National Cancer Control Programme 2022-2025

Objectives

The National Cancer Control Programme 2022–2025 provides Mauritius with a comprehensive framework to reduce cancer incidence, morbidity and mortality, while improving survival and quality of life through prevention, early detection, diagnosis, treatment, palliative care, research and rehabilitation. It seeks to provide modern, evidence-based, safe, high-quality and patient-centred services, aligned with international standards, and to address gaps in cancer management through coordinated action to 2025.[1][2][3]

• Promote healthy lifestyles and primary prevention by reducing tobacco use, harmful alcohol consumption, unhealthy diets, physical inactivity, overweight and obesity, excessive sun exposure, occupational carcinogen exposure, pollution and infection-related risks.[4][5]
• Strengthen immunisation, sexual-health education and infection prevention, including hepatitis B and human papillomavirus vaccination, to prevent cancers associated with human papillomavirus, hepatitis viruses, human immunodeficiency virus and other infections.[6][7]
• Expand structured screening and early diagnosis for breast, cervical and colorectal cancers, supported by public awareness, referral pathways, quality assurance, follow-up and treatment of precancerous lesions.[8][9][10]
• Prioritise breast, colorectal, prostate, cervical and lung cancers while maintaining services for other cancers and strengthening paediatric oncology.[11][12]
• Improve access to integrated cancer care, including surgery, chemotherapy, radiotherapy, nuclear medicine, diagnostics, transfusion support, rehabilitation, psychosocial care, palliative care and survivorship support.[10][13]
• Develop the National Cancer Hospital at Solferino into a comprehensive cancer centre and regional centre of excellence, combining care delivery with research, clinical trials, training, information services and community outreach.[14]
• Expand palliative care across inpatient, outpatient, community and domiciliary settings, with a target to cover at least 60% of people requiring palliative care by 2025.[15][16]
• Strengthen cancer information, research and radiation safety, including the population-based cancer registry, an oncology research unit, improved survival measurement and safe use of radiotherapy technologies.[11][3][15]

Implementation

Implementation uses a whole-of-government, health-system approach structured around leadership and governance, workforce planning, medicines and vaccines, health information systems, service delivery and financing. The Ministry of Health and Wellness leads policy and service delivery, centred on the National Cancer Hospital and linked regional hospitals, primary care facilities, community services and the population-based National Cancer Registry.[11][3][17]

• Coordinate programme oversight through a National Cancer Control Programme Steering Committee chaired by the Director General Health Services, with representation from the Ministry of Health and Wellness, other key ministries and non-governmental organisations.[18]
• Establish sub-committees for awareness and health education, screening, diagnostics and treatment, palliative care, and research to support professional management and coordinated implementation.[18][19]
• Engage ministries responsible for education, finance, social protection, food and agriculture, gender and family welfare, environment and radiation safety, alongside the Mauritius Institute of Health, University of Mauritius, non-governmental organisations, civil society and cancer survivors.[3][17]
• Deliver prevention through inter-ministerial regulation, taxation, public campaigns, school curricula, community activities, food-control measures, environmental monitoring, tobacco cessation and vaccination programmes.[20][21][22]
• Provide screening through primary health care centres, dedicated clinics, mobile health clinics, regional Breast Health Units, mammography, cervical cytology and colposcopy services, and faecal immunochemical testing with colonoscopy referral for positive results.[8][9][23]
• Maintain and expand treatment through the National Cancer Hospital, regional hospitals and Victoria Hospital radiotherapy services, with decentralised chemotherapy, multidisciplinary clinical teams and referral pathways across surgery, imaging, pathology, oncology and palliative care.[3][10][24]
• Upgrade infrastructure and technology through advanced radiotherapy, positron emission tomography-computed tomography, nuclear medicine, pathology, interventional radiology, apheresis, blood-component irradiation, stem-cell collection and banking, and high-dose-rate brachytherapy.[25][26][27][28]
• Develop workforce capacity through recruitment, redeployment, specialist and super-specialist training in oncology, radiotherapy, pathology, screening, palliative care, nuclear medicine, surgical oncology and medical physics.[14][29][30][18]
• Monitor implementation through quarterly Steering Committee meetings, annual reporting, programme-indicator analysis, registry data, screening databases and clinical quality-assurance arrangements.[18][19][9][26]
• Finance delivery through public resources, annual budgets and earmarked funding for hospital equipment, initial staffing and specialised services; the estimated National Cancer Hospital project value cited in the 2021–2022 Budget was 1.6 billion Mauritian rupees.[19]
• Apply identified costed investments, including 1.1 million Mauritian rupees for primary prevention, 30.2 million Mauritian rupees for breast-screening equipment, 7.65 million Mauritian rupees for palliative-care drugs, equipment and consumables, and 15 million Mauritian rupees for transfusion-support improvements.[31][32][28]

Monitoring & Evaluation

Monitoring and accountability combine population-based cancer surveillance, programme targets, service-quality controls and proposed governance mechanisms. The National Cancer Registry, maintained as a population-based registry since 1990, collects and classifies data on all cancer types to generate occurrence statistics and inform planning, coordination, monitoring and evaluation.[33][3]The 2022–2025 programme assigns management, implementation, evaluation and analysis of its indicators to a National Cancer Control Programme Steering Committee.[18]

• Establish a Steering Committee chaired by the Director General Health Services, supported by sub-committees for awareness and health education, screening, diagnostics and treatment, palliative care, and research.[18]
• Hold Steering Committee meetings every three months to supervise progress against strategies and objectives, identify deviations, and take corrective action.[18]
• Prepare an annual draft report on programme achievements.[19]
• Strengthen the cancer registry’s use in cancer-service programming and use cancer incidence, prevalence, morbidity, mortality and five-year survival as key outcome areas.[11][3]
• Develop monitoring tools with clinicians to support timely, high-quality interventions.[3]

The plan includes measurable implementation targets across prevention, screening and care. Primary prevention is intended to prevent up to 40% of cancers through risk-factor reduction.[5]Cervical screening aims to reach at least 50% of the target population by 2025, with human papillomavirus co-testing introduced by that year.[34]Breast screening targets at least 50% coverage among women aged 50 to 69 by 2025, alongside a 40% reduction in breast-cancer mortality and a 60% increase in public awareness.[35]Colorectal screening is to progress from a 2022 feasibility study to coverage of 25% of the population by 2025.[36]Palliative care aims to reach at least 60% of patients requiring it by 2025.[16]

Operational information systems and quality assurance are specified for selected services. A centralised cervical-screening system is intended to support data capture, target-population databases, quality assurance, call and recall, follow-up and management of precancerous lesions.[9][31]A central database is also planned for the National Cancer Screening Programme.[10]Radiotherapy quality assurance includes weekly, monthly and annual cobalt-60 dosimetry, semesterly photon dosimetry under the TRS-398 protocol, and radiation-protection practices.[26]Pharmaceutical oversight includes three-monthly Pharmacy Board reviews and quarterly pharmacy and therapeutics committee meetings to monitor and evaluate medicinal agents.[15][32]

Additional surveillance arrangements include daily monitoring of pesticide residues in market fruit and vegetables, ambient air-quality monitoring through fixed and mobile stations, food-control laboratory analysis, and hemovigilance reporting and feedback for transfusion reactions.[21][6][28]The source does not provide a complete indicator matrix, indicator definitions, unified reporting schedule, evaluation methodology, surveillance targets or a fully specified accountability framework for all programme components.[11][3]

Costing & Financing

Financing is framed as one of six health-system building blocks, with public resources intended to support health technologies, workforce recruitment or redeployment, skills development and affordable cancer services.[11][19]Cancer care is available free of charge in the public sector, although the source does not provide a consolidated 2022–2025 programme budget, financing gap, funding target or comprehensive economic assumptions.[15][19]

• Apply salary ranges in the Pay Research Bureau Report 2021 to human-resource costing and prevailing market prices to equipment costing.[19]
• Cost the remaining four years of the plan, from 2022 to 2025, using requirements provided by relevant user departments and specialist units.[19]
• Prioritise initial investment in infrastructure, human resources and equipment, with initial National Cancer Hospital staffing and services covered in the current budget and future specialist posts financed through annual recurrent budgets.[19]
• Allocate additional funding when new services are introduced and maintain earmarked public resources for the plan.[3][29]

Known investment commitments include an estimated National Cancer Hospital project value of 1.6 billion Mauritian rupees in Budget 2021–2022.[19]Funds were also earmarked for major hospital equipment, maintenance and replacement of cobalt-60 sources, and acquisition of two linear accelerators with multi-leaf collimators.[26][19]Staffing provisions include funded specialist posts in the 2021/2022 budget and phased recruitment for new clinical, nursing, paramedical, imaging and laboratory services.[37][38][39]

Explicit prevention and screening costs include 1.1 million Mauritian rupees over four years for primary prevention, 30.2 million Mauritian rupees for breast-screening equipment, and specified cervical-screening equipment costs.[22][31]Estimated four-year staffing costs for cancer screening total 44.863 million, with currency not specified, while five vans and database software are costed at a combined 9.5 million in 2022, also without a stated currency.[40]The source separately identifies 9.91991 million in estimated four-year costs for specified paramedical posts, without stating the currency.[41]

Further costed service investments comprise 7.650461 million Mauritian rupees for palliative-care drugs, equipment and consumables, and 15 million Mauritian rupees for transfusion support, including apheresis, blood-component irradiation, stem-cell collection and banking.[32][28]International Atomic Energy Agency and World Health Organization support is identified for selected training, but no monetary values are provided.[25][26][16]Costs for many treatment technologies, medicines, research, training, palliative-care expansion and cancer-specific interventions remain unquantified.[19][32]