National Cancer Priorities For Action

Objectives

Develop a comprehensive National Cancer Control Programme that reduces cancer morbidity and mortality, improves survival and quality of life, and delivers an evidence-based continuum from prevention and early diagnosis to treatment, palliative care, bereavement support, cancer registration, surveillance and research.[1][2]Particular attention is given to cervical, oral, head and neck, breast and liver cancers, alongside screening priorities for breast, cervical, colorectal and prostate cancer.[1][2]

• Prevent avoidable cancers by reducing tobacco and betel nut use, harmful alcohol consumption, unhealthy diet, physical inactivity and exposure to carcinogenic substances, while promoting vaccination against vaccine-preventable cancers, including cervical and liver cancer.[1][2]
• Detect cancers earlier through public awareness, accessible information for people at greatest risk, and cost-effective screening and referral pathways.[2][3]
• Provide equitable, high-quality diagnosis, treatment and supportive care in community, hospital and specialist settings, seeking the highest achievable cure and survival rates while improving quality of life.[2]
• Strengthen palliative care from early illness onwards, including pain and symptom management, spiritual and psychosocial support, and bereavement care; extend symptom relief to remote communities through trained volunteers under health-worker supervision.[3][4]
• Establish cancer registries, strengthen surveillance and research, and improve medical records and data systems to address underdiagnosis and currently incomplete knowledge of national cancer morbidity and mortality.[1][5][4]
• Build governance, workforce capacity, stakeholder coordination and resource mobilisation across prevention, diagnosis, treatment, registration, social support and partnerships.[5][4]

The strategic framework identifies five connected areas of action: prevention; screening and early diagnosis; quality of care; personal and social support; and research and evaluation.[2]It also recognises the need to organise cancer administration, strengthen referral systems and laboratory capacity, improve access to medicines, and coordinate services across all levels of the health system.[5]

Implementation

Implement an integrated delivery model spanning primary, secondary and tertiary care, with public-health action beyond the health sector and coordinated clinical services across the full patient pathway.[2][3]National leadership is proposed through a National Cancer Programme Secretariat under the Minister or Secretary of Health, with functions for prevention, diagnosis and treatment, registry and research, and social support and partnerships.[4]

• Strengthen specialist cancer services at Angau Memorial Hospital in Lae, including radiotherapy and broader treatment capacity, through additional staff, infrastructure, medicines and funding.[1]
• Expand service delivery through Port Moresby General Hospital, provincial hospitals, district and peripheral laboratory services, and a national referral system.[1][5]
• Coordinate multidisciplinary care so that specialists and other clinical disciplines can support accurate diagnosis, safe treatment, effective communication and patient-centred care planning.[2][3]
• Deploy Community Health Workers to reduce cancer risks, promote early detection and facilitate rapid referral for investigation.[3]
• Develop a skilled workforce in oncology, radiotherapy, brachytherapy, medical physics, nursing, radiation protection, regulation and cancer awareness education through in-house, overseas and university-based training pathways.[1][5][4]
• Establish cancer registries at Angau and Port Moresby General Hospital, introduce data-collection tools, and strengthen cancer-unit and medical-record systems.[4]
• Coordinate government, donor and partner activities through national cancer leadership, including a sustainable government-to-government replacement for voluntary twinning arrangements with Australian cancer institutions.[5]
• Collaborate with the International Atomic Energy Agency on human-resource development, infrastructure procurement and expert advice, supported by Papua New Guinea counterpart funding.[1]

Named institutional participants include the National Department of Health, Port Moresby General Hospital, Angau Hospital, the World Health Organization and the Department of Foreign Affairs and Trade.[4]Community and voluntary organisations also have roles in disseminating cancer information, supporting people affected by cancer and extending palliative care in remote areas.[2][4]

Monitoring should use operational cancer registries, numbers of trained health-worker cadres, collaborations established, and research undertaken and disseminated as implementation indicators.[4]Mortality is identified as the principal outcome measure for judging screening effectiveness.[2]The available material does not specify a comprehensive reporting timetable, evaluation methodology, performance targets or broader accountability process.[2][3][4]

Resource needs include manpower, infrastructure, medicines, laboratory capacity, training, improved procurement and increased operating appropriations for cancer services.[1][5]A total budget estimate of 16.4 million Kina per annum is identified, with allocations for remote palliative care, registry and records development, workforce training, and national and international partnerships.[4]The available material does not specify overall financing sources, funding shares, economic assumptions or quantified funding gaps.[4]

Monitoring & Evaluation

Monitoring and evaluation combine cancer registration, surveillance, research, screening outcomes, workforce and partnership outputs, and national coordination. A national cancer registry is a core component of the cancer control programme, intended to address substantial gaps in knowledge of cancer morbidity and mortality caused by underdiagnosis and weak surveillance.[1][5]Registry development is specifically planned at Angau Hospital and Port Moresby General Hospital, alongside data-collection tools and strengthened cancer-unit and medical-record systems.[4]

• Establish operational cancer registries and improve the resources and data systems required for cancer registration and surveillance.[5][4]
• Use cancer mortality as the principal outcome indicator for judging the effectiveness of screening programmes.[2]
• Track the number of health workers trained in cancer-related roles, including oncologists, medical physicists, radiation therapists, oncology nurses and cancer-awareness educators.[4]
• Monitor the number of collaborations established and research undertaken, including whether research findings are shared.[4]
• Advance surveillance and research as strategic priorities alongside prevention, screening and early diagnosis, quality of care, and personal and social support.[2][3]
• Coordinate implementation and accountability through national cancer leadership, stakeholder involvement, and a National Cancer Program Secretariat reporting within a structure led by the Minister or Secretary of Health.[5][4]

The National Cancer Program Secretariat is intended to cover prevention, diagnosis and treatment, registry and research, and social support and partnerships, providing an institutional basis for coordinating programme functions.[4]National coordination also involves the National Department of Health, Port Moresby General Hospital, Angau Hospital, the World Health Organization and the Department of Foreign Affairs and Trade.[4]

The available material does not specify a comprehensive monitoring framework, indicator definitions or baselines, numerical targets, data-quality procedures, reporting frequency, evaluation timetable, evaluation methods, or formal mechanisms for publishing and acting on performance findings.[2][3][4]

Costing & Financing

Financing needs are concentrated in cancer-service infrastructure, workforce development, medicines and procurement, registry and information systems, palliative care, partnerships, and programme implementation. Strengthening the Cancer Unit at Angau Memorial Hospital and expanding cancer services require substantial manpower, infrastructure, medicines and funding.[1]The International Atomic Energy Agency radiotherapy project requires Papua New Guinea counterpart funding, including for human-resource development, infrastructure procurement and expert advice.[1]

• Increase the appropriation for cancer-service operations and secure additional funding and personnel to implement approved cancer policy reforms.[5]
• Improve procurement for cancer medicines, including morphine, despite reported improvements in medicine supply.[5]
• Fund registry development, data-collection tools and medical-record strengthening at Angau Hospital and Port Moresby General Hospital.[4]
• Fund training for essential cancer personnel and development of national and international cancer-service partnerships and networks.[4]
• Fund remote-area symptom relief and palliative care delivered by trained community volunteers under health-worker supervision.[4]
• Use cost-effective screening approaches for breast, cervical, colorectal and prostate cancers.[2]

The stated total budget estimate is 16.4 million Kina per annum.[4]Explicit allocations cover remote-area palliative care, registry and records development, cancer-staff training, and partnership development for defined 2017 to 2021 or 2017 to 2018 periods.[4]

The available material does not specify total implementation costs for the wider cancer programme, detailed recurrent and capital budgets, funding-source shares, confirmed donor commitments, financing mechanisms, economic assumptions, affordability analysis, or quantified funding gaps.[1][5][2][4]