CONTROL OF NONCOMMUNICABLE DISEASES

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INTRODUCTION
The WHO reports NCDs to be the leading cause of mortality.
Noncommunicable diseases (NCDs) kill 41 million people each year, equivalent to 71% of all
deaths globally. (April, 2021)
In the Philippines, 75% of the total deaths can be attributed to NCDs, 30-50% occurred at the age
below 60 years (Ulep, 2012)
77% of all NCD deaths are in low- and middle-income countries.

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Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed
by cancers (9.3 million), respiratory diseases (4.1 million), and diabetes (1.5 million).
These four groups of diseases account for over 80% of all premature NCD deaths.
Tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets all increase the
risk of dying from a NCD.
Detection, screening and treatment of NCDs, as well as palliative care, are key components of
the response to NCDs.
INTRODUCTION

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What is a NONCOMMUNICABLE DISEASE?
It is a medical condition that is noninfectious and nontransmissible.
NCDs are referred to as “chronic diseases” due to their long duration.
 The condition interferes with the individual’s way of living a normal life brought
about by different signs and symptoms lasting more than 6 months.
“Lifestyle-related diseases”

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Cardiovascular and Cerebrovascular disease
Cardiovascular disease
“heart disease”
refer to diseases that involve the heart or blood vessels (arteries, capillaries, veins)
Cerebrovascular disease
“stroke”
a group of brain dysfunction related to disease of the blood vessels supplying the brain
Note: The most common causes of these two diseases are atherosclerosis and hypertension.

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Hypertension and Atherosclerosis
Hypertension
or high BP, is defined as a systolic BP ≥ 140 mmHg or a diastolic BP ≥ 90 mmHg
Atherosclerosis
is a disease of the blood vessels characterized by the deposition of fats and cholesterol
within the walls of the artery (WHO, 2011).

Note: Uncontrolled hypertension and atherosclerosis can lead to heart attack, stroke, kidney
damage, and a host complications (Stanhope & Lancaster, 2010)

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Contributing Factors:
A person’s genetic make-up
Socioeconomic group
Mental health
Diet
Overweight and obesity
Inactivity
Tobacco
Alcohol
Diabetes
Globalization and urbanization

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Prevention:
Focusing on risk factors for cardiovascular and cerebrovascular disease
Implementing medical screening for individuals at risk
Providing effective and affordable treatment to those who require it

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Cancer
Cancer or malignant neoplasm is a group of various diseases involving unregulated cell growth
(Newtow, 2009).
The cells divide, grow uncontrollable forming malignant tumors, and invade parts of the body.
Substances that cause some cells to undergo genetic mutations are called carcinogens.

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Risk Factors for Cancer
tobacco use
unhealthy diet
insufficient physical activity
the harmful use of alcohol
Infections (hepatitis B, hepatitis C (liver cancer), human papillomavirus (HPV; cervical cancer),
Helicobacter pylori (stomach cancer)
radiation
variety of environmental and occupational exposures of varying importance

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The majority of cancer deaths
Lung, breast, colorectal, stomach and liver cancers
In high-income countries, the leading causes of cancer deaths are lung cancer among men and
breast cancer among women.
In low- and middle-income countries cancer levels vary according to the prevailing underlying
risks. In sub-Saharan Africa, for example, cervical cancer is the leading cause of cancer death
among women.

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Screening for cancer involves the early detection of the warning signals of cancer developed by
the American Cancer Society (Allender, 2010).
Warning signals of cancer:
Change in bowel or bladder habits
A sore throat that does not heal
Unusual bleeding or discharge
Thickening or lump in breast
Indigestion or difficulty of swallowing
Obvious change in a wart or mole
Nagging cough or hoarseness
Unexplained anemia
Sudden weight loss

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WHO’s approach to cancer has five pillars:
Prevention
Early Detection
Screening
Treatment
Palliative Care

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Chronic Obstructive
Pulmonary Disease (COPD)
It is disease of the lungs in which the airways narrow over time.
It includes chronic bronchitis, chronic asthma, and emphysema.
It is estimated that 7% of deaths worldwide are due to chronic respiratory diseases (WHO, 2010)
Smoking is a strong risk factor for COPD and statistics shows that 15% of cigarette smokers
develop COPD.
Second-hand smoke and pollution also aggravate the problem.
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Diabetes
Diabetes is a group of metabolic disease in which an individual has high blood sugar because the
pancreas does not produce enough insulin (a hormone that regulates blood sugar) or the cells do
not respond to the insulin produced.
Long term consequences include increased risk of heart disease, kidney disease, blindness,
neural damage

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Symptoms of Diabetes
Increased frequency and amount of urination  Polyuria
Increased thirst  Polydipsia
Increased hunger  Polyphagia
Weight loss, vision changes, and fatigue

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Prevention
To help prevent type 2 diabetes and its complications, people should:
Achieve and maintain healthy body weight
Be physically active - at least 30 minutes of regular, moderate-intensity activity on most days
Early diagnosis can be accomplished through relatively inexpensive blood testing
Treatment of diabetes involves lowering blood sugar and the levels of other known risk factors
that damage blood vessels
Tobacco cessation is also important to avoid complications

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Control
Other cost saving interventions include:
Screening and treatment for retinopathy (which causes blindness);
Blood lipid control (to regulate cholesterol levels);
Screening for early signs of diabetes-related kidney disease and treatment.

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RISK FACTORS FOR NONCOMMUNICABLE DISEASES
Physical inactivity
It is defined as less than 5 times of 30 minutes of moderate activity per week, or less than 3 times
of 20 minutes of vigorous activity per week (WHO, 2011).
Physical activity is a key determinant of energy expenditure and is thus fundamental to energy
balance and weight control.
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RISK FACTORS FOR NONCOMMUNICABLE DISEASES
Physical inactivity
Physical activity contributes to weight loss, glycemic control, improved blood pressure and lipid
profile, and insulin sensitivity (Kelley, 2005).
The risk of getting cardiovascular disease increases by 1.5 times for noncompliance of the
minimum recommendations for physical activity.

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RISK FACTORS FOR NONCOMMUNICABLE DISEASES
2. Cigarette smoking
 It is a primary risk factor for development of NCDs (Gruber and Zinman, 2001).
Smoking-related diseases like cerebrovascular disease, COPD, and lung cancer
It damages the lining of blood vessels and reduces HDL cholesterol and oxygen in the blood
(WHO, 2013).

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RISK FACTORS FOR NONCOMMUNICABLE DISEASES
2. Cigarette smoking
 Chemicals found in cigarettes are known to
cause cancer (National Cancer Institute, 2004).
 It causes lung cancer, cancer of the mouth, pharynx, larynx, and esophagus (Laudico, 2010).

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RISK FACTORS FOR NONCOMMUNICABLE DISEASES
3. Unhealthy eating
“Obesogenic” or unhealthy eating is one of the major risk factors responsible for the global
increase of cardiovascular disease, cancer, diabetes, and obesity worldwide (WHO, 2002).
High dietary intakes of saturated fat, trans-fat, cholesterol, and salt, and low intakes of fruits and
vegetables and fish are linked to overweight and obesity (WHO, 2011).

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RISK FACTORS FOR NONCOMMUNICABLE DISEASES
3. Unhealthy eating
Unhealthy eating has adverse metabolic effects on BP, cholesterol, TAG, and insulin resistance
(Strazzullo, 2009).
Food and nutrition environments are believed to be major contributors to obesity (Glanz, 2009).

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RISK FACTORS FOR NONCOMMUNICABLE DISEASES
4. Excessive alcohol drinking
Alcohol may cause malabsorption, inflammation of the GIT, liver problems, and cancer.
It is associated with colon and rectal cancer (Bongaerts et al., 2006).

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RISK FACTORS FOR NONCOMMUNICABLE DISEASES
5. Viruses
Viruses play an important role in the development of certain cancers (Philippine Cancer Society,
2010).
Viruses cause mutation by breaking the normal cell’s DNA chain during infection.
HPV : cervical and vulvar cancer
Eptein-Barr virus : nasopharyngeal and anal cancer
HTLV-1 : non-Hodgkin lymphome
HBV & HCV : liver cancer
Oncoviruses  viruses capable of causing cancer

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RISK FACTORS FOR NONCOMMUNICABLE DISEASES
6. Radiation
Radiation is energy emitted and transferred through matter and space.
2 most common forms: UV and ionizing radiation (X-rays, gamma rays)
UV radiation adversely affects the genes, and the cell enzymes causing DNA

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RISK FACTORS FOR NONCOMMUNICABLE DISEASES
6. Radiation
Ionizing radiation causes tissue and cell damage by breaking the DNA molecule (Newton, 2009).
Solar radiation is the primary source of UV radiation and the major source of skin cancer
worldwide (Cadet et al., 2005).

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Prevention of NCDs
Promote physical activity and exercise
Promote healthy diet and nutrition
Promote a smoke-free environment
Stress management

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LAWS AFFECTING CONTROL OF NCDs
EO No. 958 : National Healthy Lifestyle Advocacy Campaign
RA No. 1054 : Free emergency medical and dental treatment for employees
RA No. 9211 : Tobacco Regulation Act of 2003
RA No. 6425 : Penalties for Violations of the Dangerous Drug Act of 1972
Slide 32:
LAWS AFFECTING CONTROL OF NCDs
RA No. 9165 : Comprehensive Dangerous Drug Act of 2002
RA No. 8423 : Traditional and Alternative Medicine Act of 1997
AO No. 179 s2004 : Guidelines for the Implementation of the National Prevention of Blindness
Program
Department Personnel Order No. 2005-0547 : Creation of a Program Management Committee
for the National Prevention of Blindness Program

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LAWS AFFECTING CONTROL OF NCDs
Proclamation No. 40 : Declaring the month of August every year as “Sight Saving Month”
RA No. 7277 : Magna Carta for Disabled Persons
RA No. 10352 : An act restructuring the Excise Tax on Alcohol and Tobacco