National Cancer Control Policy

Objectives

The 2015 National Cancer Control Policy of Papua New Guinea establishes a comprehensive National Cancer Control Programme to reduce cancer morbidity and mortality, improve survival and quality of life, and replace fragmented and opportunistic cancer-control arrangements with a coordinated national response.[1][2][3]It gives effect to the National Health Plan 2011-2020 priority of reducing cancer morbidity and mortality through healthier lifestyles.[4][5]

The long-term vision is for Papua New Guinea to build capacity to prevent and treat cancer, provide quality palliative and support services for people with terminal disease, and reduce the population burden of cancer.[6]Its mission is to implement sustainable, safe and appropriate strategies for preventing, diagnosing and treating common cancers, using suitable technology and resources to achieve high-quality care.[6]

• Reduce preventable cancer risks linked to tobacco, betel nut chewing, harmful alcohol use, unhealthy diets, physical inactivity, carcinogenic exposures and environmental risks.[7][8][9]
• Promote healthy lifestyles and age-appropriate prevention programmes, including hepatitis B virus vaccination and assessment of the feasibility of human papillomavirus vaccination for cervical-cancer prevention.[8][9]
• Prioritise prevention and early management of common and high-burden cancers, including oral, cervical, breast and liver cancers.[5][6][10]
• Provide locally appropriate, evidence-based and cost-effective screening and early-detection services, particularly for cervical, breast and oral cancers, with capacity to diagnose and treat disease detected through screening.[3][9]
• Strengthen diagnosis, treatment, referral, palliative care, psychosocial support, cancer registration and surveillance as integrated areas of cancer control.[4][3][11]
• Expand access to oral opioids for cancer pain control and palliative services at provincial, district, health-centre and community levels.[6][11]
• Develop human resources, equipment, infrastructure, research and partnerships needed for sustainable cancer prevention and care.[4][6][12]

Implementation

Implementation is organised around a nationally coordinated, tiered cancer-service model led by the National Department of Health, spanning national, regional, provincial, district, community and health-facility levels.[3][11]The approach combines prevention and public education with screening, diagnosis, treatment, referral, palliative care, data collection, workforce development and phased service expansion.[6][3][13]

• Coordinate the National Cancer Control Programme through the National Department of Health, including policy development and review, implementation coordination, standards, workforce advice, partnership coordination, research support and funding advocacy.[3][14]
• Establish a National Cancer Coordination Committee within the National Department of Health, supported by a rotating secretariat from the Medical Standards and Public Health divisions, and obtain technical advice from a National Cancer Advisory Council.[12][14]
• Develop a detailed, costed five-year programme plan with stakeholder input, defining priority actions and responsibilities across national, provincial, hospital, district and community levels.[14]
• Strengthen the National Cancer Centre at Angau Memorial Hospital in Lae as a centre of excellence for comprehensive treatment and research.[11][13]The centre is identified as the country’s only provider of external-beam radiotherapy, internal brachytherapy and chemotherapy.[10]
• Use Port Moresby General Hospital for chemotherapy and major specialised surgery, provide chemotherapy at regional and provincial hospitals under National Cancer Treatment Centre direction, and retain specialised surgical services in Lae.[10]
• Improve cancer identification, referral, laboratory and diagnostic capacity, treatment equipment, maintenance, clinical guidelines, operating procedures and staff training across service levels.[11][13]
• Develop services in phases, including consideration of a second cancer centre at Port Moresby General Hospital after the Lae facility reaches the required standard.[13]
• Integrate screening into existing public-health programmes where feasible, develop evidence-based screening guidelines, investigate Visual Inspection with Acetic Acid with or without cryotherapy, and undertake research on oral-cancer detection and treatment.[9]
• Formalise collaboration with non-governmental organisations, training institutions and other partners through memoranda of understanding or agreement to clarify roles, prevent duplication and maximise resources.[3][14]
• Engage provincial administrations, Provincial Health Authorities, public hospitals, churches, community-based organisations, women’s and youth groups, development partners, professional bodies, research organisations and regulatory agencies in implementation, advocacy, training, service support, surveillance and community participation.[15]
• Establish hospital-based cancer registries initially at the National Cancer Centre in Lae and Port Moresby General Hospital, expand to regional sites where appropriate, and progress towards a population-based registry.[13]Link registry information to the National Health Information System and require relevant public, private and non-governmental providers to supply cancer data.[13]
• Monitor implementation through quarterly reviews and quarterly or annual programme reporting, with the National Cancer Coordination Committee coordinating monitoring and evaluation under National Cancer Advisory Council guidance.[14]Assign prevention and promotion monitoring to the Public Health Division and hospital-programme monitoring to the Medical Standards Division.[14]
• Finance activities through national corporate and annual implementation planning and through provincial, Provincial Health Authority and public-hospital strategic, annual activity and budget processes.[14]Source major infrastructure through the government Development Budget and integrate workforce requirements into routine health-sector workforce planning.[14]

The programme requires dependable long-term funding, but the National Cancer Centre's annual budget of under two million Kina is described as insufficient and largely absorbed by routine operations.[12]The policy calls for annual funding advocacy, additional support for service expansion and training, and mobilisation of corporate and other stakeholder contributions; development-partner support is described as minimal.[12]

Monitoring & Evaluation

The policy establishes cancer registration, surveillance, monitoring and evaluation as core elements of the National Cancer Control Programme (NCCP), intended to address major gaps in knowledge of cancer incidence, mortality and service needs in Papua New Guinea.[4][8]Monitoring is to support coordinated planning, evidence-based prevention and care, and assessment of programme implementation across national, provincial, facility and community levels.[10][14]

• Establish a phased cancer-registration system, beginning with hospital-based registries at the National Cancer Centre in Lae and Port Moresby General Hospital, extending to regional sites where appropriate, and retaining a long-term objective of population-based registration.[13]
• Link the Cancer Registry to the National Health Information System to produce national estimates of cancer burden, while requiring provincial and district hospitals, private providers, non-governmental organisations and other relevant stakeholders to submit cancer data.[13]
• Strengthen surveillance because national cancer morbidity and mortality rates are uncertain, population-based data are absent, and many cancers remain undiagnosed.[4][8]
• Establish a Cancer Registry Committee, operating under approved terms of reference, to coordinate collection and analysis of registry and National Health Information System data and issue timely reports for programme use.[13]
• Conduct ongoing monitoring through quarterly reviews and report quarterly or annually through programme reports or the National Health Information System.[14]
• Coordinate monitoring and evaluation through the National Cancer Coordination Committee, with advice from the National Cancer Advisory Council and reporting through the Programme Committee and quarterly reviews to the Secretary and Minister of Health.[14]
• Assign prevention and health-promotion monitoring and evaluation to the Public Health Division, and responsibility for hospital-based programmes to the Medical Standards Division.[14]
• Develop measurable output, process and outcome indicators to assess performance and inform policy and planning.[14]
• Monitor provincial implementation through regular collation of facility and community information, reporting via the Provincial Health Information System, and support surveillance through regulatory inspection, including radiation-safety monitoring.[15]
• Require National Cancer Control Programme-related research to be sanctioned and approved in accordance with the Health Sector Research Policy, and use operational research to inform implementation and medicines policy.[3][15]

The available material does not define indicator values, numerical targets, data-quality standards, evaluation methodologies, registry case definitions or a comprehensive reporting timetable.[3][11][13]The source cites an estimated 10,000 to 15,000 annual cancer cases and identifies cervical, breast, oral and liver cancers among the most common, but these figures are contextual estimates rather than a specified performance framework.[8]

Costing & Financing

Financing is framed as a prerequisite for sustainable cancer control: the NCCP requires significant, dependable long-term funding to implement prevention, screening, diagnosis, treatment, palliative care, registration, workforce development and infrastructure improvements.[12]The policy also emphasises locally appropriate and cost-effective interventions, particularly screening and early detection, in recognition of Papua New Guinea’s constrained resources.[3][9]

• Develop and cost a detailed five-year NCCP implementation plan, with prioritised actions across short-, medium- and long-term timeframes.[12][14]
• Fund provincial, Provincial Health Authority and public-hospital activities through their strategic plans, annual activity plans and budget processes.[14]
• Source major infrastructure through the government Development Budget and incorporate workforce requirements into routine health-sector human-resource planning.[14]
• Advocate annually for funding through the National Department of Health, hospitals and provinces, and mobilise corporate organisations and other stakeholders for financial support and technical expertise.[12]
• Integrate screening with existing public-health programmes where feasible and formalise partner roles to reduce duplication and maximise available resources.[3][9]
• Address resource constraints affecting cancer services, including shortages of finance, personnel, facilities, equipment, supplies and radiation machines, alongside unreliable procurement of cancer drugs and equipment.[10]
• Support service expansion, equipment maintenance and upgrading, specialist and general workforce training, oral-opioid access, registry development, and staged development of cancer-treatment facilities.[11][13]

The National Cancer Centre receives an annual budget of under two million Kina, described as insufficient and generally absorbed by routine operations; additional resources are needed for service improvement, expansion and training.[12]Development-partner support is described as minimal, in part because cancer priorities had not previously been set through a cancer plan.[12]

No total NCCP budget, activity-level costing, funding-gap estimate, financing allocation, donor commitment, economic model or cost-effectiveness threshold is provided in the available extracts.[11][13][12]