National Cancer Control Plan

Objectives

Cambodia’s National Cancer Control Plan 2025–2030 sets a comprehensive, coordinated and realistic framework to reduce preventable cancer incidence, morbidity and premature mortality, while improving survival, survivorship and quality of life for people affected by cancer and their families. Its vision is a low cancer burden, high survival rates and dignified lives for people with cancer and their families.[1][2]The plan responds to a substantial national burden, with an estimated 19,795 new cancer cases and 13,799 cancer deaths in 2022.[3]

• Reduce exposure to modifiable behavioural, infectious, environmental, occupational and social determinants of cancer, including tobacco use, harmful alcohol use, unhealthy diets, physical inactivity, overweight and obesity.[2][4]
• Achieve primary-prevention targets of at least a 30% reduction in adult tobacco use and at least a 20% reduction in harmful alcohol use by 2030.[2][5]
• Expand vaccination and infection control, including hepatitis B and human papillomavirus vaccination, alongside hepatitis C identification and treatment and actions addressing other cancer-associated infections.[6][7]
• Strengthen screening and early detection linked to diagnostic confirmation and treatment, including a target of 70% cervical cancer screening coverage among women aged 30 to 49 years by 2030.[4][8]
• Improve earlier detection of breast, colorectal, childhood and older-person cancers through awareness, risk assessment, clinical examination, prompt referral and timely diagnosis.[8][9][10]
• Ensure equitable access to accurate diagnosis, quality treatment and care across pathology, laboratory medicine, imaging, nuclear medicine, surgery, radiotherapy, systemic treatment, palliative care, rehabilitation and survivorship support.[11][12][13]
• Establish at least one Comprehensive Cancer Centre meeting nationally defined standards for diagnosis, treatment, care, education and research by 2030.[14][15]
• Develop comprehensive childhood cancer services, including designated paediatric oncology centres, defined care packages, clinical guidance, referral arrangements, psychosocial and nutritional support, and dedicated radiotherapy capacity.[16][17]
• Strengthen cancer information systems, registration, surveillance, research, innovation, workforce capacity, governance, coordination, financing and emergency preparedness.[18][19]

Implementation

Implementation uses a multisectoral, evidence-based, person-centred, equitable and sustainable approach aligned with universal health coverage, the Sustainable Development Goals and relevant World Health Organization, regional and international cancer-control frameworks.[20][2]Delivery is organised across the cancer continuum and a tiered health system, with health centres providing prevention, counselling, vaccination, screening and referral; referral hospitals providing investigation and essential treatment; and national hospitals providing advanced diagnostics and specialised care.[21]

• Lead implementation through the Ministry of Health under oversight of the Inter-Ministerial Committee for Non-Communicable Disease Control, with the National Program for Cancer Control leading coordination, implementation and monitoring and evaluation.[22][23]
• Establish an National Program for Cancer Control office, National Cancer Technical Working Group, professional task forces and strengthened municipal and provincial Disease Prevention and Control Offices as subnational support structures.[24][22]
• Engage other ministries, public and private providers, academia, civil society, development partners, communities, patients and families through stakeholder mapping, communication, consultation and public-private-people partnerships.[20][24]
• Translate strategic actions into annual operational plans and budgets, supported by a three-year rolling plan integrated into Ministry of Health budget planning.[22]
• Standardise services through national policies, treatment guidelines, protocols and standard operating procedures for screening, pathology, specimen handling, imaging, treatment, palliative care, rehabilitation and childhood cancer.[12][14][25]
• Build multidisciplinary professional networks and workforce capacity for pathology, oncology, imaging, palliative care and childhood cancer through workforce planning, recruitment, specialist training, curricula reform, fellowships, e-learning and international collaboration.[12][18][26]
• Strengthen referral pathways between health centres, referral hospitals, designated national hospitals, future regional hospitals and cancer centres, particularly for positive screening results, suspected cancer and paediatric oncology.[8][11][17]
• Expand cancer registration through a five-year costed plan for hospital-based and population-based systems, beginning population-based registration in Phnom Penh and applying international coding, staging and data-quality standards.[18][27]
• Use routine facility data, surveys, cancer registries, electronic records, telemedicine and digital platforms to support service delivery, surveillance, distance learning, public education and research.[19][28]
• Conduct baseline, mid-term and final National Cancer Control Plan evaluations in 2025, 2027 and 2030 respectively, alongside routine monitoring, annual reviews and data-quality audits.[19][29]
• Mobilise funding from the Royal Government of Cambodia, national and international partners, private donations, foundations and potential earmarked tobacco and alcohol excise-tax revenue; a costing and baseline-data study is planned for 2025 because the total six-year budget was not yet available.[24][22]
• Expand financial protection by defining essential cancer medicines, commodities and services and advocating their gradual inclusion in Health Equity Fund and National Social Security Fund benefit packages.[24][30]
• Maintain continuity of chemotherapy, radiotherapy, surgery, essential medicines, communication and patient support during emergencies through facility emergency plans integrated with national emergency planning.[22][30]

Monitoring & Evaluation

Monitoring and evaluation is led by the National Program for Cancer Control (NPCC) under oversight of the Inter-Ministerial Committee for Non-Communicable Disease Control, with routine monitoring of implementation progress, challenges, inputs, activities, outputs and outcomes, and annual reviews against the indicator framework in Annex 2.[24][22]

• Conduct baseline, mid-term and final evaluations of the National Cancer Control Plan in 2025, 2027 and 2030 respectively, disseminating findings to stakeholders and using baseline findings to update data and adjust proposed 2030 targets.[19][29][28]
• Monitor impact indicators including cancer incidence and mortality rates per 100,000 population, using Global Cancer Observatory estimates, civil registration and vital statistics, population surveys with verbal autopsy, and population-based cancer registries as these become available.[30][5]
• Track five-year survival by cancer type and stage at diagnosis through population-based and facility-based registries, alongside prevention indicators for tobacco use, harmful alcohol use, physical inactivity and unhealthy diets.[5]
• Measure service coverage and quality across vaccination, screening, diagnosis, treatment, workforce, service availability and multidisciplinary care, drawing on routine programme data, health-facility assessments, surveys, and hospital-based and population-based cancer registries.[31][32][33]
• Strengthen routine facility and surveillance-site data collection on risk factors, screening, referrals, diagnosis, treatment and inequities affecting vulnerable, rural, female and ethnic-minority populations; include key cancer indicators in routine data and national and subnational surveys.[19][28]
• Improve data quality through standardised data definitions and coding, data-quality audits, analytical capacity and dissemination of national cancer surveillance reports.[18][19][28]
• Develop hospital-based and population-based registration through a five-year national plan, beginning population-based registration in Phnom Penh and expanding hospital-based registration across cancer-care sites.[18][27][28]
• Apply implementation oversight through the Working Group for Cancer Registration, professional networks and technical working groups, including a dedicated group to monitor Comprehensive Cancer Centre development.[18][15]

Costing & Financing

Financing is intended to combine Royal Government of Cambodia funding, national and international partners, private donations, development partners, international organisations and foundations, alongside annual budgets and a three-year rolling plan integrated into Ministry of Health planning.[22][34][35]Cancer funding is nevertheless described as inadequate, while substantial out-of-pocket payments create financial risk and may delay or prevent access to care.[36][37]

• Conduct a costing study and baseline-data study in 2025 because the total six-year implementation budget was not yet available.[22]
• Prioritise mobilisation of 2025 funding for NPCC operating costs, baseline work and the costing study; because the government budget plan had already been decided, funding for new core activities was expected from national and international health partners.[24][22]
• Develop costed plans for Comprehensive Cancer Centres and for a five-year programme of hospital-based and population-based cancer registration, for Ministry of Health review and approval where applicable.[14][18][15]
• Expand financial protection by defining essential cancer medicines, commodities and services and advocating their gradual inclusion in Health Equity Fund and National Social Security Fund benefit packages.[24][30]
• Advocate increased government funding, potentially including earmarked revenues from increased tobacco and alcohol excise taxes, and assess establishment of a Cambodia Cancer Foundation.[24][34][30]
• Allocate an estimated United States dollar 7,764,346 for cancer-prevention activities and at least United States dollar 500,000 for new core activities in 2025, excluding ongoing prevention activities.[22]
• Recognise the wider economic burden: premature cancer deaths were estimated to cost Cambodia United States dollar 1.1 billion in 2019, excluding direct costs.[38]