Cancer burden and control in the Western Pacific region: challenges and opportunities.

BACKGROUND

Cancer has become a priority public health challenge in the Member States of the World Health Organization's (WHO) Western Pacific Region (WPR). Rapid and unplanned urbanization, demographic transition, and lifestyle changes are driving the increase in noncommunicable diseases (NCDs), which include cancer. The WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020, targets a reduction in premature mortality from NCDs by 25% by 2025.

OBJECTIVES

The aim of this study was to review the epidemiology of cancer including cancer control efforts in the WPR.

METHODS

Information was primarily extracted from Globocan 2012, Cancer Incidence in Five Continents Vol. X, and the NCD country capacity survey carried out by the WHO in 2013. The WPR, with one-fourth of the world's population, has one-third of all cancers globally. Cancer cases in the WPR are expected to increase from 4.5 million new cases in 2012 to 6.4 million in 2025.

FINDINGS

In most of the low- and middle-income countries (LMICs) in Asia and in Pacific Island countries and areas, coverage of cancer registration is relatively low and they face many challenges in quality of cancer registry data. Eighty-five percent of LMICs have indicated the existence of a cancer control policy strategy and/or action plan. The predominance of lung, stomach, colorectal, breast, and cervical cancers makes control of the disease more amenable in the WPR. A relatively high ratio of mortality to incidence in LMICs reflects health-system limitations, especially in the diagnosis and management of cancer.

CONCLUSIONS

Strengthening cancer registration, tobacco control, and promotion of a healthy diet, as well as HBV and HPV vaccination, is the priority areas to reduce cancer burden. Health-system strengthening with a defined package of services at different levels, referral care, trained human resources, and appropriate technology is necessary to improve cancer management. Pain relief and palliative care are priorities as well. A well-planned national cancer control program with a strong component of surveillance and monitoring can help to reduce the cancer burden in LMICs and Pacific Island countries.