Martiniuk Alexandra, Jagilli Rooney, Natuzzi Eileen, Ilopitu John Wesley, Oipata Meltus, Christie Annie-Marie, Korini Jefferey, Vujovich-Dunn Cassandra, Yu William
University of Sydney, Australia; University of Toronto, Australia; George Institute for Global Health, Edward Ford Building, 2000, Australia.
General Surgeon and Medical Superintendent National Referral Hospital, Honiara, Solomon Islands.
Cancer Epidemiol. 2017 Oct;50(Pt B):176-183. doi: 10.1016/j.canep.2017.04.016.
The Solomon Islands, with a population of 550,000, has significant challenges in addressing non-communicable diseases, including cancer, in the face of significant economic, cultural, general awareness and health system challenges.
To summarise the existing knowledge regarding cancer in the Solomon Islands, to gather new data and make recommendations.
A literature review was undertaken and cancer data from the National Referral Hospital, Honiara were analysed and are presented. Key stakeholders were interviewed for their perspectives including areas to target for ongoing, incremental improvements. Last, a health services audit for cancer using the WHO SARA tool was undertaken.
Breast and cervical cancer remain the first and second most commonly identified cancers in the Solomon Islands. The Solomons cancer registry is hospital based and suffers from incomplete data collection due to its passive nature, lack of resources for data entry and processing resulting in weak data which is rarely used for decision-making. The health system audit revealed system and individual reasons for delayed diagnosis or lack of cancer treatment or palliation in the Solomon Islands. Reasons included lack of patient knowledge regarding symptoms, late referrals to the National Referral Hospital and inability of health care workers to detect cancers either due to lack of skills to do so, or lack of diagnostic capabilities, and an overall lack of access to any health care, due to geographical barriers and overall national economic fragility.
The Solomon Islands is challenged in preventing, diagnosing, treating and palliating cancer. Stakeholders recommend establishing specialty expertise (in the form of a cancer unit), improved registry processes and increased collaboration between the sole tertiary hospital nationwide and other Solomon health services as important targets for incremental improvement.
所罗门群岛有55万人口，在应对包括癌症在内的非传染性疾病方面面临重大挑战，因为该国面临着经济、文化、公众意识和卫生系统等多方面的重大挑战。
总结所罗门群岛癌症方面的现有知识，收集新数据并提出建议。
进行了文献综述，分析并呈现了霍尼亚拉国立转诊医院的癌症数据。采访了关键利益相关者，了解他们的观点，包括持续渐进式改进的目标领域。最后，使用世界卫生组织的SARA工具对癌症卫生服务进行了审计。
乳腺癌和宫颈癌仍然是所罗门群岛最常确诊的第一和第二大癌症。所罗门群岛癌症登记处以医院为基础，由于其被动性、缺乏数据录入和处理资源，导致数据收集不完整，数据质量差，很少用于决策。卫生系统审计揭示了所罗门群岛癌症诊断延迟、缺乏癌症治疗或姑息治疗的系统和个人原因。原因包括患者对症状缺乏了解、转诊到国立转诊医院较晚，以及医护人员由于缺乏检测技能或诊断能力而无法检测出癌症，还包括由于地理障碍和国家整体经济脆弱性导致总体上无法获得任何医疗服务。
所罗门群岛在预防、诊断、治疗和姑息治疗癌症方面面临挑战。利益相关者建议建立专业知识体系（以癌症科室的形式）、改进登记流程，并加强全国唯一的三级医院与所罗门群岛其他卫生服务机构之间的合作，作为渐进式改进的重要目标。
