National Cancer Control Programme 2022-2025

Objectives

The National Cancer Control Programme 2022–2025 provides a comprehensive, equitable and patient-centred framework to reduce cancer incidence, morbidity and mortality, improve survival and quality of life, and deliver prevention, early detection, diagnosis, treatment, palliation, rehabilitation and research.[1][2][3]It prioritises evidence-based, safe, effective and affordable services, aligned with universal health coverage and financial protection objectives.[1][4][5]

• Strengthen health promotion and primary prevention by addressing tobacco use, harmful alcohol consumption, unhealthy diets, obesity, physical inactivity, excessive sun exposure, occupational and environmental carcinogens, air pollution, and cancer-related infections.[6][7][8][9][10]
• Expand vaccination, sexual-health education and infection prevention, including human papillomavirus vaccination and Hepatitis B protection, to reduce infection-related cancers.[11][12]
• Improve early detection through organised breast, cervical and colorectal cancer screening, with strengthened referral, diagnostic follow-up, treatment of precancerous lesions and centralised screening information systems.[13][14][15][16]
• Prioritise breast, cervical, colorectal, prostate and lung cancers while continuing to address all other cancers.[17][18][3]
• Expand breast cancer prevention, screening, fast-track diagnosis and multidisciplinary care, with targets to reduce breast cancer mortality by 40%, reach at least 50% of women aged 50–69 years through screening, and increase awareness by 60% by 2025.[19][20]
• Improve cervical cancer control through awareness, vaccination, co-testing, screening, timely referral and standardised treatment, including a target to screen at least 50% of the target population by 2025.[21][22]
• Establish colorectal screening and multidisciplinary management, promote earlier presentation and healthier lifestyles, and strengthen endoscopy services across regional hospitals.[23][24][25]
• Reduce lung cancer incidence and mortality through tobacco control, earlier diagnosis, thoracic surgical capacity, modern radiotherapy, molecular studies and immunotherapy.[25][26]
• Standardise prostate cancer care according to disease stage, promote awareness of warning signs and target adoption of Mauritius-specific procedures and protocols among 50% of relevant medical and paramedical cadres by 2025.[27][28]
• Develop integrated treatment capacity spanning surgery, chemotherapy, targeted therapy, immunotherapy, radiotherapy, nuclear medicine, paediatric oncology, transfusion support, stem-cell transplantation, diagnostic services and allied health support.[16][29][30][31]
• Extend palliative care from hospital inpatient and outpatient services to community and domiciliary care, providing pain relief and physical, psychosocial and spiritual support, with at least 60% coverage of patients requiring palliative care targeted by 2025.[32][33][34]
• Position the National Cancer Hospital as a comprehensive cancer centre and regional centre of excellence, incorporating clinical care, prevention, research, clinical trials, professional training, cancer information and community outreach.[35][36]

Implementation

Implementation is centred on the Ministry of Health and Wellness and the National Cancer Hospital, supported by coordinated action across primary care, regional hospitals, specialised units, communities, civil society, training institutions and international partners.[6][37][3]The programme combines service expansion, workforce development, infrastructure and technology investment, clinical protocols, medicine supply, information systems and structured oversight.[18][5]

• Coordinate implementation through a National Cancer Control Programme Steering Committee chaired by the Director General Health Services, with Ministry, other ministry and non-governmental organisation representation, supported by sub-committees for awareness, screening, diagnostics and treatment, palliative care and research.[4]
• Convene the Steering Committee quarterly to supervise delivery, assess progress against objectives, identify deviations and agree corrective measures; produce an annual draft report on programme achievements.[4]
• Deliver services through the National Cancer Hospital, five regional hospitals, primary health care centres, mobile clinics and community-based teams, with chemotherapy decentralised to regional facilities and palliative care extended to homes where appropriate.[12][16][32][33]
• Establish Breast Health Units in regional hospitals, beginning with a pilot at Dr A.G. Jeetoo Hospital, and provide one-stop multidisciplinary assessment, imaging, biopsy, surgery, genetic counselling, psychological support and lymphoedema care.[20][27]
• Develop the National Cancer Hospital’s specialist capacity through radiotherapy modernisation, positron emission tomography-computed tomography, nuclear imaging, laboratory expansion, interventional radiology, stem-cell collection and banking, and surgical oncology facilities.[30][31][38][39]
• Maintain access to public-sector cancer treatment free at the point of delivery and procure medicines, supplies and equipment through Ministry-managed supply chains, including formulary review for novel therapies.[17][38][32]
• Recruit, redeploy and train specialised medical, nursing, paramedical, laboratory, radiotherapy, medical physics, screening and palliative-care personnel as services are introduced.[35][36][40][41]
• Use international twinning, expert support and training partnerships to develop stem-cell transplantation, paediatric oncology, radiotherapy, research and other specialised cancer services.[34][35][4]
• Strengthen surveillance through the population-based National Cancer Registry, which collects and classifies cancer information and supports planning, monitoring and assessment of cancer’s impact.[17][42][37]
• Apply targeted monitoring mechanisms, including screening databases for call, recall, quality assurance and follow-up; radiotherapy dosimetry and quality assurance; haemovigilance for transfusion reactions; and monitoring of prevention measures such as tobacco control and environmental exposures.[14][38][43][8][9]
• Fund major implementation inputs through public resources and annual budgets, with funds already earmarked for major hospital equipment and initial staffing; the estimated National Cancer Hospital project value is around 1.6 billion Mauritian rupees.[5]The overall estimated cost of activities, human resources and logistics is 185,203,370 Mauritian rupees.[3]

Monitoring & Evaluation

The National Cancer Control Programme 2022–2025 combines population-based cancer surveillance, programme oversight, quality assurance and disease-specific targets. The National Cancer Registry is the principal information system for measuring cancer occurrence and supporting planning, coordination, monitoring and evaluation of services.[42][37]A National Cancer Control Programme Steering Committee is intended to provide implementation oversight, indicator analysis and corrective action.[4][3]

• Maintain the population-based National Cancer Registry, which has operated since 2000 and captures cancer cases including diagnoses made by private pathologists.[17]Collect and classify data on all cancer types to measure occurrence and assess cancer’s community impact.[17][42]
• Use registry data to track burden and trends: 2,883 new cancer cases were registered in 2020, an 8% increase from 2019; cancer caused 1,431 deaths in 2020, comprising 676 male and 755 female deaths.[42][2]
• Convene the Steering Committee every three months to supervise implementation, assess progress against objectives, identify deviations and agree corrective measures.[4]Produce an annual draft report on programme achievements.[4]
• Strengthen information systems through a centralised screening database for data capture, quality assurance, call and recall, follow-up and target-population management.[14][16][44]
• Monitor explicit programme targets, including near 60% cervical-screening coverage among sexually active women aged 25 to 65 years by 2025, at least 50% mammography coverage among women aged 50 to 69 years by 2025, a 40% reduction in breast-cancer mortality by 2025, and palliative-care coverage for at least 60% of patients requiring it by 2025.[14][19][20][33]
• Apply quality and safety controls through radiotherapy dosimetry and quality assurance, quarterly Pharmacy and Therapeutics Committee review of medicines, haemovigilance monitoring of transfusion reactions, and monitoring of environmental risks including pesticide residues, air quality and asbestos.[38][45][43][9]
• Address previously identified weaknesses, including the former absence of a National Steering Committee, lack of structured national screening for cervical, breast and colorectal cancers, and non-adoption of quality-assurance programmes.[7]

Although the Programme establishes surveillance mechanisms, committees and several time-bound targets, the supplied text does not specify a consolidated indicator set, indicator definitions, reporting templates, external evaluation arrangements or a comprehensive accountability framework covering all components.[4][3][46]

Costing & Financing

The Programme is costed for 2022–2025 and combines government investment, earmarked public funding, annual recurrent-budget financing for expanding services, and quantified activity, workforce and logistics costs.[5][3]The total estimated cost for activities, human resources and other logistics is 185,203,370 Mauritian rupees, equivalent to an estimated annual average of 46,300,843 Mauritian rupees.[3]

• Allocate 120,920,460 Mauritian rupees for programme activities during 2022–2025, including 38,420,000 Mauritian rupees for secondary prevention, 58,750,000 Mauritian rupees for laboratory services and haematology, 7,650,460 Mauritian rupees for palliative care, and 15,000,000 Mauritian rupees for transfusion support.[47][48]
• Provide 54,782,910 Mauritian rupees for human resources, excluding redeployed staff, already funded posts and posts to be created as new services are introduced, and provide 9,500,000 Mauritian rupees for other logistics.[3]
• Fund primary prevention at 1,100,000 Mauritian rupees over four years, comprising tobacco-cessation collaboration, obesity, nutrition and physical-activity campaigns, and environmental sensitisation workshops.[49][50]
• Fund secondary prevention at 38,420,000 Mauritian rupees over four years, including breast-screening equipment, cervical-screening equipment and phased colorectal faecal immunochemical testing and analyser supplies.[44][51]
• Provide 6,180,461 rupees for palliative-care drugs and 1,470,000 rupees for palliative-care equipment and consumables over four years.[52]
• Use annual budgets to finance specialised recruitment and new services, while treating redeployed personnel as generating no additional cost.[36][5][49]
• Maintain earmarked capital resources for major National Cancer Hospital equipment, radiotherapy capital investments, initial staffing and cobalt-60 source maintenance or replacement.[31][5][45]

The estimated National Cancer Hospital project value at Solferino is around 1.6 billion Mauritian rupees, based on Budget 2021–2022.[5]Costing drew on user-department information on staffing, training, equipment and interventions; salary estimates used the Pay Research Bureau Report 2021 and equipment estimates reflected prevailing market prices.[5]The supplied text does not specify a complete funding-source breakdown, resource-mobilisation strategy, quantified funding gap or wider economic assumptions.[5][3]