertising on television, cable
television and radio shall be prohibited.

Ban on Sponsorships starting July 1, 2008

Restriction on Sampling below 18 years old

Executive Order No. 26 s. 2017: Providing for the Establishment of Smoke-Free Environments
in Public and Enclosed Places

Apply to all persons, whether resident or not, and in all places, found within the territorial
jurisdiction of the Philippines

Prohibited acts:

Smoking within enclosed public spaces and public conveyances except in designated smoking
areas

Sell, distribute or purchase tobacco products to and from minors

For a minor to smoke, sell or buy cigarettes or any other tobacco products

Ordering, instructing or compelling a minor to use, light up, buy, sell, distribute, deliver,
advertise or promote tobacco products
Selling or distributing tobacco products in a school, public playground, youth hostels, and
recreational facilities for minors, including those frequented by minors, or within 100 meters from
any point of the perimeter of these places

Placing, posting, displaying or distributing advertisement and promotional materials of tobacco

products within 100 meters from the perimeter of school, public playground, and other facilities
frequented particularly by minors.

Placing any form of tobacco advertisement outside the premises of point-of-sale retail
establishment

Placing any stall, booth, and other displays concerning tobacco promotions to areas outside the
premises of point-of-sale locations or adult-only facilities.

3. Intervention

Smoking Counseling Clinics in strategic localities will provide service to the identified
smokers, for them to address their behaviors, degree of tobacco addiction, and type of
social environment, using both pharmacological and non-pharmacological approaches

4. Research and Epidemiology

Lead agencies which generate and collect data on all aspects of smoking is carried out by
DOH-Essential national Health Research, Lung Center’s Research and Development
Section, PCHRD, the academe including UP-PGH, and the Colleges of Medicine and Public
Health.

Breast Cancer

The Breast Cancer Control Program refers to the implementation of a nationwide anti-
breast cancer scheme, including public information and health education, case finding, and
treatment, integrated into the community health structure and equipped to control breast cancer
in a systematic sustained manner.

Focus: Early detection and treatment, and healthy lifestyle.

The specific objectives of the program are:

To inform or educate all women 30-60 years old on breast self-examination and the importance
of doing a regular monthly breast self-examination (BSE)
To detect the maximum number of early stage breast cancer by offering yearly breast
examination to all 30-60 years women attending a health institution
To treat and/ or rehabilitate all detected cases

Program Strategies:
Full integration of the basic cancer control measures, i.e. public information and health
education, case finding and treatment, with the government's basic medical health services and
other non-governmental organizations through the primary health care approach
Operationalization of a bilateral referral system
Making more intensive use of information, education, and communication activities
Standardization recording and reporting with a built-in monitoring and evaluating system
Establishment of regular and frequent supervision
Adopting post-surgical adjuvant chemotherapy regimen for six months for all premenopausal
and hormonal receptor-negative post-menopausal patients as well as adjuvant hormonal
regimen for 2-5 years for hormonal receptor positive postmenopausal patients
Provision of adequate logistical support for public health and hospital services
Making available breast examination training programs, residency and post-residency training
programs, hospital services and anti-cancer drugs

Case Finding

Screening for breast cancer has been shown to protect against dying from breast cancer
with a relative risk of 0.3 to 0.48, especially for elder women and women who have been
screened twice. Cancer tends to be detected at a later stage in unscreened group than the
screened group. It is important to be able to diagnose breast cancer at earlier stage as the
stage at diagnosis affects the prognosis and mortality of the patient. Screening for breast cancer
can reduce mortality for this condition by 1/3.

The most common screening procedures are regular BSE, physician examination, and
mammography. Among these mammography has the greatest contribution. Mammography
however, is not easily available or financially feasible for most of the Filipino populace.
Therefore, breast examination is implemented as a secondary prevention method in the
Philippines. For women who do BSE on a regular monthly basis or for those who undergo yearly
physician breast examination, the sensitivity reported for detecting cancer ranges from 35% to
85%. For levels of 65% to 85% sensitivity, studies show benefit in terms of earlier disease
detection.

Cervical Cancer

Cervical Uteri Cancer Control Program

Focus: Early detection and treatment, and healthy lifestyle

Specific Objectives:
To educate people about cervical cancer, its symptomatology, methods of early detection and
preventive measures
To screen at least 85% of women 25-55 years of age every 3 years using acetic acid wash
To identify early lesions of cervical cancer
To establish a practical/ applicable referral system
To implement appropriate treatment protocol for the different stages of cervical cancer

Program Activities:
Public Information & Health Education
Professional Education
Primary prevention
Case-finding with use of acetic acid wash
Diagnosis with use of Pap smear and colposcopy
Treatment
Research

DOH Department Memorandum No. 2015-0120: Guidelines on Free Cervical Cancer Screening
in DOH Hospitals

Free cervical cancer screening among women 21 years old and above in all DOH hospitals
once a week in each hospital for the whole month of May
Pre-registration required, with a minimum of 100 women screened per facility
Team Composition:
Team Lead (OB/GYN)
Counsellor/Educator (POGS/SGOP members, nurse, midwife)
Recorder (Health Education & Promotion Officer)
Methods of Screening Utilized
Visual Inspection using Acetic Acid Wash (VIA)- most cost effective and practical
In cases which pre-malignant lesion is noted, a single visit approach (SVA) shall be applied in
facilities with cryotherapy equipment. In facilities without capability for doing SVA, the patient is
referred for possible treatment option to the nearest facility.

DOH Department Memorandum No, 2015-0316: Guidelines in the Implementation of Human

Papillomavirus Vaccination

Covers implementing procedure on HPV vaccination among female aged 9-10 years old at the
health facilities in the priority provinces

Region Province Region Province

Apayao Leyte
CAR
Ifugao VIII Eastern Samar
I Pangasinan Northern Samar
IVA Quezon IX Zamboanga del Sur
Camarines Sur XI Davao Oriental
V
Masbate North Cotabato
XII
Iloilo Sarangani
VI
Negros Occidental Lanao del Sur
Cebu ARMM Maguindanao
VII
Negros Oriental Sulu

All females aged 9-10 years old in the priority provinces shall be vaccinated with 2 doses of
HPV Quadrivalent vaccine, 0.5 mL, IM, Left deltoid arm

First dose at the time of visit with the health worker at age between 9 and 10 months
Second dose 6 months after the first dose
Recording and reporting completed and submitted from service delivery point to the next higher
administrative level

DOH Department Memorandum No. 2015-0146: Guidelines on the Implementation of School-

Based Immunization

Vaccination for Grade 4, Female 9-13 years old

All 9-13 years old female students in Grade 4 with parental/guardian consent shall be
vaccinated with 2 doses of the quadrivalent HPV vaccine in the designated immunization posts
in all public schools
All students shall receive HPV 0.5 mL, IM, left deltoid arm, with second dose given after 6
months
All students who receive the HPV vaccine shall be recorded in Recording Form 2