There is still a high level of malignant tumours.

Diseases of concern are thyroid cancer, benign tumours, autoimmune thyroiditis and hypothyroidism.

The incidence of cancer The incidence of malignant tumours continues to be significant in Latvia, but comparatively few of these tumours are diagnosed during preventive treatment (see the table below).

Most of the remaining 5 are sex cord gonadal stromal tumours derived from Leydig cells or Sertoli cells.

In connection with this issue, the following numbers have been recorded (admissions and discharges) for malignant breast tumours

In recent years the incidence of malignant tumours in the country increased by an average of 25 per cent.

Although, since 1998, there have been fewer incidences of malignant tumours (8,567 first time patients in 2001 as opposed to 8,685 in 2000), but over the course of the last 10 years, the incidence of such tumours has increased by a total of 9.6 (see the table).

An analysis of the structure of malignant tumours shows that there have been no significant changes over the last several years.

The constant relative risk estimates in the 1988 report were 10 per cent for solid tumours and 1 per cent for leukaemia at 1 Sv.

After reviewing the proposed study, the Panel considers that the following modifications are necessary The study of testis tumours, retinoblastoma, neuroblastoma and Wilms tumour should be excluded.

The principal cause of death in 2008 was cardiovascular disease at 43.5 for men and 57.2 for women, followed by tumours, at 29.4 for men and 21.4 for women.

The early cancer detection programme for women is intended to reduce deaths from cancerous tumours by increasing awareness of the signs of cancer and examining sufferers at least once.

Starting from the age 45 the need of hospital care both among men and women is most often due to cardiovascular diseases and also tumours, diseases connected with the muscular skeletal system and diseases of the connective tissue.

If samples of tumours from radiation exposed human groups were to be systematically stored, they would then be a very important resource for future studies on oncogenic mechanisms and for the establishment of causality between cancer in the population and physical or chemical carcinogens in the environment.

Moreover, they do not appear among the 10 principal causes of death among women of productive age (15 64) the 5 principal causes of death among women in this group are diabetes mellitus, ischaemic diseases of the heart, malignant tumours, cerebro vascular diseases and chronic obstructive pulmonary disease.

One example is the lack of a response from Abbott Laboratories concerning Cuba's request for acquisition of the metering equipment for the immunosuppressant Tracolimus (FK506), which is produced solely by this United States laboratory, and which is essential for monitoring blood levels, variations in which can cause complications from infections and secondary tumours.

With regard to the treatment of cancer, it was not possible to acquire spare parts or radiation sources for two automatic afterloading machines for the treatment of gynaecological tumours (brachytherapy equipment), purchased from the Canadian firm MSD Nordion, since that company had sold the brand for this equipment to the United States firm Varian.

Testis tumours are unlikely to be associated with environmental factors while retinoblastoma, neuroblastoma and Wilms tumour are extremely rare and The statistical analysis using the DALY index should be excluded because the calculation is not necessary to complete the epidemiological investigation and because the results of the study will not be available to support any claim before the Commission.

Mother and child care Vaccination programmes Health care for persons with disabilities and older persons Health care for students Health care in the event of an accident, emergency or natural disaster Prevention and eradication of infectious and contagious diseases Treatment for complex conditions, including the excision of tumours, limb transplants and treatment of kidney failure Psychiatric services.