National Plan Cancer Control

Objectives

The National Plan for Cancer Control 2014-2025 seeks to protect Saudi society from cancer through a comprehensive, evidence-based programme spanning prevention, early detection, diagnosis, treatment, palliative care, surveillance, research and community partnership. It aims to reduce cancer morbidity and mortality, improve quality of life for patients and families, use resources appropriately, and coordinate governmental, private and community contributions across all levels of health care.[1][2]

• Establish a nationally managed cancer-control structure with technical and administrative leadership, inter-agency coordination, financial oversight, resource allocation and periodic evaluation.[3][4]
• Reduce exposure to modifiable risks including tobacco use, unhealthy diets, overweight and obesity, physical inactivity, alcohol, radiation, excessive sun exposure, occupational and environmental carcinogens, and cancer-causing infections.[1][3][5][6]
• Achieve ten-year prevention targets of a 5% reduction in adult tobacco use, a doubling in the proportion of ex-smokers, at least a 10% reduction in overweight and obesity, and at least a 20% increase in physical activity.[5]
• Prevent infection-related cancer by reducing hepatitis B and C infection, maintaining hepatitis B immunisation, assessing human papillomavirus prevalence in young women, and considering vaccination where prevalence is high and rising.[4][7]
• Detect breast, cervical, colorectal, oral and skin cancers at early, treatable stages, with a longer-term aim to reduce mortality from these cancers by about 20% within ten years.[4]
• Strengthen breast-cancer screening and early diagnosis, targeting mortality reductions of 25-30% among women aged 50-69 years and 15% among women aged 40-49 years.[8]
• Improve cancer-service quality across primary, secondary and tertiary care through qualified staff, specialised diagnostic and treatment services, multidisciplinary care, effective referral arrangements and evidence-based clinical standards.[9][10]
• Provide integrated palliative and continuing care that addresses pain and physical, psychological, social and spiritual needs of patients and families, including home-based support where appropriate.[11][9]
• Strengthen national and Gulf cancer registries, timely reporting, survival and stage data, research capacity, patient and family participation, and community partnerships.[10][12][13]

Implementation

Implementation is organised through coordinated sub-programmes for administration, prevention education, early detection, treatment-system development, palliative care and scientific support. Delivery links primary-care centres, referral hospitals, specialised cancer centres, multidisciplinary teams, government bodies, universities, non-governmental organisations, professional and community partners, with national coordination through a Supreme National Cancer Control Committee and related sub-committees.[3][4][9][13]

• Govern implementation by establishing administrative, financial, technical and technical-assistance arrangements; agreeing priorities and timelines; coordinating responsible agencies and target groups; allocating budgets and resources; and conducting regular supervision and periodic evaluation.[4]
• Deliver prevention through cross-sectoral action involving health, education, sports, transport, recreation, urban planning, industry and labour stakeholders. Actions include health education, media and community campaigns, school curricula, healthier institutional food, food labelling, tobacco-control measures, safe opportunities for physical activity, walking and cycling infrastructure, parks and workplace risk control.[5][6][14][8]
• Control occupational and environmental carcinogens through legislation and regulation, safer substitutes, exposure limits, water-quality standards, workplace risk assessment, containment procedures and personal protective equipment where required.[6]
• Integrate hepatitis B vaccination into the national expanded immunisation programme, using three doses and adapting birth-dose timing to the epidemiological context.[7]
• Provide early detection through target-group education, primary-care wellbeing clinics, regional oncology early-detection sub-clinics, a central diagnostic clinic, mammography screening, specialist teams, referral pathways and diagnostic follow-up.[15]
• Develop cancer care by establishing cancer units in referral hospitals and specialised tertiary centres, deploying integrated multidisciplinary teams, training health workers, regularly updating clinical manuals, and applying referral models with feedback between levels of care.[9][10]
• Deliver palliative care across health-service levels by assessing need and service gaps, defining provider and volunteer roles, training caregivers and personnel, standardising protocols, ensuring access to oral morphine and other essential symptom-control medicines, establishing pain clinics and terminal-care facilities, and supporting home care.[11][2]
• Build surveillance and research systems through routine institutional data collection, data-quality mechanisms, registry improvement, survival analysis for common cancers, annual performance assessments, quality criteria, specialised research teams and timetabled priority studies.[12]
• Involve patients and families through individual and group education, guidance materials, home-care services, community-care nurses and social workers, and participation in treatment, follow-up, service delivery and quality control.[13]
• Monitor performance using screening coverage, stage at diagnosis, referral and follow-up outcomes, risk-factor prevalence, physical-activity and nutrition measures, cancer-registry completeness and accuracy, survival data, service capacity, guideline availability, patient satisfaction, research outputs and joint community activities.[7][14][15][9][10][12][13]

Monitoring & Evaluation

Monitoring and evaluation are positioned as core functions of the national cancer-control programme, combining periodic review, cancer-registry surveillance, service-performance assessment, prevention monitoring, research assessment and patient-centred quality measures.[3][2][10][12][13]The framework also links evaluation to technical and administrative management, financial oversight and resource allocation.[3][4]

• Use national cancer surveillance data to analyse incidence, crude and age-standardised rates, geographical variation, and cancer distribution by age and sex.[16][1]Strengthen national and Gulf cancer registries, ensure timely reporting, apply quality and performance standards, and provide survival and stage data.[10][12]
• Establish comprehensive information systems for routine institutional data collection, check data quality, measure registration completeness and accuracy, analyse survival for common cancers, and conduct annual performance assessments.[12]
• Assess early-detection programmes through surveys of cancer stage at diagnosis, target-group definition, detected-case diagnosis and follow-up, screening coverage, response rates, early-detection registers and the proportion of cases identified through screening.[4][15]Breast-cancer indicators include mammography coverage of 75% of the target group every three years, reductions in diagnosis at stages 3 and 4, prompt referral for abnormal mammograms, and a mortality reduction after ten years of at least 25%.[15]
• Apply evidence to screening policy: full coverage of women aged 50 to 69 years by mammographic screening was projected to reduce breast-cancer mortality by 25% to 30%, while cervical cytological screening every ten years among women aged 35 to 64 years was projected to reduce invasive cervical-cancer incidence by 60%.[3]
• Monitor primary-prevention targets over ten years, including a 5% reduction in adult tobacco use, a doubling in the proportion of ex-smokers, at least a 10% reduction in overweight and obesity, and at least a 20% increase in physical activity.[5]Assess tobacco use among adults and adolescents, dietary behaviour, fruit and vegetable consumption, overweight, obesity, central obesity, tobacco-free indoor places, cancer-causing infections, and environmental and occupational carcinogen exposure.[7][14]
• Measure prevention delivery through awareness before and after education, numbers of campaigns and programmes, school curriculum coverage, implementation of the national food and physical-activity strategy, school physical-activity hours, walking tracks and accessible parks per 10,000 population.[14]Monitor nutrition and legislative measures through school coverage, training and education activity, enacted legislation, tobacco-control commitments and legal compliance.[8]
• Conduct a human papillomavirus prevalence survey among women aged 20 to 25 years and, where prevalence is low, repeat surveys in new samples at approximately five-year intervals.[7]Consider worker health surveillance for occupational cancer where appropriate, while recognising that evidence of effectiveness is limited for many work-related cancers, particularly lung cancer.[6][7]
• Track service quality through patient distribution across primary, secondary and specialised care; staffing relative to international rates; annual training coverage; cancer-unit availability; specialised centres per million population; updated clinical guidelines; guideline-concordant treatment units; palliative-medicine availability and quality; and referral guidance and models.[9][10]
• Evaluate palliative-care needs and service gaps, assess the number of people needing palliative care using cancer deaths, and follow up implementation of palliative-care activities.[11][2]Monitor patient and family participation, satisfaction, education participation, adherence to programmes, and the availability of community-care nurses and social workers.[13]
• Assess epidemiological, clinical and economic research through completed studies, while monitoring approved research-study budgets as an implementation activity.[12]Measure community partnership through the number of joint programmes and activities with community institutions.[13]

Weekly and monthly supervision and follow-up timetables are envisaged, alongside periodic evaluation of programme performance and resource allocation.[4]The material does not provide a single detailed reporting format, universal reporting frequency, complete indicator definitions, independent accountability mechanism or fully specified surveillance governance structure.[4][2][5][10]

Costing & Financing

Financing is treated principally as an administrative responsibility, requiring financial supervision, resource allocation and budgets for the overall programme and its sub-programmes.[3][4]The plan also recognises cancer as a substantial financial and socioeconomic burden for communities and development.[1]

• Allocate budgets for the main programme and sub-programmes, identify funding sources, and engage charitable organisations to support contributions.[4]
• Secure resources for palliative care, including service provision and access to oral morphine and other essential symptom-control medicines.[2]Government financial support is identified as necessary for integrating palliative care into the national health system.[11]
• Resource multidisciplinary cancer teams, workforce training, cancer units, specialised centres, palliative and pain-relief medicines, referral systems, and maintenance of cancer registries.[9][10]
• Monitor the budget for approved cancer research studies, without specifying an amount or currency.[12]

No quantified total budget, expenditure estimate, programme allocation, funding share, identified funding gap, costing methodology, monetary economic assumption or explicit financing arrangement for prevention, screening, treatment, surveillance, research, transport, urban-planning and health-promotion activities is provided in the supplied material.[4][2][5][6][7][14][12]