National Cancer Priorities for Action: Cancer Action Priorities for 2017-2021

Objectives

The strategic framework translates the National Cancer Policy 2015 into an evidence-based cancer control programme for a resource-constrained setting, spanning prevention, screening and early detection, diagnosis and treatment, palliative care, surveillance, research and cancer registration.[1]Its overarching aims are to elevate cancer as a health priority, reduce cancer morbidity and mortality, improve survival and quality of life, and ensure that services respond to patients’ and carers’ needs across all levels of the health system.[2][3]

• Prevent avoidable cancers by addressing tobacco use, harmful alcohol consumption, unhealthy diets, physical inactivity, exposure to carcinogenic substances and vaccination.[4]
• Increase public awareness and strengthen primary prevention and early detection, particularly for common cancers, to reduce demand on limited treatment capacity.[2][4]
• Establish cost-effective screening and early-diagnosis services, including breast, cervical and colorectal screening and prostate-specific antigen testing.[4]
• Improve the quality, availability and safety of diagnosis, treatment, laboratory and referral services, including expanded capacity at district and peripheral facilities.[2][3]
• Integrate palliative, psychosocial and community-based support so that people with cancer and their families receive care from diagnosis through bereavement, including symptom relief in remote areas.[3][5]
• Strengthen patient information, choice, personal and social support, and attention to quality of life and patients’ perspectives.[4][3]
• Develop the cancer workforce, including oncologists, medical physicists, radiation therapists, oncology nurses and cancer-awareness educators.[6][5]
• Establish national cancer registries, surveillance, data-management and research systems to measure incidence, survival and mortality and guide health planning.[6][5]
• Mobilise resources, coordinate stakeholders and strengthen legal, regulatory, governance and administrative arrangements for cancer control.[2]

Implementation

Implementation combines system-wide service strengthening with a delivery model that links primary, secondary and tertiary care.[3]The approach builds on existing cancer services while shifting greater attention towards prevention, early detection, coordinated referral, workforce development, reliable data and support services, with government, health facilities, communities, civil-society organisations and international partners contributing to delivery.[2][4][5]

• Establish a comprehensive cancer control programme, national referral system and cancer leadership structure, with the National Cancer Committee Secretariat identified as a coordinating mechanism for government, partners and other stakeholders.[2]
• Strengthen cancer-service infrastructure and support systems, including the Lae Cancer Unit, peripheral laboratory capacity, diagnostic and treatment services, and medical-record systems at Angau and Port Moresby General Hospital.[1][2][5]
• Deliver palliative care in remote areas through trained community volunteers supervised by health workers, with the National Department of Health and non-governmental organisations involved during 2017 to 2021.[5]
• Use Community Health Workers to support risk reduction, promote early detection and facilitate timely referral for diagnostic investigation.[3]
• Apply multidisciplinary collaboration among cancer specialists and other clinical professions to support accurate diagnosis, safe treatment and coordinated care.[3]
• Develop clinical guidelines and strengthen oncology, radiotherapy, brachytherapy, medical physics and nursing training through established training pathways and institutional twinning arrangements.[2]
• Improve procurement of cancer medicines, including morphine, alongside strengthened treatment and palliative-care capacity.[2]
• Engage voluntary organisations with the National Cancer Programme to review cancer information and extend its reach to people at greatest risk.[4]
• Collaborate with the International Atomic Energy Agency through a country project providing human-resource development, infrastructure procurement and expert advice, supported by Papua New Guinea counterpart funding.[2]
• Partner with the World Health Organization, DFAT, national and international networks, and cancer centres including Port Moresby General Hospital and Angau Hospital to support training and service delivery.[5]
• Develop cancer registries at Angau and Port Moresby General Hospital, create data-collection tools, strengthen medical records, conduct and disseminate research, and use registry evidence to inform the National Health Plan.[6][5]
• Monitor screening effectiveness through mortality, track cancer incidence, prevalence and survival, document service quality and outcomes, and use the number of trained personnel and collaborations established as operational indicators.[4][6][5]
• Increase the existing budget appropriation for cancer-service operations and mobilise further funding, personnel, infrastructure and health-system resources; the specified total budget estimate is 16.4 million Kina per annum.[2][5]

Monitoring & Evaluation

Monitoring and evaluation centre on strengthening cancer surveillance, establishing registries, measuring service outcomes and using research to assess implementation. Existing information gaps are substantial: national cancer morbidity and mortality rates are not precisely known, and many cancers remain undiagnosed.[1]

• Establish and maintain a National Cancer Registry to capture cancer incidence, survival and mortality, inform national health planning and support the broader cancer control programme.[6][2]
• Develop cancer registries at Angau Hospital and Port Moresby General Hospital, strengthen medical-record systems, and introduce data-collection tools to improve cancer-related data management.[5]
• Strengthen surveillance to monitor incidence, prevalence and survival, and document the quality and outcomes of cancer services.[6]
• Use mortality as the principal outcome indicator for assessing the effectiveness of screening programmes.[4]
• Measure workforce progress through the number of cancer-trained personnel and partnership progress through the number of collaborations established.[5]
• Coordinate national cancer research and use it to evaluate the progress and effectiveness of activities under the Cancer Plan, while sharing research findings.[6][5]
• Coordinate cancer data and supported activities through the cancer control programme and registry arrangements.[2]

The available material does not specify a comprehensive indicator set beyond mortality, trained personnel and collaborations; nor does it define reporting frequencies, data-quality procedures, evaluation milestones, performance targets, responsible reporting bodies or enforcement mechanisms for accountability.[1][2][5]

Costing & Financing

Financing requirements combine a stated annual budget estimate and several specified programme allocations with broader, unquantified needs for personnel, infrastructure, service delivery and policy implementation. The total budget estimate is 16.4 million Kina per annum.[5]

• Allocate 50,000 Kina to symptom relief and palliative care for cancer patients in remote areas during 2017 to 2021.[5]
• Allocate 200,000 Kina to cancer registries, data collection, medical-record strengthening and cancer research across stated activities occurring between 2017 and 2021.[5]
• Allocate 100,000 Kina to training essential cancer personnel during 2017 to 2018.[5]
• Allocate 100,000 Kina to national and international partnerships and networks supporting cancer services during 2017 to 2018.[5]
• Increase the existing budget appropriation for cancer service operations.[2]
• Mobilise resources to finance the strategic plan, including additional funding, personnel, infrastructure and other health-system inputs.[2][1]
• Provide Papua New Guinea counterpart funding for the International Atomic Energy Agency country project supporting human-resource development, infrastructure procurement and expert advice.[2]

The material does not specify the total cost of the wider strategic plan, the source or distribution of the annual budget, financing shares between government and partners, funding gaps, expenditure schedules, cost-effectiveness assumptions or other economic assumptions.[2][4][3][6][5]