DJIBOUTI BURDEN OF CANCER

(1)

Total # cancer cases (2018)

Total # cancer deaths (2018)

674 472

10.3%

aPAF, cancer deaths ^bPAF, cancer cases ^cPAF, melanoma cases

TRENDS

Estimated past and future trends in total cases per year (breast and lung) Probability of premature death from cancer per year

INVESTMENT CASE (2019)

*Lower middle income

At this income level, investing in a package of essential services and scaling-up coverage will:

Costs per year Projected lives saved per year

DJIBOUTI

BURDEN OF CANCER

25.1%

Total population (2019)

Tobacco (2017)^a Alcohol (2016)^a Infections (2012)^b Obesity (2012)^b

17.2% 2.0%

973,557

Premature deaths from NCDs (2016)

Cancer as % of NCD premature deaths (2016)

2.1%

PAFs

(population attributable fractions)

1,553

Cancer Country Profile 2020

UV (2012)^c Occupational risk (2017)^a

n/a 0.7%

26.1%

7.7%

6.1%

6.8%

2.8%

5.9%

3.7%

4.2%

3.3%

2.8%

18.4%

8.3%

7.2%

9.1%

3.6%

6.6%

5.3%

4.7%

3.2%

0.6%

Breast Cervix uteri Colorectum Leukaemia Liver Non-Hodgkin lymphoma Oesophagus Ovary Prostate Thyroid

Most common cancer cases (2018)

Incidence Mortality

0 20 40 60 80 100 120

2020 2022 2024 2026 2028 2030

6.75%

6.66%6.61%6.60%6.60%6.59%6.55%6.54%6.51%6.43%6.33%6.31%6.30%6.28%

6.22%

6.11%6.08%6.04%6.01%5.97%5.94%5.91%5.87%5.84%5.80%5.77%5.74%

5.70%

5.80%5.66%5.52%5.38%5.24%5.10%4.96%4.82%4.68%4.54%4.40%4.26%

4.12%

2.00%

7.00%

12.00%

17.00%

2000 2005 2010 2015 2020 2025 2030

Past trends Projected linear trend SDG target 128

14 176

18 303

38 -

50 100 150 200 250 300 350

Breast cancer Lung cancer

2012 2018 2040

- 0.50 1.00 1.50 2.00 2.50 3.00 3.50 4.00 4.50

2020 2022 2024 2026 2028 2030

US$ (per capita)

(2)

HEALTH SYSTEM CAPACITY

aper 10,000 cancer patients

WORKFORCE

aper 10,000 cancer patients

Quality of mortality registration*** 2007-2016 No coverage 2019 n/a

# of radiation oncologist^a 2019 n/a

2019 0.0

# of mammographs^a 2020 59.3 # of surgeons^a 2013 252.2

# of CT scanners^a 2020 59.3 # of radiologist^a 2019 n/a

# of MRI scanners^a 2020 14.8 # of nuclear medicine physician^a 2019 0.0

# of PET or PET/CT scanners^a 2020 0.0 # of medical & pathology lab scientists^a 2005 44.5

Integrated NCD plan 2019 n/a 2019 -

NCCP (including cancer types) 2019 not in effect 2019 0 cancer(s)

MPOWER measures fully implemented and

achieved 2018

2

Pathology services 2019 generally available

Cancer management guidelines 2019 yes 2019 generally not

available Palliative care included in their operational,

integrated NCD plan 2019 n/a

2015-2017 0

Breast cancer screening program 2019 yes

*Defined daily doses for statistical purposes (S-DDD) per miliion inhabitants per day Breast cancer screening program: Starting

age, target population 2019

50 GLOBAL INITIATIVES

Elimination of Cervical Cancer Global Initiative for Childhood Cancer

HPV vaccination programme coverage 2018 n/a 2020 37

Cervical cancer screening 2019 yes Early detection programme/guidelines 2019 no

Screening programme type 2019 organised Defined referral system 2019 no

Screening programme method 2019 PAP smear

Screening participation rates 2019

Early detection programme/guidelines 2019 no

Defined referral system 2019 no

**The incidence estimates for this country have a high degree of uncertainty because they are not based on population based cancer registry

***The mortality estimates for this country have a high degree of uncertainty because they are not based on any national NCD mortality data

DJIBOUTI

10%-50%

Annual cancer cases (0-14 years old) Bone marrow transplantation capacity

# Public cancer centres per 10,000 cancer patients

# of treatment services (surgery,

radiotherapy, chemotherapy) 2019 1 Availability of opioids* for pain

management Availability of population-based cancer

registry (PBCR)** 2019

# of external beam radiotherapy (photon,electron)^a

Cancer Country Profile 2020

No information

2019 0.0

FORMULATING RESPONSE

Annual cancer cases (0-14 years old) Palliative care availability:

community/home-based care 2019 generally not

available Available staff in Ministry of Health who

dedicates significant proportion of their time to cancer

# of medical physicist^a

Early detection programme/ guidelines for 4 cancers (breast, cervix, colon, childhood)

5 1

2 1

1 24 3

Acute lymphoid leukaemia Hodgkin lymphoma Burkitt lymphoma CNS, low grade tumours Retinoblastoma Wilms tumour Other childhood cancer