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Review
. 2019 Sep;20(9):e475-e492.
doi: 10.1016/S1470-2045(19)30400-0. Epub 2019 Aug 5.

Cancer control in the Pacific: big challenges facing small island states

Diana Sarfati  1 , Rachel Dyer  2 , Filipina Amosa-Lei Sam  3 , Michael Barton  4 , Freddie Bray  5 , Eka Buadromo  6 , Alec Ekeroma  7 , Sunia Foliaki  8 , James Fong  9 , Josephine Herman  10 , Linda Huggins  11 , Kiki Maoate  12 , Ineke Meredith  13 , Glen Mola  14 , Neal Palafox  15 , Viliami Puloka  16 , Hai-Rim Shin  17 , Jane Skeen  18 , Wendy Snowdon  19 , Malama Tafuna'i  20 , Andrea Teng  2 , David Watters  21 , Paula Vivili  22
Affiliations
Review

Cancer control in the Pacific: big challenges facing small island states

Diana Sarfati et al. Lancet Oncol. 2019 Sep.

Abstract

This Series paper describes the current state of cancer control in Pacific island countries and territories (PICTs). PICTs are diverse but face common challenges of having small, geographically dispersed, isolated populations, with restricted resources, fragile ecological and economic systems, and overburdened health services. PICTs face a triple burden of infection-related cancers, rapid transition to lifestyle-related diseases, and ageing populations; additionally, PICTs are increasingly having to respond to natural disasters associated with climate change. In the Pacific region, cancer surveillance systems are generally weaker than those in high-income countries, and patients often present at advanced cancer stage. Many PICTs are unable to provide comprehensive cancer services, with some patients receiving cancer care in other countries where resources allow. Many PICTs do not have, or have poorly developed, cancer screening, pathology, oncology, surgical, and palliative care services, although some examples of innovative cancer planning, prevention, and treatment approaches have been developed in the region. To improve cancer outcomes, we recommend prioritising regional collaborative approaches, enhancing cervical cancer prevention, improving cancer surveillance and palliative care services, and developing targeted treatment capacity in the region.

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Figures

Figure 1:
Figure 1:. Map of the Pacific region
Green islands are part of Melanesia, red islands are part of Polynesia, and yellow islands are part of Micronesia.
Figure 2:
Figure 2:
Estimated proportion of total cancer incidence and mortality for the top five cancers by gender in selected Pacific island countries and territories (GLOBOCAN 2018)
Figure 3:
Figure 3:. Required travel routes and times taken by patients within selected Pacific Island countries and territories to access cancer care
Transportation methods and time taken for patients from Kiribati (A), Tokelau (B), Solomon Islands (C), and Papua New Guinea (D) to reach cancer care. NRH=National Referral Hospital of Honiara.
See this image and copyright information in PMC

Comment in

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