World Cancer Day: Closing the Care Gap

Dr Poonam Ketrapal Singh, WHO Regional Director for Southeast Asia

On World Cancer Day, WHO will mobilize health systems across the Southeast Asia region to prevent and detect cancer early, provide prompt treatment referrals, strengthen access to palliative care, and bridge gaps in access to healthcare. calling for reinforcement. Quality cancer services – the theme of this year’s anniversary.

Cancer is the second leading cause of death worldwide, with an estimated 9.9 million deaths in 2020. An estimated one-third of cancer deaths worldwide are caused by tobacco use, high body mass index, alcohol use, low fruit and vegetable intake, and physical inactivity.

In the WHO Southeast Asia Region, an estimated 2.3 million people developed cancer in 2020 and 1.4 million died from the disease. Cancer is estimated to account for more than 20% of premature deaths from non-communicable diseases (NCDs) in the region, killing about 4.7 million people each year. In 2020, lung, breast, and cervical cancers accounted for 400,000 of the total cancer-related deaths in the region, with nearly two-thirds of those diagnosed with cancer died of this disease. diagnosis and treatment.

Since 2014, the region has accelerated action for cancer prevention, detection, treatment and control, with increasing focus on eliminating cervical cancer as a public health problem. . Eight countries in the region currently have population-based cancer registries (PCBRs) in place, and her three countries of Myanmar, Nepal and Sri Lanka are focus countries for tackling childhood cancer. Ten of the region’s 11 Member States provide tertiary care services for cancer diagnosis and treatment, including surgery and chemotherapy services, and nine also provide radiotherapy services. It offers.

WHO is committed to implementing a new regional action plan on oral health from 2022 to 2030, including oral cancer, which is among the top five most common cancers in 2020 and accounts for 7.4% of new cancers. We continue to support the countries of the region. Five countries – Bhutan, India, Myanmar, Sri Lanka and Thailand – currently have national cancer control plans, while the Maldives and Nepal are finalizing them. The region is now on track to meet the WHO NCD Global Action Plan target of a 30% relative reduction in tobacco use between 2010 and 2025.

The region is making rapid life-saving progress when it comes to cervical cancer. Five Member States – Bhutan, Maldives, Myanmar, Sri Lanka and Thailand – have introduced nationwide his HPV vaccination, and Bangladesh, India and Timor-Leste will do the same. Indonesia has introduced her HPV vaccination in several provinces, covering tens of millions of girls. New evidence shows that her single dose of the HPV vaccine provided protection comparable to her double dose schedule and, coupled with additional cost savings, should allow countries to reach all women and girls. .

To accelerate progress and close gaps in care, the region has several priorities. First, introduce and/or expand HPV vaccination into routine immunizations to prevent cervical cancer and to cover at least 90% of adolescent girls. At the same time, the region is committed to not only increasing taxes on tobacco products, but also to promoting health and wellbeing, including not just enacting but enforcing important tobacco control measures such as health warnings, tobacco advertising, promotion and bans on sponsorship. We must continue to promote a positive lifestyle.

Second, increase the ability to detect cancer early at the primary health care (PHC) level, strengthen the training of health workers, improve infrastructure and resources, and open referral pathways to initiate treatment quickly. The focus is on streamlining. In all countries, PHC doctors and nurses should be prepared to provide palliative and end-of-life care close to the patient’s home and family in the community.

Third, we will rapidly and systematically improve the capacity of tertiary care facilities so that they can provide comprehensive diagnostic and therapeutic services. This is essential for reducing cancer mortality. Interventions should target high-burden cancers with a high chance of cure. It should be accessible to everyone. Improving existing he PBCRs and establishing new registries where necessary to ensure that policy makers have access to quality information to plan, monitor, evaluate and adjust interventions accordingly is needed.

Fourth, includes cancer services in risk pooling or prepayment schemes and health benefit packages. To this end, national health budgets must focus on ending devastating healthcare costs, improving the quality and accessibility of public sector services, and strengthening financial protection.

Actions cannot and should not be awaited. Over the past two decades, the world has made great strides in the science of cancer control. But more needs to be done to close the care gap, improve cancer survival and accelerate towards the 2025 NCD and 2030 Sustainable Development Goals goals. , to treat and control cancer and ensure equitable access to quality cancer services for all, everywhere.