RESUMO
Screening of cancers is an important intervention in reducing the incidence and mortality related to cancers. Bhutan is one small country that is witnessing an increasing incidence and mortality related to cancers. The government implemented a time-bound population-level screening for gastric, cervical and breast cancers from 2020 to 2023 with an overall coverage of 91.2% of the eligible population. Among 370,225 individuals screened for H pylori, 32.4% tested positive; among 53,182 who underwent upper gastrointestinal endoscopy and biopsy, 255 (0.07%) had gastric cancer. Among 10,749 tested for HPV DNA, 9.3% were positive; among 9887 evaluated with colposcopy and biopsy, 154 (0.13%) had cervical cancer. For breast cancer screening, 72,283 underwent clinical breast examination, 845 mammography and cancer was detected in 73 (0.10%) individuals. In this article, we review how Bhutan implemented a population-level cancer screening programme with on boarding of multiple stakeholders and the participation of people across all districts.
RESUMO
Postgraduate medical education in Bhutan began in 2014 which marked a new era in the medical education in the country. From a mere handful of surgeons in 2003 to the numbers today, general surgical services have come a long way in Bhutan. Medical education has progressed tremendously to adoption of modern medical educational methods promoting objectivity in all aspects. This article dwells with the historical perspective as well as the state of the general surgical education and the services in Bhutan. It is the first of its kind of article to be written.