UICC WorldCancerDeclaration Progress Report 2016 Book PDF

World Cancer
Declaration
Progress Report 2016
Tomorrow is now:
Our journey to 2025
Contents
The World Cancer Declaration 03

Foreword 04
Introductions 05
How to use this report 07
Cancer control plans 09
Cancer registration 11
AFRO region 13
Tobacco control 43
EMRO region 45
Nutrition, healthy weight and physical activity 57
EURO region 61
HPV vaccination and HBV vaccination 88
PAHO region 92
Cancer screening and early detection 117
SEARO region 119
Quality multidisciplinary cancer treatment 128
WPRO region 130
Palliative care and pain relief 142
Conclusions 144
NCD Alliances 145
UICC member organisations 147
Cancer Atlas 156
Image credits Acknowledgements Editors
Cover: A young patient and his carer The editors wish to thank the UICC: Kirstie Graham, Yann Hakam,
in the paediatric oncology ward of the organisations from nearly 160 Nandita Kaza, Miriam Mikhail,
Istanbul University Oncology Institute countries who provided input into this Rebecca Morton Doherty, Rosie
report. Tasker, Julie Torode, Vanessa Von
Image of Sanchia Aranda: © Cancer der Muhll
Council Australia Organisations who contributed to
each national report are featured at For further information please contact:
Other images: © UICC the top of the relevant country page. advocacy@uicc.org
These reports reflect UICC’s members
perspectives on their country’s cancer
control progress.
We would also like to recognise the

input of World Cancer Research
Fund International in developing the
thematic page on nutrition, healthy
weight and physical activity. Our
thanks also goes to the American
Cancer Society for their consent to
use infographics drawn from the
Cancer Atlas (Second Edition) across
the other thematic pages. To explore
these infographics and Cancer Atlas
further please visit: http://canceratlas.
cancer.org/.
World Cancer Declaration
Overarching goal
There will be major reductions in premature deaths from cancer and
improvements in quality of life and cancer survival rates.
Target 1 Target 6
Strengthen health systems for Universal access to screening

effective cancer control and early detection for cancer
Health systems will be strengthened to ensure sustained Population-based screening and early detection programmes
delivery of effective and comprehensive, patient-centred will be universally implemented, and levels of public and
cancer control programmes across the lifecourse. professional awareness about important cancer warning signs
and symptoms will have improved.
Target 2 Target 7
Measure cancer burden and impact Improve access to services across

of cancer plans in all countries the cancer care continuum
Population-based cancer registries and surveillance systems Access to accurate cancer diagnosis, quality multimodal
will be established in all countries to measure the global treatment, rehabilitation, supportive and palliative care
cancer burden and the impact of national cancer control services, including the availability of affordable essential
Programmes. medicines and technologies, will have improved.
Target 3 Target 8
Reduce exposure to cancer risk Universal availability of pain

factors control and distress management
Global tobacco consumption, overweight and obesity, Effective pain control and distress management services will
unhealthy diet, alcohol intake, and levels of physical inactivity, be universally available.
as well as exposure to other known cancer risk factors will have
fallen significantly.
Target 4 Target 9
Universal coverage of HPV Improve education and training

and HBV vaccination of healthcare professionals
The cancer causing infections HPV and HBV will be covered by Innovative education and training opportunities for healthcare
universal vaccination programmes. professionals in all disciplines of cancer control will have
improved significantly, particularly in low- and middle-income
countries.
Target 5
Reduce stigma and dispel

myths about cancer
Stigma associated with cancer will be reduced, and damaging

myths and misconceptions about the disease will be dispelled.
World Cancer Declaration Progress Report 2016 3

Foreword
Sir George A.O. Alleyne The development of this Progress Report concurrent with the
first year of the Sustainable Development Goals (SDGs) is
PAHO/WHO Director Emeritus advantageous as it gives benchmarks against which progress
Since the United Nations (UN) High Level Meeting in 2011, can be measured, especially in relation to cancer which
the voice and reach of the non communicable disease features prominently among the NCD targets. It also highlights
(NCD) community have increased dramatically, and there the potential for synergies between several of the SDG targets,
is agreement on the four main areas of activity needed to and particularly the goal to achieve universal health coverage
help drive progress at the global, regional and local levels. (UHC). It must be clear that effective and efficient services for
These are: advocacy, accountability, capacity development, cancer are an essential component of the package of services
and knowledge exchange. While not all organisations in to be delivered progressively through UHC.
the NCD community have the same capacities, each one
I commend the Report.
offers a unique perspective and area of expertise, which
collectively strengthens the global civil society voice. This
Report demonstrates the particular reach and diversity of
the UICC movement, with contributions from professional
bodies, patient groups, researchers, and those working at
the community level. As one of the four main NCDs, having
a diverse, united and strong advocacy voice from the cancer
community will enhance the effectiveness of the NCD
movement as a whole.

Introduction
Cary Adams With this in mind, the UICC membership organisations have
worked collectively to create this World Cancer Declaration
Chief Executive Officer, Union for Progress Report, providing a unique civil society perspective
International Cancer Control on national successes and major challenges that remain to
Since world leaders came together for the UN High Level realise the Declaration targets. Reports from 113 countries
meeting on NCDs in 2011, the political will to address were developed by one lead organisation in consultation with
cancer as part of the coordinated global response to NCDs other UICC members in each country where possible. These
has continued to build. Most recently, in 2015, we saw the national views are accompanied by official data on the national
inclusion of a clear standalone target for NCDs within the capacity to respond, drawn from the WHO’s 2014 Country
health goal of the Sustainable Development Goals a priority Cancer Profiles and 2015 NCD Progress Monitor. The
for UICC when we founded the NCD Alliance along with Report also includes a series of thematic pages highlighting
the World Heart Federation and the International Diabetes resources and global initiatives led by UICC and its partners
Federation in 2009. that can help advance progress against each target.
The next 12 months in particular are a pivotal time for For governments worldwide, this Report also demonstrates
governments and the cancer community on the road to 2025. that the 1000-strong UICC membership is a trusted civil
As well as marking the midpoint from the launch of the World society partner in research, planning and service delivery, with
Cancer Declaration targets in 2008 to their delivery in 2025 – the ability to check and challenge progress, and to act as a key
it is a key period in the preparatory process for the 2018 UN platform for sharing expertise and implementation experience
Review of the implementation of commitments included in the with others.
2011 UN Political Declaration on NCDs and the 2014 UN We believe that by presenting the current state of play in
Outcome Document on NCDs, and a landmark opportunity cancer control, governments and policy-makers will be
to press Member States on the urgency for action. motivated to take on lessons learned from others’ successes
We believe now is the time to harness this collective energy and inspired to take leadership in areas where much is still to
and commitment to drive forward progress to achieve the be done. We hope this Report will encourage persistence with
World Cancer Declaration targets as part of the NCD country-level implementation and inspire a more collaborative
agenda. These nine visionary targets are aligned with the approach to cancer solutions pan-government and across
global ambition of a 25% reduction in premature mortality sectors, so that together we can reduce premature deaths
from NCDs by 2025, and set out the priorities for cancer from cancer and other NCDs, and improve the quality of life for
prevention, early detection, diagnosis, treatment and care to people living with cancer everywhere.
achieve this mortality reduction in every country. I would like to thank all UICC member organisations for
their contributions to this Report, but more importantly the
great and meaningful work they do every day in the fight
against cancer.

Introduction
Tezer Kutluk increase access to paediatric oncology services including

in Barbados, the Democratic Republic of the Congo,
President, Union for International Pakistan, Russia, and Tonga, but noted that improving
Cancer Control early diagnosis and expanding paediatric registries are
The publication of the World Cancer Declaration Progress a still priority.
Report 2016 coincides with a major milestone in UICC’s Inequities in access to quality diagnosis, treatment and
history, as we celebrate reaching 1,000 members across care continue in many countries. In particular, access to
162 countries. Our growing membership has much to be surgery, radiotherapy and essential cancer medicines
proud of, particularly over the last eight years in which remains an enormous challenge for many governments
we have helped to spearhead the civil society movement with little progress to report from the majority of countries.
for NCDs. As UICC’s President, I had the personal This, despite the recently published Lancet Oncology
honour of giving the opening address, on behalf of civil commissions on expanded access to cancer surgery and
society, at the 2014 UN High Level Review on NCDs. radiotherapy, and the recent update of the cancer section
The next High Level Review is set to take place in 2018, of the WHO Model List of Essential Medicines and the
and by showcasing cancer control success stories we high profile that the UN High Level Panel on Access
can collectively push cancer control in low- and middle- to Medicines has afforded the topic. Equally, the gap in
income countries firmly on to the agenda of development skilled human resources for cancer care was highlighted
funders. across all regions. Even in high resource settings, including
It is clear from the country reports that major strides have Norway, Sweden, and Australia, there remain challenges in
been made across the cancer care continuum since the equity of access and concerns of sustainability.
launch of the World Cancer Declaration in 2008. Some The good news is that this report is testament to what is
stand out successes include the introduction for the first possible through collaboration and provides several key
time of plain packaging for cigarettes in Australia in 2012; examples of how a truly multisectoral approach, which
the exponential increase in the number of girls immunised builds on current best practice, can increase a country’s
against HPV and the success of rolling out national-scale capacity to mount an effective national cancer response.
vaccination efforts in the African region such as Rwanda’s There are numerous examples in the Report of UICC
national HPV programme; national colorectal screening members supporting and in many cases leading national
programmes in Spain; establishment of the national cancer and regional partnerships in cancer control. The Bahrain
grid of public sector cancer hospitals across India; and Cancer Society has partnered with other NGOs to form the
the increased access to palliative care and pain relief for Gulf Federation for Cancer Control, for example; and the
cancer patients in El Salvador. Kosova Task Force for Cancer Control is an active member
Our member organisations also highlighted common areas of the Mediterranean Task Force for Cancer Control,
where there is significant room for improvement. Although developing regional materials and workshops.
notable progress has been made in tobacco control, It is also important to acknowledge that over 50% of
several European countries including Germany, Spain and active national and regional NCD alliances include a UICC
the UK remarked that efforts to address other cancer risk member organisation. One of the challenges now is to
factors, particularly obesity and physical inactivity have broaden these efforts by joining forces with other national
been limited. Across the Western Pacific and South East and regional networks to embrace links between NCDs
Asia, countries reported progress in the development and other sustainable development goals such as poverty,
of cancer registries but they underlined that more must the environment, gender equality and sustainable cities,
still be done to improve data quality and coverage. and to work with all levels of government towards our
Several UICC members highlighted ongoing efforts to shared goal of reducing the burden of cancer and other
NCDs.

How to use
this Report
Structure
The World Cancer Declaration Progress These country reports have been grouped
Report 2016 consists of 113 country geographically by WHO region.
reports and two regional commentaries
Between each of these regional chapters,
that document progress against the World
the Report includes a focus piece on one of
Cancer Declaration targets. Each country
the Declaration targets. These give a brief
report focuses on four core areas:
introduction to the topic, highlighting key
1 Overall progress statistics, with a specific focus on sharing
global initiatives and resources for use in
2 Key successes national advocacy work.
3 emaining challenges in order for

R
countries to reach the 2025 targets
4 Achievements of the
lead author

How to use
this Report
Data sources and keys Abbreviations

Alongside data from UICC Members, the report also draws Alongside data from UICC Members, the report also draws on
on two key documents from WHO, displayed in the two data two key documents from WHO, displayed in
trackers at the top of each country report:
Throughout the report a number of common abbreviations are
• The first tracker is compiled from the WHO Country used, as noted below;
Cancer profiles which synthesises the global status of
cancer prevention and control, drawing on data reported AFRO WHO Regional Office for Africa
by Member States on a range of key cancer control
WHO Regional Office for the Eastern
activities. From these profiles, we have selected the 11 EMRO
Mediterranean
metrics which relate most closely to progress against the
Declaration targets. We encourage you to explore the full EU European Union
cancer country profile data for your country as a great EURO WHO Regional Office for Europe
starting point for understanding national progress, and FCTC Framework Convention on Tobacco Control
engaging with governments and cancer planners.
HBV Hepatitis B virus
• The second tracker highlights key data from the WHO HPV Human papillomavirus
NCD progress monitor which presents data on how each IAEA International Atomic Energy Agency
country has progressed against the ten targets identified
IARC International Agency for Research on Cancer
within the 2014 UN Outcome Document on NCDs. We
have selected and included the parameters most relevant LINAC Linear accelerator
to cancer prevention and control efforts. We encourage MRI Magnetic resonance imaging
you to explore the full data for your country in the NCD NCD Non-communicable disease
progress monitor for a snapshot of country progress on
NGO Non-governmental organisation
NCDs more broadly.
Pap Papanikolaou test (Pap smear)
The symbols used within this tracker have been taken directly
Pan American Health Organization
from the WHO NCD progress monitor and the key below PAHO
(WHO Regional Office for the Americas)
provides a brief overview of their meanings:
PET Positron emission tomography
SEARO WHO Regional Office for South-East Asia
Target has not been achieved
SPF Sun protection factor
Target has been partially achieved
UHC Universal health coverage
Target has been fully achieved UICC Union for International Cancer Control
USD United States dollar
UV Ultraviolet
VIA Visual inspection with acetic acid
WHO World Health Organization
WPRO WHO Regional Office for the Western Pacific

Operational National Cancer Control Plans, 2013
Cancer Control Plans Countries with an operational national cancer plan Countries without an operational national cancer plan No Data
A national cancer control In 2011, the World Economic Forum reported that the
global cost of inaction on NCDs could total USD 47
plan is the foundation for an trillion over the next 20 years, with almost half of that
effective and efficient national economic burden, USD 21 trillion, affecting low- and
middle-income countries1.
cancer response.
National cancer control plans are a vital first step
for countries to implement the most impactful and Lao
PDR
cost effective interventions. They make a public

commitment to action and can serve as a tool
Target 1 to engage international support and civil society
engagement in order to reduce the national cancer
burden and improve patient outcomes.
In 2015, 71% of countries had an operational NCD
plan addressing cancer, up from 50% in 20102. The
greatest progress has been seen across Africa and
the Americas - however significant work remains to
translate many of these plans into effective national
Strengthen health systems programmes. By contrast, 52 countries have publically
for effective cancer control available cancer control plans3.
The Global Action Plan for the

“Evidence-based cancer plans are the Getting involved: International Cancer Control Partnership (ICCP) Portal
Prevention and Control of NCDs
foundation of effective cancer control.
calls on countries to develop and The ICCP Portal offers:
The Partnership brings together
implement a national multisectoral a diverse group of international • A one-stop shop for learning and sharing best practices about how to develop and implement national
NCD policy and plan. organisations dedicated to achieving cancer control plans
equitable, evidence-based strategies for • Access to more than 160 cancer and NCD plans in multiple languages
each and every country, and the ICCP
• Open online resources that can support national cancer control efforts from early detection and
portal offers users a unique opportunity treatment to costing tools.
to draw on global experiences and
resources to develop these”.
Edward Trimble, Director, National
Cancer Institute, US - an ICCP
partner organisation
World Economic Forum, The Global Economic Burden of Non-communicable Diseases www3.weforum.org/docs/WEF_Harvard_HE_
1
GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf [Accessed 19.08.16]

WHO, Assessing National Capacity for the Prevention and Control of Noncommunicable Diseases (2015) http://apps.who.int/iris/bitstre
2
am/10665/246223/1/9789241565363-eng.pdf?ua=1 [Accessed 19.08.16]

3
ICCP Portal Resources www.iccp-portal.org/resources-search

Status of Population-Based Cancer Registries, 2013
Cancer Registration High-quality PBCR (national) High-quality PBCR (regional) PBCR (national or regional) Registration activity No Data /Status Unknown
Cancer registries are an Robust cancer registry data provides the basis for
governments to prioritise investments in cancer
essential component of an control according to the national burden. Effective
effective and efficient national cancer surveillance using a population-based
approach can be developed in all resource settings.
response to cancer. The greatest increase in numbers of cancer registries
was seen across the African region, whose number
more than doubled between 2010 and 20154.
These registries have a crucial role to play in
Target 2 identifying national cancer burdens, as well as
determining the impact of cancer control interventions
on the national cancer burden and patient outcomes.
Measure cancer burden and

impact of cancer plans in all “Population-based cancer registry data
countries [are] an essential foundation of national
cancer control planning—if you don’t
know your cancer burden, how can
scarce resources be targeted at the
most appropriate solutions for cancer?”
Getting involved: GICR Coordinated by IARC in collaboration with
Eduardo Cazap, President, Latin designated local Principal Investigators, the
American and Caribbean Society of The IARC-led multi-agency Global Initiative
The Global Action Plan for the objective of the Hubs are to assist in sustainably
Medical Oncology (SLACOM) for Cancer Registry Development (GICR) was
expanding high-quality population-based cancer
Prevention and Control of NCDs launched in 2011 to establish effective mechanisms
registries within defined regions, by providing the
outlines the need to improve to expand the coverage and quality of data
necessary:
accountability for the from population-based cancer registries in less
developed countries, and to attain a global fund for • Mentorship and support
implementation of NCD plans by
such activities. • Targeted training
assuring adequate surveillance, • Guided research capacity
monitoring and evaluation Now operational, a series of IARC Regional Hubs
• Advocacy tools.
84% of countries have an for Cancer Registration are being rolled out in
capacity.
Africa, Asia and Latin America, with plans for the
operational cancer registry, Caribbean and Pacific Islands.
with 59% of countries collecting
population-based data5.
4

5

Algeria
Contributors: ENNOUR for Helping Cancer Patients – Sétif
WHO cancer country profile 2014 Link to profile
Mortality (male) Mortality (female) Cancer plan Cancer registry HBV vaccination HPV vaccination
10,900 11,000 Yes Population-based 95% No data
Breast screening Cervical screening Radiotherapy Chemotherapy Oral morphine

Generally available at public
Generally available at public Generally available in the Generally available in the Not generally available in
primary healthcare level
primary healthcare level public health system public health system the public health system
(Pap smear only)
WHO NCD progress monitor 2015 Link to monitor

Public
Tobacco Alcohol Alcohol Alcohol NCD
Risk factor NCD Tobacco Smoke-free awareness on
health availability advertising pricing management
survey action plan taxation policies diet/physical
warnings regulations bans policies guidelines
activity
Progress against the World Cancer Key successes UICC Member's achievements
Declaration targets Algeria’s main success has been the Association Ennour has built ‘Hope Lodge’,
Algeria has made significant progress against implementation of a national network of cancer a centre that provides care for patients with
the Declaration targets including: registries. This was achieved with the support limited resources from across Algeria. Adult
of a UICC Training Grant in 20145. and paediatric patients are provided with food,
• Participation in international cancer survival lodging, access to care, and psychological
studies CONCORD and CONCORD-21,2 In addition, the development of the National
support for several weeks, as well as for their
that looked at the efficiency of health Cancer Plan 2014-2019 and National
families where necessary.
systems and their impact on patient survival Tobacco Control Plan in 2011 are also key
rates achievements. Association Ennour has also worked to reduce
exposure to tobacco smoke, particularly for
• Building on local registries (including the
Key challenges children. They have collected data around
Setif cancer registry) to develop population-
prevalence of smoking in Algeria and
based cancer registries and surveillance Collaboration with international institutions developed information sheets, reports and
systems across Algeria3,4 including UICC, WHO and IARC will be critical interviews in French and Arabic on the need
• Increased efforts to tackle exposure to for ensuring the effective implementation and for smoke-free environments for children in
tobacco, as one of the key risk factors for evaluation of Algeria’s National Cancer Plan. Algeria. In collaboration with the American
cancer, as detailed in the National Cancer Cancer Society, they have established a
In particular, Association Ennour would like to
Plan coalition to consolidate tobacco control and
see the development of national programmes
• Introduction of the HBV vaccination for all to manage breast, cervical, and colorectal cancer prevention efforts, and advocate for the
children. cancer, and further training for physicians ratification and implementation of WHO FCTC
on cancer registration, screening, and the in Algeria.
importance of patient follow-up. There is
also a need to develop research in cancer
epidemiology, and for increased efforts to
ensure full implementation of the WHO FCTC.
Footnotes:
1. www.ncbi.nlm.nih.gov/pubmed/18639491
2. http://thelancet.com/journals/lancet/article/PIIS0140-6736(15)61443-X/fulltext
3. http://sante.dz/plan_national_cancer.pdf
4. www.ennour.org/images/enf.pdf
5. www.ennour.org/images/Workshop%20cancer%20affiche%20final.jpg

Benin
Contributors: Association pour la Lutte Contre le Cancer au Bénin
1,700 2,000 No No 78% No data

Not generally available
Generally available at public Not generally available in Not generally available in Not generally available in
at public primary
primary healthcare level the public health system the public health system the public health system
healthcare level

Public
activity
Declaration targets Whilst Benin has started to make general ALCC Bénin has actively engaged in the
A national cancer control plan has been progress towards the Declaration targets as prevention and control of NCDs and cancer,
developed that includes strategies and outlined above, it was felt that there were no including:
targets to: particular areas of success to highlight.
• In 2008, conducting the WHO STEPwise
• Reduce the number of cancer patients that approach to surveillance and assessment of
have to be evacuated to another country to Key challenges risk factors for NCDs at a national level
receive care Association pour la Lutte Contre le Cancer au • Working to increase public awareness and
• Develop a qualified workforce to deliver Bénin (ALCC Bénin) would like to see a number knowledge of cancer risk factors
effective cancer care of measures taken in order to help accelerate • Promoting palliative care through the Benin
• Promote the use of HPV and HBV progress towards the Declaration including: Association for Palliative Care, which has
vaccinations • Improving access to radiotherapy through led to the establishment of two palliative
• Build a centre of excellence for cancer care, the creation of a national centre for care centres and the provision of palliative
as well as units to deliver radiotherapy, radiotherapy and nuclear medicine care services at home
palliative care and adjuvant chemotherapy, • Establishing a national oncology institute • Advocating for the use of surgery and
and departments for gynaecological and in Benin chemotherapy in cancer cases, and
breast oncology. working to enable multidisciplinary
• Creating cancer screening programmes for
Alongside the development of a cancer plan, consultations.
breast, prostate, colon and cervical cancers
Benin has also been working to develop a in order to reduce the number of patients
population-based cancer registry based out of presenting at a late stage and thereby
Cotonou. improve potential treatment outcomes.
Finally, there has been a movement nationally
to improve general awareness of risk factors
for cancer, with a focus on tobacco, alcohol,
sedentary lifestyles, obesity and poor diets
lacking in fruit and vegetables.

Burundi
Contributors: Alliance Burundaise Contre le Cancer; Ministry of Health of Burundi
2,300 3,100 No No 96% Yes

Not generally available Not generally available
Not generally available in Not generally available in Not generally available in
at public primary at public primary
the public health system the public health system the public health system
healthcare level healthcare level

Public
activity
No data
Progress against the World Cancer Key successes • Introducing palliative care and domiciliary
Declaration targets services into the national health system
In recent years, national authorities have
become much more aware of cancer as an • Mobilisation of sustainable funding for
Despite political uncertainty and limited
issue in Burundi. This has resulted in much cancer control activities.
resources for cancer control, Burundi has been
able to make progress against the Declaration more concerted action to develop the policies
targets including the: needed to tackle cancer, and reduce exposure UICC Member's achievements
to key risk factors. These actions have included The ABCC works to help reduce exposure
• Routine vaccination against HBV as part of
the following: to key risk factors, and tobacco in particular.
the national scheme since 2006
• HBV vaccination is being offered to children Since 2006, ABCC has:
• Introduction of HPV vaccine in April 2016
in two pilot projects in the districts of under five, and HPV vaccination is being • Run a campaign promoting tobacco-free
Rumonge and Ngozi. Scale-up of these piloted environments for pregnant women and
pilot projects is planned for 2018. • National strategic plans have been children under five
developed to reduce tobacco consumption • Provided training for volunteers about the
and exposure to smoke, as well as to reduce risks associated with tobacco use, and
the harmful consumption of alcohol held workshops for youth clubs, students
• Training of general practitioners on the and their teachers on cancer, as well as
detection of precancerous lesions, and promoting anti-tobacco songs
a related awareness campaign on the
• Introduced World Cancer Day in Burundi
screening of women aged 26 and over
and organised activities to mark the day
• Burundi has developed a national plan for
cancer control. • Raised cancer awareness amongst health
authorities and encouraged them to act,
for example resulting in the vaccination
Key challenges
of children against HBV and integration
There are a number of key actions which the the vaccine into the national plan, with
Alliance Burundaise Contre le Cancer (ABCC) funding from the Bill and Melinda Gates
would welcome to strengthen cancer control. Foundation
These include: • Negotiated with IAEA, as part of a larger
• Improving awareness of cancer, and of national group, to establish an integrated
primary, secondary and tertiary prevention cancer centre. ABCC will help to organise
strategies national counselling for screening, early
• Establishing a national screening and cancer diagnostics, and palliative care
early detection programme for breast and • Created the Burundi NCD Alliance, with
cervical cancers other associations, to reinforce local
• Creation of a national referral centre for prevention and policy activities and
cancer care and treatment, with facilities integrated these into the activities of
for treatment and pathology, such as the East Africa NCD Alliance.
upgrading those currently available at the
University Hospital of Kamenge

Cameroon
Contributors: Cameroon Laboratory and Medicine Foundation Health Centre
3,800 4,400 Yes Population-based 89% Yes

Generally available at public Not generally available
Generally available at public Generally available in the Generally available in the
primary healthcare level in the public healthcare
primary healthcare level public health system public health system
(clinical breast exam only) system

Public
activity
No data No data
Progress against the World Cancer Key successes National policies targeted at reducing poverty
Declaration targets and illiteracy within the general population will
Despite the challenges, over the past eight also be important to help drive efforts towards
Cameroon has made mixed progress against years, Cameroon has seen remarkable the Declaration targets.
the Declaration targets primarily due to limited successes in tobacco control. The national
resources, poor infrastructure and the absence tobacco control coalition has focused on
UICC Member's achievements
of a functional national cancer society. In spite engaging the public through education and
of this, Cameroon has taken steps to: sensitisation measures around the dangers of The Centre’s focus in recent years has been on
tobacco use, while simultaneously working with improving awareness of cancer, both amongst
• Improve public awareness about cancer risk the government to implement higher tobacco the general population and healthcare
factors, particularly regarding tobacco use taxes, and other control measures directed at professionals. In particular, the Centre has
and alcoholism. In recent years, there has tobacco companies. focused on Burkitt’s lymphoma and cervical
been a concerted anti-tobacco campaign cancers, and has worked to build national
At the same time, Cameroon has rolled out a
• Deliver health education on cancer capacity to address these through education.
large-scale HPV screening programme, which
symptoms and reduce the stigma Burkitt’s lymphoma is the prevalent childhood
reached twice as many women as the goal set
associated with a cancer diagnosis cancer in Cameroon, but lack of awareness of
for 2015. The government is also taking steps
• Improve access to opioids. Whilst symptoms means they are often misinterpreted
to improve cervical cancer treatment.
they remain scarce in Cameroon, the by patients and many healthcare professionals.
government has worked to ensure that For example, oropharyngeal presentation can
Key challenges be misinterpreted as an oro-dental abscess,
morphine is available in pharmacies by
prescription. The absence of a cancer registry and or an intra-abdominal mass for ascites. This
functional national cancer society in Cameroon crucially delays accurate diagnosis and
are key hurdles to achieving the Declaration treatment, resulting in higher mortality.
targets by 2025, and warrant urgent action.
Data are needed to both develop and evaluate
national actions, and are an important
complement to continued research efforts to
improve the quality of cancer services.
The Cameroon Laboratory and Medicine
Foundation Health Centre (The Centre)
acknowledges that further progress in tobacco
control and HPV programmes is much needed,
which should build on existing advocacy
efforts, campaigns and screening projects.
Furthermore, increasing the quality and
number of healthcare professionals who can
diagnose and treat cancer is essential, whilst
developing the training opportunities and
physical infrastructure to support and enable
individuals will be crucial to long term success.

Chad
Contributors: Ministry of Health of Chad; Hopital Général de Référence Nationale;
Action Tachadienne Contre le Cancer
2,000 2,500 No data No data 48% No data
No data No data No data No data No data

Public
activity
No data No data
Progress against the World Cancer • Enhance national prevention strategies, Key challenges
Declaration targets including public awareness around cancer
risk factors. Work is being conducted One of the key challenges within Chad is the
The burden of cancer in Chad is a significant in partnership with the media, national limited resources available for cancer control.
problem and costs an estimated USD 10 associations and schools in order to foster While there are a number of plans being
million per year. This is largely incurred by healthier behaviours. While the stigma developed, their success and implementation
patients seeking treatment internationally, around cancer is not an issue, some cultural rests on the identification of sustainable
due to shortfalls in the provision of services beliefs and illiteracy levels, which reach 80% resources.
nationally. This has a major impact both on the in some sectors of the population, affect the Aside from this, there is a need to evaluate the
national economy, and on families, who risk population’s care seeking behaviour effectiveness of Chad’s NCD strategy (2016-
being pushed further into poverty. However, 2030), which includes cancer.
• Improve access to screening and early
Chad has worked to strengthen the role and
detection. National plans have been
impact of the national cancer programme. In
developed for screening services, however, Author's achievements
particular, the government is working to:
due to resource shortages these have not
yet been rolled out The Ministry of Health is proud of the strategies
• Establish a high-level national committee
that have been developed to address the
for cancer • Increase coverage rates of the HBV vaccine national burden of cancer in Chad. The Ministry
• Develop Chad’s cancer registries and use for all children, which was first introduced has also been working actively to develop
these data to enhance cancer research in 2008. An HPV vaccine is currently being relationships with international agencies such
nationally, as well as to evaluate current piloted as IAEA, the African Organisation for Research
cancer control efforts on an annual basis • Develop national palliative care services, and Training in Cancer, the National Cancer
• Increase the human, physical and financial including increasing morphine availability Institute of the United States of America, the
resources dedicated to cancer control. • Build alliances between organisations American Cancer Society and UICC.
The plan to build the country’s first cancer engaged in cancer control in Chad.
centre in N’djamena has been developed
and the government is currently exploring Key successes
funding options as, in the current situation,
treatment within Chad is more expensive Chad has now adopted its inaugural cancer
than treatment internationally. It is hoped plan and the Ministry of Health is in the process
that the centre will be able to deliver of writing a plan to develop national cancer
chemotherapy and radiotherapy services registries, building on a number of regional
registry projects that are currently taking place.
• Develop training courses on radio-
oncology, oncology, pathology and One of Chad’s key successes has been the
radiophysics development of a national tobacco control
programme, and the adoption of a number of
tobacco control laws by the government.

Comoros, the
Contributors: Union Comorienne Contre le Cancer
200 200 No No 83% No data

Generally available at public Generally available at public
primary healthcare level primary healthcare level
(clinical breast exam only) (Pap smear only)

Public
activity
Declaration targets National action against cancer has been Due to lack of equipment, government
Within Comoros, development of cancer limited; however Comoros has begun to involvement and qualified personnel, UCCC
control has been limited and the Union celebrate international cancer days, and has has concentrated primarily on sensitising the
Comorienne Contre le Cancer (UCCC) is the used these as an opportunity to improve public on the importance of cancer prevention.
only organisation actively fighting cancer. public awareness around cancer. Follow-up These messages include the need for regular
campaigns have also been used in villages visits to the doctor for high-risk population
UCCC has sensitised the government and and schools to further disseminate these groups.
development partners of the importance messages.
and need to develop a cancer response and An ongoing agreement has been reached with
a national government focal point has been In addition to this, two doctors have been the Felix Guyon University Hospital of Réunion
appointed to lead the fight against cancer. trained in how to deliver pain relief and which enables doctors to send samples taken
palliative care, which is an important first step from patients with suspected cases of cancer
for the country in this area. Over the last couple to the Felix Guyon laboratory for testing. This
of years, UCCC has also managed to invite means that for the first time in Comoros’
cancer specialists to conferences and lectures history, there is the potential for early detection
for healthcare professions in order to deliver of cancer.
key information.
Key challenges
UCCC is working on the following activities to
help address key challenges:
• Develop a cancer registry in order to
measure the national cancer burden and
assess the impact of cancer plans
• Develop strategies to reduce exposure to
risk factors and deliver universal access to
HPV and HBV vaccination
• Work with communities to dispel myths
around cancer and to reduce the stigma
associated with a cancer diagnosis
• Achieve universal access to screening
and diagnosis, as well as pain control and
distress management
• Improve the opportunities for training and
education for healthcare professionals
interested in cancer care.

Congo, the
Contributors: Union Congolaise contre le Cancer
800 700 Yes Hospital-based 69% No data
Generally available at public Generally available at public Not generally available in Generally available in the Generally available in the
primary healthcare level primary healthcare level the public health system public health system public health system

Public
activity
Declaration targets • Creation of three major oncology services in UCC's key achievements include:
• The Congo has developed a strategic plan two of the country’s main cities, Brazzaville
• Creation of two additional oncology
to combat NCDs, with a special emphasis and Pointe-Noire
services in the country’s second largest
on cancer • Celebrations to mark World Cancer Day city, Pointe-Noire
• The HPV vaccine is currently being provided and raise public awareness of cancer
• Creation of a dedicated NGO that helps
to young girls in two country districts, • Development of a national tobacco control combat cancer
Lékoumou and Oyo programme
• Becoming a member of both UICC and
• A free cervical cancer screening • Development of training courses for the L’Alliance des Ligues francophones
programme, using VIA, was run from 2000 medical oncology at the University of Africaines et Méditerranéennes contre le
to 2003 with support from IARC. The Medical Specialists cancer
programme has continued to run since • Introduction of the HBV vaccination into the • Establishment of a post-doctoral specialty
2009 at a subsidised rate to encourage routine vaccination programme. training programme in medical oncology.
greater participation.
This has successfully trained 27 African
Key challenges doctors, of which eight were Congolese, to
help address the national skills shortage.
The Union Congolaise contre le Cancer (UCC)
would welcome action to:
• Establish adequate social protection
measures to facilitate greater access to
cancer tests and treatment
• Acquire additional equipment, specifically
a linear accelerator, to improve the
radiotherapy treatment modalities which
can be offered
• Acquire a vehicle equipped with screening
equipment that is able to deliver screening
services in different parts of the country,
particularly in more remote and rural
districts
• Extend HPV vaccination to the entire
country
• Consolidate the national programme
against cancer.

Congo, the Democratic Republic of the
Contributors: Congolese League Against Cancer

Public
activity
No data No data No data No data
Progress against the World Cancer Key challenges UICC Member's achievements
Declaration targets • Cancer patients continue to present with Since 2012, the Congolese League Against
• Development of the Democratic Republic of late stage cancers, particularly female Cancer (LCCC) has:
the Congo’s first cancer registry, based out patients, which significantly limits treatment
• Established relationships with key national,
of Lubumbashi hospital options and chances of success. As such,
regional and international organisations,
there is a need to tackle the public myths
• Introduction of radiation therapy, however such as L’Alliance des Ligues francophones
and misconceptions around cancer, and
it is only currently available at one private Africaines et Méditerranéennes contre
improve public awareness around key risk
hospital le cancer, the African Organisation for
factors and symptoms in order to enable
• Development of a paediatric oncology unit Research and Training in Cancer and the
people to access the services they require
at Lubumbashi University Clinic International Network for Cancer Treatment
in a timely manner
and Research; including working with
• Implementation of activities to raise • There are a number of organisations the African Network of National Cancer
awareness of cancer, including in working to tackle cancer nationally, however Registries to advocate for a national cancer
conjunction with World Cancer Day. coordination across the group is poor. A registry and gather statistics from the
mechanism to bring stakeholders together pathology anatomy laboratory
to help build trust and coordinate work
• Run a screening campaign in Lubumbashi
could be very valuable and may help to
and organised cancer awareness
make the most efficient use of national
campaigns through local television and
resources
radio channels. LCCC has celebrated World
• Diagnostic tests and medicines for cancer Cancer Day and used the day to launch
remain very expensive, which significantly the Lubumbashi Cancer Registry and raise
limits patients’ ability to access the awareness around cervical cancer
diagnostic and treatment services they
• Developed a paediatric oncology unit at
require
Lubumbashi University Clinic, addressing
• Expansion of the cancer registry beyond four of the most common childhood
Lubumbashi Hospital would be welcomed cancers with assistance from the Franco-
in order to better document the national African Group for Paediatric Oncology
cancer burden and support more effective (FAGPO)
cancer planning.
• Supported patients to be transferred
abroad for treatment and facilitated
customs clearance for donated cancer
medicines
• Organised training for healthcare
professionals on cervical screening, and
paediatric oncology with assistance from
FAGPO
• Organised and participated in national,
regional and international conferences on
cancer, particularly retinoblastoma.

Côte d’Ivoire
Contributors: Programme National de Lutte contre le Cancer
Not generally available at Not generally available at Not generally available in Not generally available in Not generally available in
public primary healthcare level public primary healthcare level the public health system the public health system the public health system

Public
activity
Declaration targets Key achievements in Côte d’Ivoire include the PNLCa has coordinated a number of cervical
Côte d’Ivoire has taken six key steps towards re-establishment of the Abidjan cancer registry cancer activities in collaboration with
achieving the Declaration targets including: in 2011 which, by 2013, was able to publish international partners including Jhpiego
its first results. The registry is also part of the and UNFPA. Since 2009, 20 cervical cancer
• Re-establishment of the Abidjan cancer
African Network of Cancer Registries that screening projects have been piloted, and a
registry in order to assess the national
means it is able to benefit from expert advice further 71 cervical screening sites have been
cancer burden
and support, to develop the registry in the opened. In total, these facilities have screened
• Implementing a law to ban smoking in coming years. over 50,000 women, identifying 2,100
public places precancerous lesions and 96 cases of invasive
Efforts to reduce key risk factors, most notably
• From 2000, inclusion of HBV in the cancer.
smoking in public places, should help to
national vaccination programme and in
reduce the long-term burden of cancer in There has also been a strong focus on training
2015, introduction of an HPV vaccination
Côte d’Ivoire and there have been significant and education to detect and treat cancers
programme with assistance from Gavi, the
improvements in the accessibility of screening nationally. A pool of 20 national VIA and
vaccine alliance.
services. cryotherapy trainers has been established
• Development of training for health along with 21 national cervical screening
professionals including a diploma in Key challenges supervisors to improve access to cervical
medical oncology, starting in 2015, and the screening. Since 2009, 350 physicians,
training of 350 health workers in screening A number of key hurdles remain and the midwives and nurses have received training
for cervical cancer Programme National de Lutte contre le on cervical screening, supported by the
• Commencement of work on the Abidjan Cancer (PNLCa) would like to see continued development of national guidelines and
radiotherapy centre in order to provide more improvements in the rates of early detection standards for prevention and detection of
comprehensive cancer care. and diagnosis of cancer. To achieve this, cervical cancers.
there would need to be further public and
professional training on cancer risk factors,
symptoms and treatment options, in order
to encourage patients to take part in regular
screening activities. The upcoming opening
of a new breast screening unit will also help
address this need.
They would also welcome steps to improve
the supply of quality anti-cancer medicines at
affordable prices in Côte d’Ivoire, as access to
treatment remains an issue.

Ethiopia
Contributors: Mathiwos Wondu-Ye Ethiopia Cancer Society

Public
activity
No data
Declaration targets • The Ethiopian Food, Medicines and Health Thanks to the continued and concerted effort
Ethiopia’s first national cancer control plan was Care Control Administration Authority, of the government and other stakeholders,
developed and officially launched through a Federal Ministry of Health, Mathiwos Ethiopia has been able to create a conducive
collaboration between the Federal Ministry of Wondu-YeEthiopia Cancer Society, socio-political environment to prevent and
Health and civil society organisations, including Tobacco-Free Kids and the Africa Capacity control cancer, and NCDs more broadly. Within
the Mathiwos Wondu-YeEthiopia Cancer Building Foundation are collaborating on this context, Mathiwos Wondu-YeEthiopia
Society (MWECS) and its partners. Building two projects that advocate for a strong Cancer Society has actively participated in
on this: comprehensive tobacco control law and the National Technical Working Group on
tobacco prevention measures in line with NCDs, thereby helping to conduct a situational
• Six radiotherapy machines are being the WHO FCTC analysis to determine the scale of the issue and
procured to start cancer treatment in five to demonstrate the growing burden of NCDs
• For the first time, oncology training is being
regional university medical centres and a and their risk factors. This process created the
delivered at Addis Ababa University
new cancer centre is being established and strategic framework, a key policy and strategic
will soon be launched in Addis Ababa • The National Cancer Control Committee
document, which was integrated into the
is being chaired by HE Mrs. Roman
• Cryotherapy machines are being procured Fourth Health Sector Development control
Tesfaye, the First Lady of Ethiopia, and the
for more than 118 public hospitals in order plan. This is a crucial step to ensuring the
committee is working collaboratively with
to deliver ‘see and treat’ programmes for integration of cancer prevention into all health
relevant agencies and organisations to
cervical cancer activities.
challenge the growing cancer burden in
• The HPV vaccine is being piloted in two Ethiopia.
regions, and scale-up plans are being
developed Key challenges
• A WHO STEPwise survey on NCDs is being
conducted to generate more accurate The ongoing collaborative work of the
information about the NCD burden in National Cancer Control Committee, and
Ethiopia the development and launch of the National
Cancer Control Plan have put in place strong
• Work is ongoing to establish national and foundations for cancer control in Ethiopia,
regional cancer registries however, further efforts will be required to
• Cancer medicines are becoming ensure effective implementation of the plan
increasingly available and affordable as a and to secure progress against the Declaration
result of continued collaboration between targets.
civil society and the Ethiopian Government.

Ghana
Contributors: Breast Care International
5,000 5,500 Yes Hospital-based 90% No data
Not generally available at Not generally available at Generally available in the Generally available in the Not generally available in
public primary healthcare level public primary healthcare level public health system public health system the public health system

Public
activity
Declaration targets Ghana’s key success was the development BCI has worked with communities across
The Ghanaian Ministry of Health has and launch of its National Strategy for Ghana to educate over one million people,
developed the Health Sector Medium Term Cancer Control in 2015. The plan provides and screen over 800,000 women for breast
Development Plan (HSMTDP), which has a key strategies and interventions for the cancer since 2002. With strong support
major focus on intensifying prevention and management and control of major cancers for from the media, BCI awareness programmes
control of NCDs and improving the delivery of the next five years. If implemented effectively, have yielded a significant and sustained
healthcare services. The strategies employed the plan should help to reduce cancer mortality improvement in public awareness of breast
within the HSMTDP include the promotion by 30% through primary prevention, screening cancer4.
of healthy lifestyles, the development of a and early detection, and improve diagnosis and
BCI is also working with patients to develop
national cancer registry and improvements treatment. It also aims to improve the quality
survivor groups such as the Peace and Love
in the detection and management of NCDs. of life for those with cancer and their families
Survivors Association5. As more patients
For example, solid tumours are now managed by 40%, as well as support rehabilitation and
are surviving due to improvements in early
using multidisciplinary approaches with some palliative care3.
diagnosis and treatment, these groups are
adjuvant treatments including radiotherapy, becoming more important in order to support
rather than through surgery or chemotherapy Key challenges individuals through their treatment and
alone. There have also been important rehabilitation.
A national screening programme would help
improvements in palliative care strategies1,
improve the rates of early diagnosis, and
regarding pain management regimes and
therefore the number of patients that can
incorporation of palliative care principles into
be effectively treated. For example, while the
home-based care projects for AIDS and cancer
Ghanaian National Health Insurance covers
patients2.
the treatment of breast and cervical cancers,
late patient presentation often limits treatment
options to palliative care. Implementation of the
National Strategy for Cancer Control will be the
key to success.
Breast Care International (BCI) would also
like to see further engagement with the
Ghanaian public in order to dispel myths and
misconceptions around the ability to treat
cancer, and increase the willingness to get
involved in prevention activities.
Footnotes:
1. http://read.uberflip.com/i/68480-am-2012-daily-news-monday-sec-c/12
2. Wright, M., Clark, D., Hunt, J., & Lynch, T. (2006). Hospice and palliative care in Africa: A review of developments and challenges. Oxford: Oxford University Press.
3. www.iccp-portal.org/sites/default/files/plans/Cancer%20Plan%20Ghana%202012-2016.pdf.

Guinea
Contributors: Génération Sans Tabac; Association Guinéenne Pour la Lutte
Contre le Cancer

Not generally available Not generally available
at public primary at public primary
healthcare level healthcare level

Public
activity
No data
Declaration targets Guinea has taken a number of steps to fight Génération Sans Tabac (GST) has been
The Guinean government introduced a cancer nationally, with a particular focus on successfully working to deliver smoke-free
number of tobacco control acts in 2004 which improving tobacco control and reducing public spaces. The airport and hospitals in
regulate advertising, tobacco consumption in consumption with the introduction of tobacco Guinea are now smoke-free as the result of
public, and require tobacco manufacturers to control laws. Aside from this, Guinea has various awareness and advocacy campaigns.
include health warnings on tobacco products implemented a clinical algorithm to support The objective of these campaigns is to save
(Arrêté n° A/2003/00442/MSP/SGG and n° the early detection, diagnosis and treatment of lives by:
A/2003/00443/MSP/SGG). cervical and breast cancers.
• Raising awareness of the dangers of
The third success has been the delivery of tobacco consumption as a public health
public awareness campaigns, many of which issue, with a particular focus on the health
have been led by civil society organisations and impacts for women and girls
are being delivered through schools, the media • Strengthening advocacy efforts with multi-
and social media platforms. sectoral partners to ensure implementation
of the WHO FCTC.
Key challenges
Between now and 2025, Guinea must work
to reduce cancer mortality despite its limited
resources. Activities such as awareness
campaigns and conferences in Guinea’s
biggest cities must continue in order to
educate the public about cancer risk factors,
signs and symptoms. The media have a crucial
role to play in these awareness-raising efforts.

Kenya
Contributors: Kenya Cancer Association

primary healthcare level at public primary
(clinical breast exam only) healthcare level

Public
activity
Progress against the World Cancer Key successes The last step would be the development of
Declaration targets capacity to deliver pain control as, particularly
Kenya now has policies in place to support in low-resource settings, pain relief is managed
Kenya has taken a number of important actions cancer care3 that are driven and monitored by families, and is often influenced by unhelpful
to improve cancer control including: by the National Cancer Institute. For example, myths and traditional beliefs.
the 2012 review of the tobacco control policy
• Development of cancer specific policies, identified key policy weaknesses and public
such as the 2012 National Cancer UICC Member's achievements
support for further measures4,5,6. Kenya has
Prevention and Control Act, which led to also developed cancer registries covering Through concerted advocacy work, KENCASA
the establishment of the National Cancer Nairobi, Eldoret, and Mombasa. has helped to ensure the integration of cancer
Institute1 into existing national NCD programmes.
Public-private partnerships have improved
• Creating a National Hospital Insurance This work has focused on the need to ensure
access to oncology medicines by negotiating
Fund that now covers cancer and other wider access to cancer and NCD education
a lower purchasing price for medicines and
NCDs for low-income patients. This has and screening services, as well as to develop
exemptions from import taxes; while the
significantly increased the number of an evidence-based strategy to integrate
government is helping to ensure effective
patients who are able to seek treatment NCD services into existing health structures,
distribution networks.
nationally and overseas specifically those for HIV/AIDS.
• Devolution of healthcare services, which Key challenges In 2011, KENCASA also organised the first
has enabled services to be tailored to the media training workshops for 70 journalists
regional context. It has also facilitated A key priority is the strengthening of the from the leading media houses in Kenya.
advocacy for NCDs and resulted in health system to ensure that the equipment These workshops were focused on how to
increased oncology services at the county and personnel are available to meet patient communicate messages about cancer, and
level. demand. This requires further work as the resulted in a collaboration to develop several
• The Ministry of Health has engaged Gavi in country currently has six radiation, six medical, awareness campaigns around breast and
an effort to include HPV in the list of regular and two gynaecological oncologists. The cervical cancer screening free of charge.
vaccines as a preventive measure for existing medical schools do not currently
train oncologists, however the five leading KENCASA has helped to foster a public-private
cervical cancer
institutions are developing oncology curricula. partnership to improve access to oncology
• The provision of further oncology training services for all sections of the population. The
by the Aga Khan University Hospital2, The Kenya Cancer Association (KENCASA) partners include civil society organisations,
including a higher diploma for clinical would like to see further policy development private-sector oncology centres and
officers, and plans for an 18-month diploma and enforcement to reduce exposure to cancer pharmaceutical companies. By bringing these
for oncology nurses. risk factors, especially from industrial sources, groups together, KENCASA has been able to
as there has been little action on this to date. subsidise the costs of cancer medicines and
thereby help to improve access.
Footnotes:
1. www.ipcrc.net/pdfs/Kenya-National-Cancer-Control-strategy.pdf
2. www.aku.edu/admissions/undergraduate/dip-oncology-nursing-kenya/Pages/home.aspx
3. www.kehpca.org/wp-content/uploads/national cancer-treatment
4. www.who.int/fcts/reporting/party_reports/ken/en/index.html
5. www.itcproject.org/countries/kenya
6. www.msh.org

Madagascar
Contributors: Fondation Akbaraly
6,800 6,100 Yes Hospital-based 74% Yes

Public
activity
No data
Progress against the World Cancer Key challenges • Raising awareness and conducting
Declaration targets screening for women in Fianarantsoa, as
Unfortunately, there are a number of well as villages in the Haute Matistra region,
Madagascar has taken a number of steps to competing national priorities for Madagascar, and more broadly across southern parts of
tackle cancer including: and therefore cancer is not receiving as much Madagascar. More than 8,000 women were
attention as it needs. There is growing pressure targeted by awareness campaigns in 2015
• Development of a national cancer policy in
from community groups to change the national
2010 and the creation of a national NCD • Establishing a prevention and screening
policy on cancer medicines and Fondation
policy in 2013 programme for cervical and breast cancers
Akbaraly would welcome an update to this
• Support for a national network of hospital- policy. There is also a need for: at primary and secondary health centres
based cancer registries in the Haute Matistra region and southern
• Training of more doctors and oncology parts of Madagascar. More than 5,147
• Passing of tobacco control laws banning
specialists, in order to manage the national visits have been made to the Centre Rex
smoking in enclosed public spaces and
burden of cancer in a timely and effective of Fianarantsoa, which includes 1,797
introducing graphic health warnings on
manner Pap smears, 1,296 breast exams, 1,008
cigarette packages
• Establishment of national awareness- mammary and pelvic ultrasounds and 140
• A second imPACT review, which was mammograms
raising and screening projects to improve
held in partnership with the IAEA PACT
rates of early diagnosis • Organising free Pap smears and clinical
team in August 2015, that developed
• Installation of radiotherapy facilities to treat breast exams at the Centre Rex of
recommendations to enhance current
patients within the public health system, Fianarantsoa and the Centre de Santé de
cervical cancer screening to detect and
as part of a broader strategy to improve Base de la Region. Alongside this, more
treat pre-cancerous lesions
treatment access in Madagascar than 30 missions to rural villages were
• The government has developed a cancer conducted in 2015 with the use of a mobile
centre in the capital, Antananarivo, and has • Development of palliative care services.
health unit
worked with organisations like Fondation
UICC Member's achievements • Delivering training sessions for
Abaraly to develop two regional treatment
healthcare professionals in the public and
facilities to help improve access to services.
Fondation Akbaraly has six priority areas of private sectors, as well as sessions for
work to help reduce cancer in Madagascar: representatives from partner organisations
Key successes
to support them in improving cancer
• Promoting World Cancer Day. In 2015 and
• Radiotherapy has been introduced, awareness amongst women from different
2016, Fondaton Akbaraly held an event in
however it is only available within private socioeconomic groups
southern Madagascar for over 215 women
clinics that are prohibitively expensive for who visited the organisation, alongside 45 • Reaching out to local civil and religious
many patients representatives from key local authorities, authorities to build a broad base of support
• Implementation of a HPV screening pilot radio and television channels. Six local for cancer control, and including these
project. organisations, including the Red Cross, groups in Fondation Akbaraly’s network of
Club Soroptimist and the Jeune Chambre local partners.
international, supported these events
Footnotes:
1. www.iccp-portal.org/sites/default/files/plans/Madasgascar%20-%20Politique%20Nationale%20cancer%202010.pdf
2. www.iccp-portal.org/sites/default/files/plans/Madagascar%20-%20Politique%20nationale%20contre%20les%20maladies%20non%20transmissibles_0.pdf
3. www.tobaccocontrollaws.org/legislation/country/madagascar/laws/desc

Malawi
Contributors: Malawi National Cancer Registry
2,800 4,600 No Population-based 89% Yes

Not generally available Generally available at public
Not generally available in Not generally available in Generally available in the
at public primary primary healthcare level
the public health system the public health system public health system
healthcare level (VIA only)

Public
activity
No data
Progress against the World Cancer Key successes Further work has also been welcomed to
Declaration targets implement universal HPV vaccine coverage
• Malawi now has a national cancer control alongside systems to evaluate its impact.
• Malawi has worked to establish more policy within the NCD policy launched by
hospital-based cancer registries; one the Ministry of Health Lastly, the country’s economy is largely
in Lilongwe at Kamuzu Central Hospital • There has been an increase in cancer agricultural and tobacco is the major foreign
and another at Mzuzu Central Hospital. In surveillance, with data of high enough exchange earner. This poses a great challenge
addition, the Ministry of Health has set up quality for Malawi to be included in the to reaching international smoking cession
cancer coordinators in all district hospitals ‘Cancer Incidence in Five Continents Vol. X ’ targets, as the government is not committed
IARC publication to anti-smoking campaigns. However, the
• The government has developed a national
successful implementation of the national
alcohol policy to ban alcohol that is sold in • Cancer education programmes have alcohol policy, which is a clear step in the right
100ml sachets by unlicensed retailers been delivered through local media and direction towards addressing key risk factors.
• In September 2013, Malawi embarked on by advocacy groups, and there has been a
a pilot project to administer three doses of documented increase in public awareness
the HPV vaccine to 6,950 adolescent girls • Chemotherapeutic drugs are now more
The Malawi National Cancer Registry (MNCR)
aged between the ages of nine and thirteen widely available in hospitals, including in
started as a histopathology registry in 1989
in the districts of Zomba and Rumphi. The public facilities, and an active IAEA-funded
at Queen Elizabeth’s Hospital, Blantyre. In
pilot finished in 2015 and the country is national palliative care programme has
1993, MNCR became the only population-
now preparing for a national roll out been established through the Palliative
based registry in Malawi, recording cases
• The College of Medicine in Malawi Care Association of Malawi
from all hospitals and clinics in Blantyre
has received a grant from the Medical • The first cohort of trained oncologists District however they were diagnosed. Cancer
Education Partnership Initiative which have begun to work in hospitals across the incidence data generated by the registry
is currently being used to fund several country, and a cancer treatment centre appeared in the ‘Cancer Incidence in Five
trainees in cancer-related areas. containing Malawi’s first radiotherapy Continents Vol. X1’ IARC publication
centre, is being constructed alongside the
training of dedicated specialist staff. MNCR is also a founding member of Malawi
Cancer Consortium, which is leading an
Key challenges HIV-Cancer linkage study with the aim of
measuring the cancer burden among HIV
Cancer is still not recognised as a notifiable positive individuals in Malawi. In addition,
disease in Malawi, posing serious challenges to MNCR is contributing to the drafting of the
creating an effective cancer registry. However, National Cancer Control Programme, in its
as part of the national cancer control policy, role as secretariat of the National Cancer
there are plans to enforce compulsory cancer Committee. These efforts have led to the
notification throughout the country. There is inclusion of a cancer section in the Malawi
also a need to transition some of the hospital- Standard Treatment Guidelines by the Malawi
based registries (especially the Kamuzu Ministry of Health.
Central registry in Lilongwe) into population-
based registries.
Footnotes:
1. www.iarc.fr/en/publications/pdfs-online/epi/sp164/CI5volX_Full.pdf

Mali
Contributors: OncoMali
2,400 4,300 No data Population-based 74% Yes
Generally available at public Generally available at public Not generally available in Generally available in the Generally available in the
primary healthcare level primary healthcare level the public health system public health system public health system

Public
activity
No data
Declaration targets Since 2008, the Malian government has been With the financial support of six Rotary clubs,
Mali has developed a national policy on the subsidising chemotherapy drugs, as well as OncoMali has successfully provided training
control of NCDs, which includes cancer. In morphine for all patients, which has markedly for 56 general medical practitioners from
1999, Mali opened a specialised centre for improved the accessibility of cancer care for a Bamako on cancer diagnosis, treatment and
the treatment of adult cancers, and a similar number of Malian people. care, with the aim of improving referral services
centre for the treatment of paediatric cancers in oncology in Mali.
Over the last four years, Mali has been marking
was opened in 2005. Furthermore, a centre for World Cancer Day with a number of different The above-mentioned training aimed to
radiotherapy was opened in 2014. events organised by civil society and patient increase the ability of general practitioners to
groups across the country. refer patients with signs of cancer, or patients
for whom a cancer diagnosis was suspected to
Key challenges a specialised service so that they could benefit
from optimal cancer care.
Association OncoMali would welcome:
OncoMali works with the Haematology and
• The introduction of training for medical
Oncology Service at the CHU Point G Hospital.
oncologists, radiotherapists, surgeons,
This is the only service that manages cancer
specialist nurses, psychologists, biologists
treatment and care in Mali and records detailed
and technicians within the country to help
information.
address the current skills shortage
• Further efforts to raise awareness and
improve the training given to all general
medical practitioners in early diagnostic
methods, and the development of
guidelines for appropriate referrals, to
improve early diagnosis rates and timely
access to treatment.
The final key challenge is to improve the
prognosis of different cancers in Mali. There
were 656 new cases of cancer in 2014 across
Mali, which represented an 11% increase
since 2013, and a further 467 cases in the
first six months of 2015. The majority of these
were diagnosed in their third or fourth stage,
with breast, colon and cervical cancers most
common.

Mauritania
Contributors: Ligue Mauritanienne de lutte contre le cancer; Association Mieux Vivre
avec le Cancer Gynécologique
600 700 Yes No 80% No data
Not generally available at Not generally available at Not generally available in Not generally available in Generally available in the
public primary healthcare level public primary healthcare level the public health system the public health system public health system

Public
activity
Progress against the World Cancer Key successes Key challenges

Declaration targets The development of the National Oncology Further efforts are required to achieve the
Mauritania has developed an integrated Centre in 2008 was a major achievement for Declaration targets in Mauritania, including:
National Strategic Plan against NCDs (2012- Mauritania. The Centre offers chemotherapy
• Implementation of the National Strategic
2020) and, in collaboration with the global and radiotherapy, and has ten specialised
Plan against NCDs, and approval of the
donor community, the private sector and civil doctors with nurses, general practitioners and
tobacco control legislation
society, the government is working to integrate radiation therapist trainees to support them.
cancer into national development programmes The centre has 40 beds and on average, treats • Continued development of Mauritania’s
and is actively engaged in the fight against 1100 patients per year. The development of cancer registries
cancer. this facility has also subsequently enabled the • Development of a surgery unit as part of
development of a paediatric oncology unit, the national oncology centre, to increase
In 2005, the Government ratified the WHO a diagnostic facility and a medical imaging the treatment options available, and
FCTC. Since then, Mauritania has established facility. the construction of housing facilities for
a national tobacco control programme, and patients and their families
drafted a tobacco control law, which is awaiting In cooperation with IAEA, Mauritania has been
the approval of the National Assembly. Ahead able to deliver specialised radiotherapy training • Increased awareness of and access to
of this, a number of municipalities have created for three radiotherapists, seven radiotherapy palliative care and patient support.
smoke-free places. There have also been a technicians, and three nuclear medical
number of advocacy programmes around physicists. In partnership with the Lalla Salma UICC Members’ achievements
smoking in schools and workplaces to raise Association and their partners, Mauritania
LIMALCC has been working to improve cancer
awareness around the risks, and to dispel has been able to deliver advanced training to
control nationally in partnership with the
myths and misconceptions around cancer. current nurses to help them deliver care for
government and other cancer organisations.
cancer patients.
Mauritania is also working to introduce the LIMALCC has helped develop a cancer
HPV vaccine for all eligible girls. Mauritania has also established a national registry, advocated for the development of the
tobacco control programme and legislation is National Centre for Oncology and created anti-
The development of cancer registries to cover awaiting approval by the National Assembly. tobacco clubs.
the whole country is a key area of work and
Mauritania has started to use these data to Finally, there has been active engagement with LIMALCC has also delivered education and
assess the effectiveness of cancer control civil society in Mauritania to help support and awareness-raising sessions for the general
programmes and interventions. care for patients. Ligue Mauritanienne de lutte public, screening campaigns for cervical
contre le cancer (LIMALCC) brings together cancer, training for healthcare professionals on
Finally, there has been a push to improve eight national associations to coordinate cancer, and created an assisted living facility
cancer facilities. A cervical cancer screening national cancer control efforts. for patients to support them during treatment.
centre was opened in Rosso, along with the
national oncology centre in Nouakchott. Through LIMALCC and the Ligue
Mauritania is developing training courses for Mauritanienne contre le tabac networks,
oncologists and palliative care nurses to help organisations involved in cancer control
meet national needs, and steps are being taken have been brought together to harness and
to improve morphine availability. To support coordinate efforts.
poor patients during the treatment process,
dedicated local accommodation has been
opened in Nouakchott.

Mauritius
Contributors: Link to Life
400 300 No data Population-based 89% No data

Public
activity
Declaration targets • A national cancer control plan and a cancer Link to Life has organised several campaigns
Mauritius has made good progress in registry have been established in Mauritius on breast, cervical, prostate and colon cancer,
increasing access to screening services, with • The Ministry of Health and Quality of Life, which run at least twice a week in various
free breast and cervical cancer screening in partnership with various NGOs, have regions of Mauritius. Workshops and specialist
available to vulnerable groups of women across been working to introduce further tobacco training opportunities for doctors, nursing
the island throughout the year, through Link control measures with a particular focus officers and psychologists were also organised
to Life. Any suspected cases of breast cancer on including pictorial warnings on tobacco in 2015 to improve professional awareness and
are referred to a radiologist for follow-up, after packets skills.
which patients are referred to the hospital. • Treatments, such as radiotherapy and Link to Life also provides support services for
Mauritius has also initiated an HPV vaccination chemotherapy, are now available free of cancer patients, from psychological support
programme, with Link to Life vaccinating more charge to cancer patients. to massage therapies, lymphodema treatment
than 300 girls. and beauty therapies, as well as group
Key challenges sessions to build cancer patients’ self esteem
In 2015, more than 60 awareness and confidence.
campaigns were conducted around the To improve cancer control in Mauritius, Link to
island. Accompanying this, training for Life would welcome: In 2015, Link to Life launched the ‘Reach to
psychotherapists, social workers and other Recovery Mauritius’ campaign to support
• More national cancer control campaigns, cancer patients nationally.
healthcare professionals has been organised
which make better use of the media in order
to improve professional understanding
to disseminate important information to a
and awareness of cancer prevention, early
wider proportion of the public
detection, treatment and care.
• More public and private partnerships to
support current cancer control measures,
including engaging NGOs in cancer control
decision-making.

Namibia
Contributors: Cancer Association of Namibia
400 300 No data Population-based 89% No data

Generally available at public Not generally available in Not generally available in Generally available in the
primary healthcare level the public health system the public health system public health system
(PAP smear only)

Public
activity
Declaration targets The Namibian Government implemented The Association is a registered non-profit
Through recent multimedia campaigns, the Tobacco Control Act No. 1 (2010) for the organisation that serves as the umbrella
Namibia has made significant progress in control, use, distribution and marketing of body for cancer awareness, education and
raising awareness of and reducing exposure tobacco products in an attempt to help fight financial support for the fight against cancer in
to cancer risk factors, and also addressing the cancer, lung and heart diseases in the country. Namibia. The Association raises funds for all its
cultural stigma associated with the disease. activity, with no additional assistance from the
Key challenges government or international agencies.
The Cancer Association of Namibia (the
Association) has also helped drive national As the CAN Association is seen as the The Association recently embarked on a
progress with respect to screening and ’responsible body’ to fight cancer in national awareness campaign targeting the
early detection of cancers, through the Namibia, the Association would welcome the most rural areas of the country, which have
rollout of numerous community awareness establishment of more urgent action on cancer previously not been reached. The aim is to
and screening campaigns in 2015. These awareness, and medical treatment and care reach at least 70% of the Namibian population
campaigns remain a high priority in 2016 and within the Ministry of Social Services. of 2.4 million and educate them on cancer in
will focus on breast, cervical, prostate and their mother tongue. This involves delivering
testicular cancer screening. information in thirteen languages across over
824,000 square kilometres by the end of 2017.
Furthermore, as a result of collaboration
between the Ministry of Health and Social Additionally, this campaign has led to the
Services of Namibia and several international creation of the first ‘Cancer Manual for
partners, Namibia will see its first HPV and the Republic of Namibia’, which has been
HBV vaccination campaign kicking off in 2016. developed in English as well as other Namibian
The campaign will target state schools and languages, and was distributed for free on
health clinics. World Cancer Day. Information from the
manual was also aired on local radio stations.

Nigeria
Contributors: Federal Ministry of Health in Nigeria; Breast Cancer Association of Nigeria;
Breast Without Spot Initiative; Partnership for the Eradication of Cancer in Africa (Nigeria)
30,400 38,800 No Population-based 63% No data

Public
activity
No data
Progress against the World Cancer Key successes • Building treatment capacities, both through
Declaration targets the development of comprehensive cancer
Nigeria has seen significant improvements centres, and strengthening and equipping
Nigeria's Federal Ministry of Health reports in the availability of training for cancer care local health units and referral systems
progress including: nationally, although some challenges remain.
Improvements include facilities providing • Helping to dispel myths and stigma around
• An increase in the number of population- education on palliative care, oncology cancer through the rollout of jingles,
based cancer registries from two to six postgraduate training opportunities for supporting NGOs and the private sector to
by 2016, while the number of hospital doctors, a residency training programme for deliver awareness campaigns, and further
registries increased from 12 to 26 medical physicists, and an oncology nursing strategic national awareness programmes,
training school. with a particular focus on breast and
• Adoption of the national Tobacco Control
cervical cancers that significantly
Bill in May 20151
Alongside this, Nigeria has worked to improve contribute to the national burden2.
• Initiation of a universal HBV vaccination awareness of cancer through jingles in
plan ,and development of a similar plan for local languages. Raising awareness is a key Author's achievements
HPV vaccination component of national programmes to achieve
• Creation of awareness-raising jingles universal HBV immunisation among children Nigeria’s major cancer control success has
(short songs) in electronic media in local and to scale up cervical cancer screening. been improvements in the availability of
languages equipment for cancer treatment, including
Key challenges the installation of radiation equipment in eight
• Development of a national cervical
hospitals and breast, cervical and prostate
screening strategy UICC members have suggested that there is screening equipment in six other tertiary
• Support for NGOs to deliver cancer scope for Nigeria to build on current progress healthcare facilities. However, there have
screening alongside government services by: been issues in maintaining the functionality
• Improvements in immunohistochemical of these facilities. The IAEA are assisting
• Developing population-based registries to
diagnostic equipment in Abuja and Ibadan in the implementation of a curriculum for
serve all states within Nigeria
medical physicists to ensure quality control in
• Improved availability of pain relief in the • Completing the national strategic plan on radiotherapy centres. Local pharmaceutical
form of oral morphine cancer, systematically engaging with NGOs industries are also being supported by the
• Establishment of a palliative care training to shape and deliver it government to produce adjuvant essential
facility for nurses and healthcare workers • Rolling-out the HBV vaccination plan to medications, and import duty and related taxes
• Training of medical physicists, which ensure universal access for chemotherapeutic drugs were abrogated
started in 2012 at Ibadan University, • Increasing screening outlets and locating in 2014.
and the development of a postgraduate programmes in primary and secondary Other achievements include the passage
programme in nuclear medicine. healthcare centres. This requires further of the Tobacco Control Bill in May 2015,
training for healthcare professionals, with a the incorporation of the HBV vaccine into
focus on cancer screening, and will depend the Expanded Programme of Immunisation
upon extensive collaboration with NGOs for children in 2014, and promotion of the
HPV vaccination in both government and
Footnotes:
1. www.tobaccocontrollaws.org/legislation/country/nigeria/laws/desc
private health facilities. Building on this, a
2. Jedy-Agba E, Curado MP, Ogunbiyi O, Oga E, Fabowale T, Igbinoba F, Osubor G, Otu T, Kumai H, Koechlin A, Osinubi P, plan for a pilot Gavi assisted HPV vaccination
Dakum P, Blattner W, Adebamowo CA. (2012). Cancer incidence in Nigeria: a report from population-based cancer registries. programme is at an advanced stage.
Cancer Epidemiol. 2012 Oct;36(5)

Rwanda
Contributors: Partners In Health
2,700 3,200 Yes No 98% Yes

Public
activity
No data
Progress against the World Cancer Key successes • Enhance screening capacities in cervical,
Declaration targets breast and other cancers
The Rwandan MoH is the global leader
in cervical cancer prevention through its • Rollout national pathology services in
Rwanda has made progress against the
strategic national implementation of the collaboration with the American Society for
Declaration targets through several key
HPV vaccine. Implementation began with Clinical Pathology
initiatives. Firstly, the Ministry of Health (MoH)
has developed a nationwide HPV vaccination national sensitisation campaigns prior to • Establish radiotherapy treatment centres
programme, and it continues to build on this rollout of the vaccination. In collaboration with • Implement cancer and palliative care
success to maintain high coverage rates. the Ministry of Education, pre-adolescent training and education opportunities for
Secondly, national symposia on oncology and adolescent school girls were targeted all categories of health professionals at
are conducted regularly to improve the through the public and private school system. multiple levels of the health system.
coordination of care throughout the country. Ultimately, the inclusion of teachers, local
Most recently, Rwanda became the first leaders and community health workers in the UICC Member's achievements
recipient of a novel pathology service delivery strategic planning allowed for a successful
programme from the American Society for public-private-community partnership. With Partners In Health has worked together
Clinical Pathology, which will establish robust the support of Merck, Gavi and others, the with the Rwandan MoH to strengthen the
pathology centres nationally. Furthermore, implementation of a school-based multi-phase quality of care at the Butaro Cancer Centre
the MoH has also successfully established vaccination strategy over three years achieved of Excellence1. With the support of partners,
an implementation plan for the national a coverage rate of 93%. This accomplishment including Dana-Farber Cancer Institute and
palliative care programme, which will include a has been well-documented and viewed as Brigham and Women's Hospital, this cancer
community-based element. an international precedent, upon which other referral facility serves the needs of Rwanda as
countries should follow. well as surrounding countries2. Through the
support of the MoH, Partners In Health’s key
Key challenges achievements have been:
Rwanda will seek to strengthen the following • The addition of the ambulatory cancer
strategic areas in order to achieve the centre and a paediatric oncology unit at the
Declaration targets: Butaro Cancer Centre of Excellence. This
has alleviated pressure on the oncology
• Establish robust cancer centres at national
ward, improving patient satisfaction, and
referral hospitals
a more efficient and effective operational
• Establish a national cancer registry and a structure3
national electronic medical records system,
• The development of telepathology services,
specific to cancer, to facilitate clinical care,
which has improved the turnaround time of
monitoring, evaluation, and research
results
• Continue successful rollout of HPV
• The updating of clinical protocols and
vaccination programme
electronic medical records templates
• Establish a body of community-based and forms, which has allowed for greater
Footnotes: healthcare providers to implement efficiency and adherence to standards of
1. www.pih.org/blog/faster-better-care-for-breast-
cancer-in-rwanda campaigns to sensitise and reduce stigma, care
2. www.ncbi.nlm.nih.gov/pmc/articles/PMC4797361/ in addition to the provision of follow-up care
pdf/12885_2016_Article_2256.pdf • Oncology nurse training, which has
3. www.worldcancerday.org/content/paul-rwanda reinforced best practices in clinical and
psycho-social support.
Seychelles
Contributors: Ministry of Health of the Republic of the Seychelles
No data No data No Population-based 99% Yes
Generally available at public Generally available at public Generally available in the Generally available in the Generally available in the
primary healthcare level primary healthcare level public health system public health system public health system

Public
activity
No data
Progress against the World Cancer Key successes • Currently, Seychelles has one palliative
Declaration targets care centre that can accommodate only
The establishment of a population-based 2% of terminally ill patients. While most
Cancer is the second leading cause of death national cancer registry in Seychelles has terminally ill patients are cared for at home,
in the Seychelles, and tremendous efforts provided the data necessary to understand the a centre that can implement pain control
have been put towards achieving the nine national cancer burden and thereby tackle the and distress management for patients is
Declaration targets. Progress includes: most common cancers. much needed
• Development of a national cancer control Education in cancer health has been promoted • Improving awareness around cancer
plan, and the establishment of a cancer through media outlets, as well as through prevention and introducing mechanisms for
registry in 2008 partnership with NGOs, such as the Cancer screening that will target at-risk populations
• Inclusion of HPV and HBV vaccinations as Concern Association and Soroptimist. These is crucial. There is a pressing need for
part of the National Health Plan outreach programmes have contributed robust screening programmes for breast
to improved rates of early detection and and colorectal cancers in particular.
• Health promotion programmes in
treatment, and impacted national survival
workplaces, schools, and media outlets to
rates. Author's achievements
improve awareness of cancer risk factors.
Further health education is helping to The Seychelles provides free healthcare The MoH has established a cancer programme
challenge stigma and myths around cancer services to try to ensure that every person unit covering health education, screening and
• Delivery of diagnostic and treatment can access treatment. Services, such as outreach activities within the broader national
services free of charge radiotherapy, that are not available in the NCD structure. The unit is lead by the Cancer
Seychelles are still covered by sending patients Programme Manager whose responsibility is to
• Introduction of screening programmes,
for overseas treatment. ensure that cancer plans are fully implemented.
following which the Seychelles has seen a
95% decrease in the number of late stage One key area of work within the MoH has
cervical cancers being diagnosed. Key challenges
been the establishment of the national cancer
The Ministry of Health (MoH) has identified registry which provides the data required
three key areas which require further work, to monitor the cancer burden and the
and which should be addressed through the effectiveness of screening activities for breast,
implementation of the national cancer control prostate and colorectal cancers.
plan:
• With the increase in newly diagnosed
cancer patients per year, there is a need to
increase the number of trained healthcare
professionals. Education and training on
cancer care for healthcare professionals
needs to be stepped up to meet the
national demand, as well as to improve the
quality of care across the country

Sierra Leone
Contributors: Crusaders Club Ministry Sierra Leone
900 1,300 No data No data 92% No data

Public
activity
Declaration targets The MoHS has created a ‘Cancer Group Since 2009, the Crusaders Club Ministry Sierra
Although cancer control in Sierra Leone has Committee’ that brings together organisations Leone has been working both independently
been hampered by a lack of resources, there from across the country who are engaged in and with international organisations to improve
has been progress in a number of areas cancer control in order to coordinate activities. cancer awareness amongst healthcare
through collaboration between the NCD unit In 2012, this group organised a series of professionals and the general public through
within the Ministry of Health and Sanitation successful events to mark World Cancer Day capacity building workshops.
(MoHS) and national NGOs focused on cancer. and also took an active role in the national
The advocacy team began to operate in 2010
health fair, organised by the MoHS.
The development of a Health Education Unit, and has trained nurses and teachers across six
within the MoHS, has also played an important Sierra Leone has also developed a national institutions in Freetown and Kissy to improve
role in delivering and supporting health cancer registry. The registry was launched in cancer awareness and become cancer
education for the general population. This 2012 and is responsible for tracking all cancer advocates within their own institutions1.
group has actively worked with civil society diagnoses nationally and developing baseline
The Crusaders Club has also successfully
organisations to dispel damaging myths and cancer data.
organised awareness-raising activities as part
misconceptions about cancer. It has focused of the Global Cancer Awareness Campaign
on how cancer can be prevented and treated Key challenges in 2015 and World Cancer Day in 2012, and
nationally. provides funds for cancer research projects.
The Crusaders Club Ministry Sierra Leone
Information about risk factors has also been would welcome action in the following areas:
disseminated in collaboration with local and
• Further awareness-raising efforts
international NGOs. Workshops have been
focused on key risk factors for cancer,
held on tobacco use and obesity, and Sierra
and in particular tobacco and alcohol
Leone is starting to see reductions in both of
consumption
these risk factors nationally.
• International support to equip state
HBV and HPV vaccines are being administered, hospitals with modern equipment to
however shortages in stocks of both have ensure that patients have access to
posed a problem and prevented universal screening, accurate and timely diagnosis,
coverage. Similarly, while there have been and essential medicines. This should be
some improvements in access to diagnosis, delivered through dedicated wards in all
treatment and care, there is the potential for far government hospitals
greater advances with the right investments.
• Development of palliative care centres
In particular, patients in Sierra Leone have
across the country
limited access to palliative care services and
medicines for pain control. • Training opportunities for healthcare
professionals and advocates.
Underpinning all of these elements is the
need to secure sustainable funding for cancer
control and treatment.
Footnotes:
1. http://ecancer.org/news/3892-spreading-cancerprevention-messages-in-sierraleone.php

South Africa
Contributors: Cancer Association of South Africa

Public
activity
No data
Progress against the World Cancer Key successes • Development of a network of youth
Declaration targets ambassadors to advocate and raise
In particular, South Africa has achieved the awareness about cancer in schools and in
Key measures taken in South Africa include: following: higher education institutions.
• Rollout of the HPV vaccination across South • Reducing exposure to risk factors by
African schools by the National Department improving food labelling and passing UICC Member's achievements
of Health in 2014, assisted by a vaccine legislation to prohibit food from containing
implementation working group, which more than two percent of trans-fats. BPA CANSA has successfully introduced several
included key civil society groups was banned in baby bottles in 2011 health awareness campaigns9 on cancer to
reach more communities and spread the
• National rollout of awareness and early • Active support of cancer research, with
cancer message nationally. Over 200 fact
detection services to help deliver early South African scientists helping to discover
sheets and position statements have been
detection programmes in previously the mutation that causes colon cancer
developed to support national advocacy and
underserved communities. Nine of the and helping to develop an early diagnostic
awareness efforts, which are shared through
mobile health clinics are being operated test for colon cancer. In addition, South
online platforms. The documents are reviewed
by the Cancer Association of South Africa Africa has funded key pieces of research
and updated regularly to ensure the availability
(CANSA)1 related to development of the HPV and
of accurate cancer information.
• Introduction of measures to help people HBV vaccines. CANSA supports more than
reduce their exposure to risk factors, 31 research projects annually, using funds CANSA has also worked to reduce exposure
including an online tobacco cessation from bequests7. to carcinogens, such as through campaigning
programme ‘eKickButt’, which is a free for a ban on BPA in baby bottles10. One
service to the public2 Key challenges of the current campaigns is focused on
implementation of the proposed sugar tax,
• Health awareness campaigns including: CANSA would welcome the following changes highlighted by the Minister of Finance, in
a campaign to dispel cancer myths with in order to improve the priority, access to and order to help combat obesity11 and previous
infographics in four languages3, a 'Smart affordability of cancer care in South Africa: successful campaigns lead to cancer
Choice Seal' campaign to encourage South
becoming a notifiable disease from April 2011..
Africans to read product labels and make • Amendment to the current South
informed choices4, and a campaign to African patent law, in order to improve As a member of the Ministerial Advisory
protect water from carcinogens5 the affordability of cancer medicines for Committee for the prevention of cancer and
• Implementation of support programmes patients a member of the national Tobacco Action
for cancer survivors such as ‘iSurvivor’, an Group, CANSA has worked extensively through
• Re-orientation of the healthcare system,
online support service6. partnerships to further national efforts for
including national health insurance,
NCD and cancer control and was awarded
prescribed minimum benefits for cancer
Footnotes: the WHO AFRO 2009 World No Tobacco Day
patients and a national cancer control
1. www.cansa.org.za/cansa-mobile-health-clinics/ achievement award. It has also helped to found
2. www.ekickbutt.org.za/ 3. www.cansa.org.za/reduce-your-cancer-risk/ programme
4. www.cansa.org.za/cansa-seal-of-recognition/ the Cancer Alliance and co-founded the South
5. www.cansa.org.za/fracking/ 6. http://isurvivor.org.za/ • A national ban of the use of sunbeds by African NCD Alliance.
7. www.cansa.org.za/about-cansa-research/ children. CANSA has collected over 16,000
8. www.cansa.org.za/keeping-the-youth-safe-from-skin-cancer/
signatures supporting the requested The CANSA TLC programme has also been
9. www.cansa.org.za/reduce-your-cancer-risk/ 10. www.cansa.org.za/why-
should-baby-bottles-be-bpa-free/ 11. www.treasury.gov.za/public%20 ban, which is still being considered by the established, which provides affected children
comments/Sugar%20sweetened%20beverages/POLICY%20PAPER%20
National Department of Health8 and families with free lodging & support.
AND%20PROPOSALS%20ON%20THE%20TAXATION%20OF%20
SUGAR%20SWEETENED%20BEVERAGES-8%20JULY%202016.pdf

Tanzania, United Republic of
Contributors: Ocean Road Cancer Institute

Public
activity

Declaration targets The government has focused on improving To further improve diagnosis and treatment
There are approximately 50,000 new cancer awareness of cancer through education services in Tanzania, ORCI would welcome the
cases every year in Tanzania. Many of these sessions in schools and workplaces, as well as following:
cases present at a late stage of the disease, using the media to disseminate key information • Planned review of the cancer treatment
resulting in poor treatment outcomes. It is about cancer. protocol in collaboration with the MD
estimated that only 10% of patients are able to Furthermore, in partnership with Gavi, the Anderson Cancer Center and the Susan G.
access treatment. Ministry of Health has started to vaccinate Komen organisation
The Tanzanian government has taken a school children against HPV. This initiative • Building of a modern hostel for cancer
number of steps to address this, including complements the national HBV vaccination patients to create a ‘home-away-from-
the establishment of the Ocean Road Cancer programme that focuses on immunising high- home’ in collaboration with Pink Ribbon
Institute (ORCI) and the introduction of risk populations before they reach the age of Red Ribbon.
free treatment for cancer patients. In 2013, 15. A key challenge will be the transformation of
Tanzania developed its first national cancer In response to the national cervical cancer current hospital-based cancer registries into a
control strategy to integrate cancer control burden, 1,050 healthcare providers have been population-based registry.
into the health system, implement prevention trained to screen for cervical cancer across
strategies, address inequities in access, and 253 sites. These more remote facilities have UICC Member's achievements
improve patients’ quality of life. To achieve this, succeeded in screening around 400,000 ORCI has been working to improve the quality
the government has established a second women. This is a significant improvement, as of cancer patient care in Tanzania and this will
cancer treatment centre in the north of the until recently, only two tertiary facilities offered be enhanced by plans to install two new LINAC
county. Tanzania has also developed an screening services. radiotherapy machines in 20162. This will
extensive NCD plan (2008-2018)1.
enable the centre to treat more patients more
Following the decentralisation of palliative care
effectively.
services, district-level healthcare staff have
been trained to administer pain medications,
and have been supplied with oral morphine.
Palliative care guidelines have also been
developed and will be launched soon.
Local training programmes have helped to
address the shortages in the cancer healthcare
workforce. A Bachelor’s degree in radiotherapy
technologies and Master’s degree in clinical
oncology are offered nationally, and an online
programme for a certificate in oncology
has been developed in partnership with an
Footnotes:
overseas institution. There is a plan underway
1. www.iccp-portal.org/tanzania-national-non-communicable-disease- to develop courses on nuclear medicine,
plan-2008-2018 BEVERAGES-8%20JULY%202016.pdf
2. www.orci.or.tz/
medial physics and nursing oncology in the
coming years.

Togo
Contributors: Ligue Togolaise contre le cancer

Not generally available at Not generally available at
public primary healthcare public primary healthcare
level level

Public
activity
Progress against the World Cancer Key successes • Creation of specific training programmes
Declaration targets for oncology to meet national needs, and
Togo has worked to develop the institutional development of immigration incentives for
Togo has made key progress in the following framework needed to fight cancer. A key specialists from the Togolese diaspora to
areas: success was the adoption of the Strategic Plan return
for Non-communicable Diseases in June 2012.
• In 2012, the Togolese Council of Ministers • Creation of psychological support services
passed three tobacco control decrees, for cancer patients.
Key challenges
setting out laws around tobacco labelling
and packaging, banning smoking in public The Ligue Togolaise Contre le Cancer (LTCC)
places, and the mandate and composition would welcome action to ensure:
of a national tobacco control committee • Continued political will to improve cancer The LTCC was founded in May 2014 as
• A National Cancer Institute was established control nationally, as well as the required an alliance of Togolese organisations. The
in 2015 budget allocation to support national plans organisation conducts a number of activities to
support cancer patients including:
• In 2015, the Ministry of Health initiated an • Development of a population-based cancer
HPV vaccination campaign for girls under registry • Supporting patients to seek care at
the age of 11 years • Organisation of national cancer screening specialised centres and monitoring the
• The first national cancer conference, programmes for breast, cervical and continuity of treatment
entitled ‘Prevention and management prostate cancers, as well as national cancer • Offering psychological, social, spiritual,
of cancer in Togo: challenges and awareness campaigns, using the media, to physical and occasionally, financial support
opportunities’ was held in Togo in February sensitise the general public to cancer patients as well as conducting
2014 • Installation of full medical imaging facilities advocacy and fundraising to help meet
• A day of reflection on palliative care was in each regional health facility to improve patient needs
held in 2015. diagnosis accuracy. Endoscopy in particular • Celebrating World Cancer Day and
is almost non-existent and plays a crucial conducting awareness-raising campaigns
role in diagnosing digestive cancers through the media and local institutions
• Establishment of a pathology laboratory such as schools, churches, hospitals,
markets and companies to help dispel the
• Development of a fully-equipped
stigma around cancer. In 2014, LTCC also
radiotherapy centre in Togo
leveraged cancer action month to hold a
• Effective implementation of the tobacco solidarity march for cancer patients
control decrees
• Distributing flyers with information about
• Improved access to cancer medicines, cancer
including oral or intravenous morphine,
• Donating medicines to the hospital at Lomé
monitored by a palliative care committee
and to individual patients
with the capacity to conduct palliative care
training • Offering free screening for breast cancer
every October (Breast Cancer Awareness
Month) since 2009, with a particular focus
on targeting low socioeconomic groups and
providing screening at a subsidised rate for
the general public.
Uganda
Contributors: Uganda Cancer Society
public primary healthcare public primary healthcare the public health system the public health system public health system

Public
activity
No data
Progress against the World Cancer Key successes Finally, UCS will work to intensify awareness-
Declaration targets raising efforts nationally to help dispel myths
The launch of the national HPV vaccination around cancer and provide life-saving
The Government of Uganda, through the programme and the introduction of a tobacco information on screening and early detection.
Ministry of Health, has taken a number of key control law in 2015 signal major government
actions to improve cancer prevention and commitment to tackling cancer risk factors
control including: nationally3.
UCS coordinates civil society efforts for cancer
• Tabling a Cancer Control Bill in parliament, Alongside this UCI, Uganda’s only national
prevention and control nationally by providing
and the allocation of a dedicated budget to cancer referral unit, has gained independent
a platform for member organisations to
cancer activities status and become a centre for excellence
discuss, share ideas and jointly plan activities.
• Passing a comprehensive tobacco control for cancer control4. The establishment of the
This harnesses synergies and helps prevent
law in 2015 to reduce tobacco use and FHCRC facility at UCI will also go a long way in
duplication of efforts. UCS also works closely
exposure to second-hand smoke improving cancer treatment and management
with the Uganda NCD Alliance network to
in Uganda through research.
• Launching a nationwide HPV vaccination strengthen cancer prevention and control
programme in 2012 with support from Finally, the steady growth of civil society through joint activities5.
development partners movements for patient support and
Founded by and hosted at the UCI, UCS works
• Inclusion of civil society and private sector awareness-raising has contributed to a positive
to support patients, and in 2015, received
actors in raising public awareness of policy environment for cancer prevention and
a grant from the American Cancer Society
cancer1 control.
to enhance its organisational capacity and
• Developing treatment infrastructure strengthen its role in mobilising resources.
including the construction of a new Key challenges UCS used this opportunity to build up its team
cancer ward, and a radiotherapy centre. In The Uganda Cancer Society (UCS) would to help deliver more effective cancer prevention
partnership with Fred Hutchinson Cancer welcome the establishment of a functional and control in Uganda.
Research Centre (FHCRC) a new cancer cancer control programme, with an emphasis
research, outpatient care and training on prevention, alongside specific national
facility at the Uganda Cancer Institute indicators for cancer within the NCD plan.
(UCI) has been developed with a focus on There is also a need to significantly invest in the
increasing research outputs2. human resources available to manage cancer
and decentralise services, including screening.
The financing of national cancer programmes
remains a challenge and as such UCS is
advocating for the appropriate prioritisation
of cancer in the national development agenda
and budget, through the introduction of a law
on cancer.
Footnotes:
1. www.uccf-ug.org
2. www.uci.or.ug/uci-research
3. www.tobaccofreekids.org/tobacco_unfiltered/post/2015_07_30_uganda
4. www.uci.or.ug/history-and-background
5. http://ugandacancersociety.org/

Zambia
Contributors: Zambian Cancer Society; Tobacco-Free Association of Zambia
Not generally available at Not generally available at Not generally available in Generally available in the Generally available in the
public primary healthcare level public primary healthcare level the public health system public health system public health system

Public
activity
Progress against the World Cancer Key successes institutes is also critical, as there is still a gap in
Declaration targets knowledge about the epidemiologic profile of
• The government has developed a National cancers in Zambia.
Cancer has been recognised as a public health Cancer Control Strategic Plan for the
concern in Zambia, and as a first step, radiation management and control of cervical, breast, In order to improve equitable access to
and chemotherapy services are being provided prostate cancers and retinoblastoma oncology services, Zambia will also need to
through the Cancer Diseases Hospital (CDH), • Cervical cancer screening using the decentralise these services across the country.
which became operational in 2007. In the see-and-treat method with VIA has been Finally, there is a need for stricter enforcement
second phase of work, which is currently rolled-out in each of Zambia’s 10 provinces, of the tobacco law provisions, including
underway, the hospital wards will be able to covering 51 sites. More than 300,000 compliance with smoke-free environments,
provide 252 bed-spaces for in-patients. women have been screened through this alongside larger pictorial warnings and tax
programme and over 300 health workers increases.
The establishment of the first radiation therapy
have been trained
technology training programme at the CDH
has led to a reduction in the cost of training, • A three-year HPV vaccination UICC Member's achievements
and increased the availability of the much demonstration project has been
successfully completed with over 30,000 The Zambian Cancer Society (ZCS) is a non-
needed human resources to facilitate cancer
adolescent girls vaccinated profit organisation that aims to improve the
treatment.
quality of life of persons affected by cancer
• In 2008, Zambia ratified the WHO FCTC irrespective of age, gender or type of cancer.
and a law was enacted to strengthen The Zambian government encourages
the 1992 smoking ban to include all synergistic partnerships with key stakeholders
public places (except indoor offices). In including civil society to support cancer
collaboration with the International Tobacco prevention and control.
Control Project team, Zambia evaluated
current tobacco control efforts leading To supplement the government’s efforts to
to the implementation of awareness improve education and training of healthcare
campaigns professionals, ZCS has developed the
• Integration of the HBV vaccine into the country’s first psychosocial counselling
national vaccination programme. curriculum on cancer.
The expected impact of the training is
Key challenges multifaceted. At an individual level, participants
will acquire new skills and competencies. At
While Zambia has made major strides in
national level, a new programme delivering
addressing the increasing cancer burden, it
psychosocial counselling in cancer will be
still faces significant challenges, with around
integrated into existing HIV, home-based care
two thirds of patients presenting with late stage
and palliative care programmes to enhance
disease. Comprehensive cancer awareness
the continuum of cancer care. The training
programmes should therefore be a priority in
will be rolled out nationally and sustained in
Zambia.
collaboration with the Ministry of Health. The
Further investment in research, through the first group of counsellors will be trained in
development and strenghtening of research 2016.

Zimbabwe
Contributors: Cancer Association of Zimbabwe, Ministry of Health and Child Care

Not generally available at Generally available in the Generally available in the Generally available in the
public primary healthcare level public health system public health system public health system
(clinical breast exam only)

Public
activity
Progress against the World Cancer Key successes • Integration of cancer control activities with
Declaration targets existing HIV/AIDS, tuberculosis and NCD
Zimbabwe’s main achievement has been the services to harness the strengths of existing
Zimbabwe has made progress across the nine development and launch of two key strategic projects
Declaration targets, with a strong focus on documents - the ZCPCS and the Palliative
Care Policy. Zimbabwe has also ratified the • Build the capacity of healthcare staff,
building the capacity of the healthcare system:
WHO FCTC. and update local cancer treatment and
• A NCDs unit has been developed to management guidelines
coordinate action on cancer. The Zimbabwe The development of human resources has • Scale up local cancer research to inform
Cancer Prevention and Control Strategy also been a priority and has been addressed policy and guidelines.
(ZCPCS) was launched in March 2014, but through the introduction of oncology nurse
remains uncosted training in 2014, as well as continued training
of oncologists and radiation therapists, and the
• A national cancer forum has been created
recruitment of three haematologists. CAZ has provided psychosocial support
to provide a platform for stakeholders to
through individual or family counselling and
advise the Minister of Health and Child In recent years, Zimbabwe has particularly
support groups. These efforts aim to enable
Care1 on cancer issues, and a registry has focused on high impact, preventable, and
clients to cope with their condition and to
been developed2 curable cancers, such as cervical cancer.
reduce stigma and discrimination. On average,
• HPV demonstration projects have been These efforts are expected to result in a
the CAZ centre offers 120 counselling sessions
implemented, and high coverage rates were reduced cervical cancer burden, allowing
per month to cancer patients and their families.
reported across Marondera and Beitbridge for a focus on other cancers in the future.
districts VIA screening has been rolled out in central, CAZ has also delivered education on breast
provincial and district/mission hospitals; and and cervical cancer, and started a screening
• A cervical cancer screening programme
two HPV demonstration projects were carried outreach project 200km from the capital, which
is being rolled out, and a cervical cancer
out in preparation for the HPV vaccine roll-out. was recently evaluated using a baseline survey
control strategic plan is in development
and an endline review3. The project saw 4,228
• Five new radiotherapy machines have been Key challenges women screened for cervical cancer and 3,316
installed as part of the refurbishment of two women screened for breast cancer. CAZ’s
radiotherapy centres at Parirenyatwa and The Cancer Association of Zimbabwe (CAZ) workplace program has helped to improve
Mpilo hospitals would welcome action to: access to cancer education and screening
• The Palliative Care Policy has been • Develop sustainable funding for cancer to employees with the support of employers.
developed outreach projects in order to ensure the Access to cervical cancer screening has
• World Cancer Day is celebrated annually provision of accessible and affordable greatly improved, with most of the provincial
and is used as a platform for the national treatment for patients hospitals now offering VIA services. This is a
dissemination of information on cancer. positive and notable development, particularly
• Decentralisation of comprehensive cancer
given that cervical cancer accounts for one
prevention, treatment and care services
third of the total cancer burden in Zimbabwe.
Footnotes:
1. www.mohcw.gov.zw
2. http:/afcrn.org/membership/members/83-zimbabwe-harare
3. www.cancerzimbabwe.org

African Organisation for Research and Training in Cancer:
Building capacities through regional alliances
Regional progress against the World Key successes AORTIC’s achievements

Cancer Declaration targets Capacity building for cancer control across the Over the last few years AORTIC has seen
Concerted action on cancer control has African region has been the leading success. an encouraging and constant growth in its
increased across the African region in This has involved a number of national and membership, as well as sustained interest from
response to the rising burden of the disease on international partners..One key achievement most African governments and international
the continent. Policymakers remain aware that has been bringing together the African cancer organisations. This demonstrates that there is
the burden of cancer is forecast to continue control community through AORTIC and national and international enthusiasm to fulfil
growing as a result of greater exposure to key the creation of strong relationships between AORTIC’s mission of providing all Africans with
risk factors associated with changing lifestyles its members. These partnerships have also the benefits arising from better research and
and an aging population in many African facilitated the adoption and the update of training for cancer, as well as the provision of
countries. national and regional strategic cancer plans in diagnostic, treatment and palliative services
line with the needs of the patients. where needed. The organisation is, and will
A foundation stone of effective cancer remain, a voice for scientists as well as the
response is a cancer control plan and so far, The region has a dedicated and inspirational
patient community and brings together
23 countries have developed, or are in the leadership for cancer and NCDs across
scientists, researchers, advocates, clinicians,
process of developing a strategy. AORTIC also all sectors of society. A number of Africa’s
volunteers, national and international alliances.
contributed recently by developing a template First Ladies have championed the need for
for a regional strategy1,2. A number of countries effective and accessible cancer prevention AORTIC has been working to support all
have also developed cancer registries in and care services in their countries, and are African members and local NGOs to build
partnership with African Cancer Registry leading the call for action using continental capacity for cancer control in their own
Network3. Through this process AORTIC has alliances4,5. Alongside these efforts, AORTIC countries and develop further cancer research
supported and facilitated country progress has played a role in the development of future offering support for education through a
through the dissemination of the information African cancer leaders through the popular number of fellowships and workshops. AORTIC
across its membership, delivering education, African Cancer Leaders Institute for African is at present updating the report detailing
and helping to establish prevention, screening scientists, clinicians and researchers. The present national cancer control planning
and early detection strategies across different programme contributes to training, networking efforts on the continent.
resource settings. and professional support for young leaders to
Finally advocacy, and the training of cancer
engage and take cancer research, advocacy,
advocates on the ground, has become one of
education, policy and clinical practice forward
the key priorities of the organisation in recent
as part of a continental network.
years. The sustained work of AORTIC’s diverse
but united members will translate into better
Key successes access to care across Africa and improve
AORTIC continues to engage in promoting the outcomes and quality of life for cancer patients.
development and implementation of national
cancer control plans for each and every
country. However, across the continent, there
is a continuing need to further improve skills
in disciplines such as pathology, surgery, and
radiotherapy in order to improve patient care.
AORTIC works alongside international and
national alliances in order to increase equity in
access to care for all those affected by cancer
in Africa.
Footnotes:
1. www.iccp-portal.org/resources-search?search_api_views_fulltext=&sort_by=search_api_relevance&sort_
order=DESC&page=1&f[0]=type%3Acancer_plans&f[1]=search_api_combined_1%3A82
2. www.AORTIC-africa.org/index.php/resources/
3. http://afcrn.org/membership/members/68-current-members
4. www.au.int/en/pressreleases/31203/first-ladies-africa-determined-stop-breast-cervical-and-prostate-cancer-death
5. www.iaea.org/newscenter/news/first-ladies-commit-to-action-and-leadership-on-cancer-control

Estimated contributions of tobacco control measures to declines in tobacco use
Tobacco Control Increased Tax Contribution

Real cigarette prices rose
Tobacco control measures are estimated to have contributed
to substantial decreases in smoking and smoking-related deaths.
Increased Tax Contribution
Real cigarette prices rose
230% 230%
tax increased

8 times
61% 22 Tax Contribution 14
48% 
Additional Revenue
Additional Revenue Ad Bans $10 billion in taxes
6
$6 billion in taxes
Anti-smoking Campaigns
% % Measured Health Improvements
Tobacco use is associated Tobacco control policies are cost-effective and
14
46% prevalence decline
7
Measured Health Improvements Smoke-free Laws
are estimated to have contributed to substantial 25% male prevalence decline
with 70% of all lung cancers,
from 35% to 17%
decreases in smoking and smoking-related deaths. Warning Labels 420,000 deaths averted
6
4 million fewer smokers
20% of cancer deaths6, and Effective measures require strong multisectoral 32,000 deaths averted 6.6 million
8
4
Cessation Programs fewer deaths in 40 years
collaboration for successful national action. 290,000 10
is a known causal factor in fewer deaths in 20 years

THAILAND BRAZIL
Tobacco taxation has been identified as the single

over 10 cancer types - many most important population-wide measure that
of which could easily be governments can take to reduce NCDs. Taxation
can simultaneously raise revenues for investment
prevented. in cancer and NCDs, whilst reducing the long-term
disease burden across all income settings.
87% of countries are working to implement Getting involved: McCabe Centre Getting involved: Global Task Force
tobacco taxes, in line with the provisions of the for Law and Cancer for Tobacco Free Portfolios
Target 3 WHO Framework Convention on Tobacco Control
The McCabe Centre for Law and Cancer The Global Taskforce for Tobacco Free
(FCTC).
runs an international legal training programme Portfolios is a global coalition working to
However, many of the 180 parties to the FCTC are that builds national capacity to support the encourage pension funds, sovereign wealth
facing significant challenges in implementation. prevention and control of cancer and other funds, insurers, banks and fund managers
NCDs. to implement investment strategies that
are tobacco-free. Many individuals and
The course focuses on building coherence
organisations are unknowingly contributing to
between health, trade, investment, human
the global tobacco epidemic via their finances,
Reduce exposure to cancer rights and sustainable development. The
undermining the excellent tobacco control
programme comprises a three-week intensive
risk factors “The McCabe Centre offers a unique legal course run primarily for government
advances that have been achieved by the
global health sector and governments across
and highly successful international lawyers from low- and middle-income
the world. The Global Task Force for Tobacco
legal training programme which equips countries, hosted in Melbourne, Australia twice
Free Portfolios strives to disentangle the global
lawyers and policy makers with the per year, and shorter versions of the course run
finance sector from the tobacco industry.
skills and knowledge required to better in other countries and regions.
tackle the legal issues relating to the Since October 2013, the McCabe
The Global Action Plan for the prevention and control of cancer and Centre has trained over 200 government,
Prevention and Control of NCDs other NCDs.” intergovernmental, academic and NGO lawyers
and policy experts from over 75 countries.
calls for a 30% relative reduction in Jonathan Liberman, Director, Most of these training activities form part of
prevalence of current tobacco use McCabe Centre for Law and Cancer the McCabe Centre’s role as a WHO FCTC
in persons aged 15+ years. Knowledge Hub.
“When it comes to tobacco control we
must think big and aim high because
the current status quo is a world that is
on track for one billion tobacco related
deaths this century.”
Bronwyn King, CEO, Tobacco Free
Portfolios
WHO IARC, World Cancer Report 2014 http://publications.iarc.fr/Non-
6
Series-Publications/World-Cancer-Reports/World-Cancer-
Report-2014

Afghanistan
Contributors: Afghan Society Against Cancer
8,100 7,400 No No 71% No data
Not generally available at Not generally available Not generally available in Not generally available in Generally available in the
public primary healthcare level public primary healthcare level the public health system the public health system healthcare system

Public
activity
Progress against the World Cancer Key successes UICC Member’s achievements
Declaration targets The Afghan Society Against Cancer (ASAC) Since ASAC was formed in 2009 it has
Afghanistan has not yet developed a cancer is pleased that Afghanistan has ratified the celebrated World Cancer Day annually. Using
registry, and shaping activities without WHO FCTC. This has been supported by the day as a platform, it has advocated for
knowing the cancer burden is very challenging. draft legislation for tobacco control, which the the establishment of at least one cancer
Similarly, there is no data to monitor trends Ministry of Public Health recently sent on to the treatment centre within the country. To do this,
or track progress nationally against the World Ministry of Justice for adoption.1 it established a group of advocates called the
Cancer Declaration targets. Notwithstanding, Afghanistan Cancer Control Coalition2. The
Afghanistan is now undertaking activities Key challenges coalition has worked together and encouraged
across some of the targets. For example, the Ministry of Public Health to take a first
Using the World Cancer Declaration as a step in this direction by setting up the first
vaccination against the HPV has now been
framework, there are a number of significant specialised oncology ward in one of the public
integrated into the national immunisation
challenges for Afghanistan across the hospitals in Kabul.
programme.
spectrum of cancer control. However, the
ASAC would consider the following to be Alongside this, ASAC conducts targeted health
priority actions: promotion activities with the public to improve
awareness of cancer risks and symptoms.
• Scale up national cancer awareness and Activities have included the development
early detection/screening programmes and distribution of leaflets on breast health,
• Establishment of a population-based cancer risk factors and opportunities to
cancer registry reduce exposure, as well as promoting early
• Training of healthcare professionals across detection through encouraging early help-
the speciality professions of cancer control seeking behaviour. ASAC is particularly proud
of its home hospice programme for improving
• Establishment of holistic pain management
access to palliative care, and it hosted a
and palliative care services.
conference on palliative care in 2012.
Footnotes:
1. http://moph.gov.af/en/news/10209
2. http://glynstrong.co.uk/tag/afghanistan-cancer-control-coalition-accc/

Bahrain
Contributors: Bahrain Cancer Society; Royal College of Surgeons in Ireland-Bahrain
200 200 Yes Hospital-based 99% No data

Generally available at pub-
Generally available at public Generally available in the Generally available in the Generally available in the
lic primary healthcare level
primary healthcare level public health system public health system public health system
(Pap smear only)

Public
activity
No data No data No data
Progress against the World Cancer Key successes would like to see a whole-of-government
Declaration targets approach to managing cancer, and in
NCDs are the greatest health threat in particular in establishing proper management
More recently the MoH has launched a 2011- Bahrain and the MoH has been working with of carcinogenic materials and radioactive
2020 national prevention campaign to fight stakeholders to reduce exposure to risk factors, isotopes.
cancer by reducing exposure to cancer risk for example by increasing the import duty
factors. This focuses on the most prevalent risk on tobacco products from 100% to 200%,
UICC Member’s achievements
factors in Bahrain, namely poor diet, low levels alongside work to improve access to high
of physical activity and tobacco consumption. quality care across the life course. The primary The Bahrain Cancer Society (BCS) focuses on
success has been the development of the increasing public awareness about cancer risk
This builds on previous tobacco control Bahrain Health Strategy that focuses on how factors and the need for regular screening. It
efforts including Bahrain’s revised 2009 to promote healthy lifestyles and improve early has organised a series of educational lectures,
tobacco control law which prohibits tobacco detection through cost-effective interventions. workshops and seminars on these topics in
advertising, promotion, and sponsorship A Cancer Control Committee has also been schools, universities, companies and with the
and the use of tobacco products (including established to help promote public awareness general public. BCS has also run social media
e cigarettes) in enclosed public spaces and of cancer risk factors, signs and symptoms and campaigns to further improve outreach and
public transport. In 2007 Bahrain also became to coordinate education, early detection and has distributed free printed resources. BCS
a party to the WHO FCTC. To support national patient palliative care services. also runs cancer support groups for patients.
tobacco control efforts, Bahrain has opened
three anti-tobacco clinics and hopes to expand Bahrain has also been very effective in In partnership with the Ministry of Health,
to included a further two clinics to ensure that improving immunisation rates under the BCS has helped to establish a cancer registry
services cover the whole country. Expanded Programme on Immunization, and office and a cancer centre to deal with cancer
coverage of HBV vaccination has reached victims and provide palliative or hospice care.
Bahrain also operates a number of almost 100%. Following a study that demonstrated that
opportunistic screening programmes, with a breast cancer is a major health problem in
focus on breast and cervical cancers. Key challenges Bahrain, and given the increasing incidence,
as evidenced by the cancer registry, BCS also
Further work is needed to promote awareness launched the National Screening Campaign
among the general public and healthcare for Early Detection of Breast Cancer in 2005
professionals of cancer risk factors, and the for all women aged 40 and over. Working with
importance of early detection and screening. the Ministry of Health, it has raised public
The authors would welcome the establishment awareness and initiated mammogram services
of a national screening programme for the at all governorate’s health centres to improve
most common cancers nationally. Improving access and reduce waiting times.
diet and increasing physical activity are
particularly important in Bahrain. BCS has also worked together with other
NGO partners to form the Gulf Federation for
Creating healthy workplaces and raising Cancer Control, which launched its first joint
awareness of occupational and environmental awareness campaign from 1st to 7th February,
cancer risk factors will also be critical. Amongst coinciding with World Cancer Day.
young people alternative forms of tobacco
consumption, such as ‘sheesha’ are very
popular and need to be controlled. The authors

Egypt
Contributors: National Cancer Institute - Cairo

(clinical breast exam only) (VIA only)

Public
activity
Declaration targets One of Egypt’s key successes has been the Drawing on the experience of multidisciplinary
Egypt has taken a number of key steps to creation and implementation of national teams, NCI holds workshops for pharmacists,
further cancer control nationally including: guidelines for cancer management, which are nurses, surgeons and radiotherapists from all
reviewed and updated annually. over Egypt to improve cancer management
• Adoption and adaptation of international nationally. In addition, NCI holds an annual
cancer control recommendations to In addition, the National Cancer Institute
conference and regularly shares updates with
produce a series of national guidelines. (NCI) is in the process of building the biggest
the public on cancer management and the
For example, Egypt now uses targeted regional cancer centre to address the shortage
outcomes of clinical trials. For example, NCI
therapies as the standard management in specialised facilities across low-income
has helped improve breast cancer screening
in many solid and haematological countries in the Middle East and North Africa,
and early detection rates amongst patients and
malignancies and to help improve access to cancer care in
the local community. This work is supported
the region.
• Establishment of a Higher Council for the by a biostatistics unit that helps track patient
fight against cancer, under the Ministry From a policy perspective, Egypt ratified the outcomes for the Institute.
of Health which includes university, WHO FCTC in 2005 and has since started
Alongside this periodic training, NCI provides
military, police and civilian hospitals and to introduce tobacco legislation, such as
masters, doctorate and fellowship degrees
specialist units. The Council is responsible warnings on tobacco packages.
in medical oncology, radiotherapy, surgical
for creating and updating the national oncology, paediatric oncology, anaesthesia and
guidelines, and implementing the national Key challenges pain management with the aim of improving
cancer control policy cancer management nationally. This has
In the coming years, Egypt will need to further
• Creation of a new hospital to manage breast implement national cancer policies and also been vital in expanding NCI’s expertise
cancer, which receives 150 cases every day guidelines, particularly around addressing risk nationally and improving coverage of services
and treats 22,000 new cases annually factors to reduce the cancer burden. A key step in more remote areas.
• Establishment of a specialised nursing would be to improve cancer awareness among
institute for cancer management, which the population to help reduce exposure to risk
trains around 40 specialist cancer nurses factors and improve the rates of early detection
annually. and the control of cancer. In order to improve
cancer treatment outcomes on a population
level, Egypt will need to focus on building
cancer expertise, especially physicians, in all
parts of the country.

Iran, Islamic Republic Of
Contributors: Iranian Cancer Association
Generally available at public Generally available at the Generally available in the Generally available in the Generally available in the
primary healthcare level public primary healthcare level public health system public health system healthcare system

Public
activity
No data
Progress against the World Cancer Key successes • Secondary care level cancer units, including
Declaration targets hospitalisation and some radiotherapy
Iran’s major successes towards achieving the services
Iran has taken a number of key steps including: Declaration targets include:
• Comprehensive multidisciplinary centres
• Full insurance coverage for the majority of • Achieving 95% insurance coverage of with an extended variety of cancer sub-
essential cancer medicines the population in all cancers and nearly specialties supported by national guidelines
all essential medicines. This includes and processes, as well standardised
• Establishment of a pathology-based cancer
new technologies such as microsurgery, introduction of PET scanning, MRI and
registry
intraoperative radiotherapy, neo-adjuvant emerging new technologies.
• Building on public and governmental therapies, 3D computerised treatment Introduction of a population-based cancer
awareness of cancer risk factors, leading planning on linear accelerators, and bone registry and a national HPV strategy would
to the prohibition of smoking in all public marrow transplant support existing measures to reduce cancer
places
• Increasing the number of specialised lifestyle risk factors and the potential future
• Obligatory HBV vaccination for newborns comprehensive multidisciplinary centres burden of cancer. A final key measure will be to
(since 1993) and high-risk populations. to seven increase the number oncology fellowships in
The development of an HPV vaccination order to provide the skills needed to manage
• A co-education programme for cancer
strategy is currently being assessed cancer effectively.
survivors and the general public to improve
• School-based health promotion and cancer awareness and reduce stigma
awareness for all primary level students Author’s achievements
• Banning public smoking and alcohol
• Improving access to clinical oncology consumption ICA was part of an IAEA-PACT3 mission
services and uptake of new techniques,
• Evaluating screening and early detection which, working with the government, formed
such as breast-conserving surgery
programmes in order to tailor them to Iran’s the National Committee for Cancer Control.
with a more than 80% success rate in
needs ICA has also produced a Persian language
comprehensive multidisciplinary centres
• Development of public and private pain oncology website that provides public-facing
• Increasing fellowships in the six sub- information. It has also been involved in several
clinics in a country where access to
specialties related to oncology and education and awareness media campaigns
narcotics is limited.
developing continuous medical education that are supported by handouts and a booklet
and continuous professional development on how to prevent cancer through positive
courses in line with international (ESMO1 Key challenges
lifestyle choices.
and NCCN2) guidelines. The Iranian Cancer Association (ICA) would
like to see further work to develop three levels
of cancer care across all 31 regions, given that
the recent lifting of sanctions, Iran should now
be able to access more modern treatments:
• Primary care level detection and diagnosis
of cancers, and introduction of out-patient
chemotherapy services
Footnotes:
1. European Society for Medical Oncology
2. National Comprehensive Cancer Network
3. International Atomic Energy Association – Programme of Action for Cancer Therapy

Iraq
Contributors: Zhianawa Cancer Center; Iraqi Cancer Board (Ministry of Health of Iraq)
National Cancer Research Centre (Baghdad University)

Generally available at public Not generally available at
Generally available in the Generally available in the Not generally available in
primary healthcare level public primary healthcare
public health system public health system the public health system
(clinical breast exam only) level

Public
activity

Declaration targets In 2001, the National Programme for Early Action is still required to:
Iraq has made significant progress in a number Detection of Breast Cancer was established • Strengthen surveillance systems to monitor
of key areas including: in four specialised referral training centres and evaluate the impact of Iraq’s national
in Baghdad, Basrah and Mosul, and 16 cancer control programmes
• Implementation of comprehensive tobacco
specialised clinics for the early detection
control legislation1 in accordance with the • Appropriate palliative care services to
of breast cancer were set up in the major
WHO MPOWER tool, and the existence control pain and distress
hospitals of each governorate. The main
of national regulations on the prohibition • Establish comprehensive of comprehensive
objectives of the programme are to down-
of commercials and public availability of cancer centres
stage breast cancer at the time of presentation
alcohol
to reduce morbidity and mortality from the • Ensure the availability of qualified
• Launch of national public mobilisation disease, and promote public awareness of risk postgraduates in cancer specialties, such
campaigns on tobacco control, the factors, signs, symptoms, and screening tools as radiation oncology.
promotion of physical activity and healthy for breast cancer.
diet. Anthropometric measurements
In 2009, the Ministry of Higher Education UICC Member’s achievements
and obesity screening have also been
introduced in schools and Scientific Research organised a national The Zhianawa Cancer Center (ZCC) is a
breast cancer research programme to further public, tertiary cancer care facility specialising
• Implementation of the WHO STEPwise
support this work. Under the supervision of in radiotherapy. ZCC was opened in March
surveillance survey on NCD risk factors
the IARC Screening Unit, the National Cancer 2009 and provides care for cancer patients
• Development of a population-based cancer Research Centre of Baghdad University from all regions of Kurdistan and Iraq free-of-
registry2 developed a comprehensive database for charge. ZCC is equipped with two modern
• Reduction of stigma and myths around Iraqi patients diagnosed with breast cancer. linear accelerators and one high-dose-rate
breast cancer through public health In 2012, WHO/EMRO suggesting using brachytherapy suite.
awareness campaigns on risk factors, that model to compare the demographic
including in rural areas characteristics, clinico-pathological ZCC is accredited by the Kurdistan Board for
presentations and management outcomes Medical Specialties as well as the University
• Implementation of population-based breast
among patients affected with the disease in the of Sulaimani as a training centre for radiation
cancer screening programmes, which are
Eastern Mediterranean Region, which led to oncology and medical physics.
supported by research programmes3
the establishment of a Regional Comparative
• Improved access to accurate diagnosis ZCC also launched a multi-disciplinary
Breast Cancer Research Project4. An online
and multimodal treatment of cancer, with oncology teaching course series in February
information system has been now been
chemotherapy, radiotherapy, and hormonal 2015 and hosted the ‘Best of ASTRO’ meeting
established to collect data systematically from
treatment now offered free of charge. in December 2015, in collaboration with many
patients at targeted breast cancer facilities in
Almost 80% of the requested treatment international experts.
eight countries5.
protocols are now covered, and waiting lists Footnotes:
1. apps.who.int/fctc/implementation/news/news_ira/en/index.html
for radiotherapy in different cancer centres Finally, between 2012 and 2016, specialised 2. Iraqi Cancer Board. Results of the Iraqi Cancer Registry 2012. Baghdad,
have been shortened training programmes have been established Iraq, Iraqi Cancer Registry Center, Ministry of Health, 2015
3. Alwan, NAS: Breast Cancer Among Iraqi Women: Preliminary Findings
• In collaboration with the WHO, the provision in medical oncology, radiation oncology From a Regional Comparative Breast Cancer Research Projec. Journal
of training opportunities to build the and palliative care services in Baghdad and of Global Oncology, 2016; 2 (1), 1-4)
4. Alwan NA: Iraqi Initiative of a Regional Comparative Breast Cancer
capacity of healthcare professionals. Kurdistan. Research Project in the Middle East. Journal of Cancer Biology &
Research, 2014; 2 (1): 1016-20
5. Alwan, NAS: Breast Cancer Among Iraqi Women: Preliminary Findings
From a Regional Comparative Breast Cancer Research Project. Journal
of Global Oncology, 2016; 2 (1), 1-4)
Jordan
Contributors: The King Hussein Cancer Foundation and Center

Public
activity
Progress against the World Cancer • Supporting NCD prevention through Key challenges
Declaration targets schools, including direct outreach and
training of teachers and advocates on Key challenges to respond to include:
Jordan has taken coordinated action to meet promoting healthy lifestyles • Strategic uninterrupted funding for tobacco
the Declaration targets including: control interventions to maximize and
• Offering incentive and recognition for
• Collaboration between the Ministry of institutions to go smoke-free through sustain outcomes
Health (MoH) and King Hussein Cancer the Smoke-free Zone Certification • Optimisation and standardisation of
Foundation (KHCF) and Center (KHCC) to: Programme5 and the King Abdullah Award treatment and quality of screening received
-- S
trengthen national commitment to for Institutional Excellence in different cancer units across Jordan
tobacco control through drafting and • An annual JBCP public awareness • Addressing the shortage in qualified human
launching a comprehensive National campaign to help dispel misconceptions resources for implementation of a national
Tobacco Control Roadmap1. about breast cancer, and the provision of breast cancer screening programme, and
-- R
eview the status of cancer prevention training by JBCP to approximately 400 ensuring that this is included in medical
and early detection services in primary health professionals to ensure quality in curricula
healthcare clinics. breast screening, • Ensuring sustainable funding for national
• Improving the reach of treatment for screening and early detection interventions
tobacco dependency through advocacy Key successes for breast cancer
efforts, delivering training2 to more Garnering support from all government
than 1,000 participants in Jordan, and sectors, general public and the media about UICC Members’ achievements
developing other supporting tools3. the urgency of tobacco control, and engaging KHCF/KHCC is tackling tobacco by serving
Efforts extend beyond Jordan, and have these groups in the fight against tobacco as technical expert to support MoH in
culminated in establishing training hubs4 in has been a major success. The fact that the developing and implementing the various
four countries. tobacco industry is fighting even more fiercely components of the National Tobacco Control
• Efforts, as part of the Jordan Breast Cancer is a testament to this success. Strategy, which aims to strengthen stakeholder
Programme (JBCP), to strengthen the engagement and encourage high-level political
Another important achievement has been the
healthcare system by tackling inequities in commitment.
inclusion of early detection for breast cancer
the distribution of services across the public
in the national health strategy, underling it as KHCF leads the JBCP, a national programme
health sector; advocating for investment in
a national health priority. JBCP has become a aiming to reduce mortality from breast cancer
health infrastructure by the MoH; providing
national umbrella and reference point for early and increase the early detection of breast
direct investment to upgrade more than
detection, awareness-raising, service provision cancers. In its first seven years, JBCP was able
22 breast imaging units; and developing
and capacity building related to breast cancer, to shift late stage breast cancer diagnosis from
national standards for services
and has successfully engaged the Jordanian 70% to 35%.
• Introduction of the first breast cancer community to support its mission. Further
specific registry, endorsed by the MoH efforts are however needed to provide an Footnotes:
1. www.globalbridges.org/news/blog/2015/12/22/jordan-launches-2016-
• Introduction of a Breast Imaging Units enabling environment for early detection 18-tobacco-control-roadmap/#.V6ni6qKAvSY
Certification programme, which is the first specifically within this limited resources 3. www.treatobacco.bwa-subway4.co.uk/site/en/uploads/documents/
in Jordan and the region, in an attempt to setting. Treatment%20Guidelines/Jordan%20treatment%20guidelines%20in%20
English%202014.pdf
systematically improve breast cancer early 4. www.globalbridges.org/news/blog/2016/05/02/moroccan-sidi-
detection services mohamed-ben-abdellah-university-tunisian-ministry-health-
spearheading-tobacco-dependence-treatment-training-north-africa/#.
V6njn6KAvSY
5. www.globalbridges.org/news/blog/2016/06/07/demand-smoke-free-
institutions-jordan-rise/#.V6nj1qKAvSY
Morocco
Contributors: Lalla Salma Foundation for Cancer
Generally available at public Generally available at public Generally available in the Generally available in the Not generally available in
primary healthcare level primary healthcare level public health system public health system the public health system

Public
activity

Declaration targets Morocco has seen successes in three key FLSC welcomes the progress made so far,
Morocco has made progress against each of areas: however there are a number of key actions
the nine Declaration targets, with key highlights that are essential to achieving the Declaration
• Prevention: A tobacco control law was
being: targets:
passed in 2008 and was accompanied by
• Implementation of the National Cancer a major media campaign. Alongside this, • Establishment of programmes throughout
Prevention and Control Plan (PNPCC 2010- breast and cervical screening programmes the country to deliver palliative care at home
2019), in close collaboration between the have been established across Morocco and • Restructuring of cancer research at the
Lalla Salma Foundation for Cancer (FLSC) can be accessed free of charge regional level. Morocco became a member
and the Ministry of Health • Cancer management: Significant of IARC in 2015 and they are currently
• Extensive research into the cancer investment in cancer treatment has assisting in this process
burden in Morocco, including through 15 radically changed cancer management. • Creation of a governance structure to
studies, enquiries and workshops, and the Training programmes have increased the oversee and ensure implementation of the
development of a population-based cancer number of healthcare personnel capable PNPCC 2010-2019 by all stakeholders, and
registry of treating cancer and this has been development of a monitoring and evaluation
• Delivery of health education about the accompanied by an extension of screening framework.
risks of tobacco in schools, colleges and and chemotherapy services
companies across Morocco • Social action: These actions support UICC Member’s achievements
• Organisation of free screening programmes patients and their families and include; the
provision of accommodation for patients To tackle cancer in Morocco, the PNPCC
for breast and cervical cancers
undergoing ambulatory cancer treatment, 2010-2019 was developed to provide a
• Construction and equipping of strategic vision and operational plan for the
financial support to help educate children
oncology centres across Morocco, with country. This plan is the national roadmap
in situations where a parent has died from
chemotherapy now available free of charge for cancer control and is led by an effective
cancer and the establishment of a network
for those unable to pay partnership between FLSC and the Ministry of
of volunteers in cancer treatment centres.
• Establishment of a palliative care Morocco is also establishing programmes Health.
programme in two cities to deliver pain for socio-aesthetic reconstruction. The PNPCC was developed to respond to
management to patients at home
the specific needs of Morocco’s population
• The establishment of the African School of and includes 78 measures that can be
Oncology. adapted to the resources available. It includes
interventions for prevention, screening, and
treatment, as well as for the provision of
support for patients and their families. It was
developed in accordance with the values
and culture of Morocco and with the active
involvement of civil society. FLSC feels that,
given these attributes, the plan could become
a template for implementation for other chronic
diseases.

Pakistan
Contributors: The Children’s Hospital Lahore Pakistan and Institute of Child Health
Pakistan Atomic Energy Commission
48,600 52,500 No No 72% No data

Public
activity
No data
Progress against the World Cancer Key successes • Roll-out of cancer awareness campaigns to
Declaration targets improve rates of early detection
Some of Pakistan’s key cancer control
successes have been: • Establishment of comprehensive cancer
Pakistan has taken a number of key steps
hospitals, including paediatric and palliative
in recent years to advance cancer control • The completion of a successful IAEA care units, to deliver timely and appropriate
including: imPACT mission and the development care, supported by satellite units with
• Improvements in governmental and public of clear recommendations for cancer radiotherapy facilities
awareness of adult and paediatric cancers management and control • Improvements in the availability of essential
• Registering with the IAEA PACT programme • The establishment of a cancer registry pain medicines, particularly oral morphine,
and hosting an imPACT mission to assess and a national cancer control steering and education on palliative care to
Pakistan’s national cancer burden committee to oversee programme healthcare professionals and the public
• Establishing a national cancer registry and implementation • Designation of cancer as a notifiable
national cancer control plan • A strong emphasis on raising awareness disease to ensure accurate data can be
• Development of new cancer hospitals and of cancer and the implementation of collected by adult and paediatric cancer
the upgrade of cancer technologies to prevention campaigns through hospitals registries.
improve the accuracy and effectiveness and NGOs, for example on No Tobacco Day,
of diagnosis and treatment, including CT and Mammogram Day. Tobacco control has UICC Member’s achievements
scanning, radiotherapy facilities and the been a key focus and public spaces, offices
and educational establishments have now The Oncology Department of The Children’s
inclusion of paediatric haematology units in
been designated smoke-free environments, Hospital and Institute of Child Health, Lahore
oncology wards
with heavy fines handed down for non- has successfully completed a three year
• Addition of palliative care units and project, ‘My Child Matters’, that aimed to build
compliance
improvement of supportive care services capacity in paediatric oncology The project
for adult and paediatric patients • The establishment of three mobile breast
involved the piloting of a ‘shared care’ model;
care clinics for breast cancer screening
• Approval of a grant for the establishment training nurses and paediatricians in early
of a bone marrow transplant unit and the • The government and the private sector diagnosis, stabilisation of cancer patients, and
initiation of a transplant training programme have both worked to increase the number supportive care; and improving the standards
for doctors. of cancer treatment facilities nationally and of infection control and prevention under the
improve the treatment facilities in existing guidance and mentorship of the International
units. Outreach team at St Jude’s Research Hospital
in the United States of America. A pilot
Key challenges shared care paediatric oncology unit was
In order to more effectively respond to the established at Lahore General Hospital that
increasing burden of cancer in Pakistan, the successfully treated 300 febrile neutropenia
authors would welcome the following: patients. Alongside this, a total of four five-day
training workshops were conducted to train 80
• Inclusion of cancer into Pakistan’s national paediatricians from different districts of Punjab
health action plan over three years.
• Development of comprehensive national
screening programmes for breast and
cervical cancers

Saudi Arabia
Contributors: Zahra Breast Cancer Association, Sheikh Mohammed Hussein
Al-Amoudi Center of Excellence in Breast Cancer Care

Not generally available at Generally available in the Generally available in the
primary healthcare level No data
public primary healthcare level public health system public health system

Public
activity
No data
Progress against the World Cancer There are plans to establish a National Cancer • Development of national guidelines for
Declaration targets Institute (NCI) to oversee the implementation cancer prevention and management,
of national cancer prevention and control as a prerequisite for the successful
• Saudi Arabia has a well-established national strategies, and to ensure the implementation implementation of any national cancer
cancer registry, which provides reliable data of high quality care through research, training, screening programme
at country, regional, governorate and city education, and public participation. The • Fast tracking of the establishment of the
level1 NCI would also be tasked with developing NCI to coordinate equitable access to
• In 2013, the Ministry of Health (MoH) evidence-based guidelines for cancer care across multiple health care providers,
conducted a national survey on the risk prevention and management at all healthcare enforce national cancer care policies
profile for NCDs2. The survey included key levels; coordinating training courses; initiating and standards, and minimize current
risk factors for cancer, including overweight, collaborative multi-centre epidemiological redundancy in the Saudi healthcare system.
obesity, physical inactivity, and smoking and clinical cancer research; and enhancing
community participation in cancer control and
• Following a pilot study in Riyadh, the UICC Member’s achievements
prevention programmes.
MoH is establishing a national screening
Since 2007, Zahra Breast Cancer Association
programme for breast cancer and initial
Key challenges (Zahra) has led advocacy efforts for a
plans are in place for a colorectal cancer
comprehensive national breast cancer
screening programme Data from the registry indicates that cancer
programme to address the increasing national
• The Saudi Commission for Health incidence continues to increase by nearly 5%
incidence. Through its five national offices,
Specialties licensing body has identified every year, with reports showing that 60% of
Zahra promotes screening and support
breast imaging as a sub-speciality requiring cancer patients in Saudi Arabia are under the
services and it has also secured five mobile
radiologists and institutions to meet certain age of 60, and nearly 60% of them present
mammogram units to deliver services in
standards3. with advanced tumours (Stage III and IV).
more remote regions. Zahra holds training
Establishing coordinated and effective primary
courses and workshops for technicians, health
and secondary prevention programmes is
Key successes educators and healthcare professionals with
critical. It is also essential to establish an
local experts from the Ministry of Health, King
In 2010, a National Cancer Control Committee efficient referral system between healthcare
Saudi University, King Faisal Specialist Hospital
(NCCC) was re-established under the sectors for suspected cancer cases, in order
and Research Centre, and other cancer care
umbrella of the Saudi Health Council4. NCCC to improve early detection rates and promptly
centres.
introduced the first integrated national cancer transfer patients to the appropriate cancer care
prevention and control strategy (2010- provider. Each year, Zahra marks breast cancer
2020). This strategy includes seven main awareness month and coordinates awareness-
Despite the clear evidence base, there is
components with indicators and deliverables. It raising activities, including discussion forums
currently no national screening programme
is significant to note that it recognises primary on breast cancer patients’ self esteem, equity
due to the associated costs. To address these
and secondary prevention as the foundation and accessibility to specialised cancer care5,6.
concerns, the authors would support and
for cancer programmes and emphasises the
encourage the following:
importance of involving NGOs in the planning Footnotes:
1. www.chs.gov.sa/En/HealthRecords/CancerRegistry/
and implementation of national strategies. The • A detailed situation analysis of population- Pages/CancerRegistry.aspx
government also supports and recognises wide and opportunistic screening needs, 2. www.moh.gov.sa
3. www.scfhs.org.sa/en/registration/classAndregister/Pages/
the role that NGOs and individuals play in and an evaluation of their effectiveness to default.aspx
improving cancer awareness, dispelling stigma identify priorities for action 4. www.chs.gov.sa/en/default.htm
5. www.zahra.org.sa/en/
and supporting service delivery. 6. www.guinnessworldrecords.com/world-records/largest-
human-awareness-ribbon?fb_comment_id=76760437995
5105_886627124719496
Tunisia
Contributors: Association Tunisienne de lutte Contre le Cancer

Not generally available at Generally available in the Generally available in the Not generally available in
public primary healthcare level public health system public health system the public health system

Public
activity
No data
Declaration targets The key successes for Tunisia have been the ATCC has taken a number of steps to support
Tunisia has organised a number of information development of a national cancer control plan patients and improve cancer care nationally.
days to educate the public about their cancer and within that, a specific lung cancer strategy, This includes building a home for patients
risks, cancer signs and symptoms, and targeting the leading cancer nationally in men, who are being treated for one week or
prevention strategies. both in terms of incidence and mortality. This more, as many families are unable to cover
has had a particular focus on educating young accommodation costs, which can jeopardise
In addition, the Tunisian Government has people about the dangers of smoking, as a key completion of treatment. ATCC also pays for
also been working with Bayer in a public- risk factor for lung and other cancers. the transport of patients to consultations, as
private partnership to organise and run a well as for the costs of radiotherapy, CT and
free mobile early detection service. This Key challenges MRI scans.
includes a screening caravan that provides
important access opportunities for remote Access to treatment facilities is one of the most ATCC has developed a Junior Programme
and disadvantaged communities, in order to pressing challenges in Tunisia. The Association that engages young people in the creation
improve rates of early detection and screening Tunisienne de lutte Contre le Cancer (ATCC) and dissemination of awareness messages
outcomes. would therefore like to see the development around cancer and its risk factors. The Junior
of further cancer centres, and facilities within Programme also has a crucial role to play
Finally, there are ongoing consultations with existing hospitals, to ensure the population in implementing ATCC’s street medicine
regard to how to maximise access to new benefits from screening, treatment and programme that delivers information and
cancer therapies in Tunisia in order to improve associated services. In particular, there is a cancer screening services to the general
treatment options and outcomes. shortfall of services in the southern, southwest public.
and northern regions of the country.
Where services do exist, many patients lack the
resources required to travel for treatment and
as such, many experience long delays before
seeking treatment. ATCC would like to see the
development of cancer facilities in the regional
capitals of Tunisia as a priority measure to
improve access.

United Arab Emirates, the
Contributors: Friends of Cancer Patients
700 500 No Population-based 94% No data

Generally available in the Generally available in the Generally available in the
public health system public health system public health system

Public
activity
Declaration targets • Availability of a mobile mammography unit FOCP has been actively engaged in tackling
After six years of advocating for regular • Establishment of the new Sharjah Breast NCDs nationally and internationally. On
breast cancer examination and screening in Care Centre at the University Hospital November 15th, 2015, FOCP’s Founder and
the United Arab Emirates (UAE), Friends of Sharjah Patron H.H. Sheikha Jawaher bint Mohammed
Cancer Patients (FOCP) Pink Caravan initiative Al Qasimi launched the Sharjah Declaration
• Production of health education materials
purchased the first state of the art mobile on NCDs at the culmination of the first
on breast cancer awareness and self-
mammography unit under the patronage of His Global NCD Alliance Forum. The Forum saw
examination techniques.
Highness Sheikh Dr Sultan bin Mohammed national and regional NCD alliances discuss
AL Qasimi, Supreme Council Member Ruler of the current NCD movement, the need for
Key challenges action, and strategies to accelerate action
Sharjah UAE, in order to provide quality breast
care throughout the seven emirates all year There is a definite need for a central cancer and hold governments accountable to their
round. registry, including data from all seven emirates, commitments.
to enable the UAE to accurately define the In addition to this, FOCP’s Pink Caravan has
Furthermore, in collaboration with Pink
cancer burden, identify cancer types and launched a comprehensive pamphlet to raise
Caravan and Gustave Roussy, the University
patterns, understand and determine cancer awareness including information on breast self-
Hospital Sharjah has launched its new
causes as well as key risk factors. Data examination steps for women and men. The
Sharjah Breast Care Centre. This centre will
collected by cancer registries is also an integral pamphlet has been endorsed by The Princess
offer the UAE’s first 24-hour diagnosis and
resource for cancer research. The absence of Grace Hospital, a leading multidisciplinary
cancer treatment activation plan. The aim of
a national cancer registry has hindered efforts hospital in London.
this plan is to encourage early diagnosis and
to address the UAE’s cancer burden more
rapid treatment of cancer patients in order to
effectively.
improve treatment outcomes. This facility is
the first of its kind within the UAE and hopes to
provide a service that will alleviate the anxiety
experienced by patients during the testing and
treatment for cancer.

Yemen, the Republic of
Contributors: National Cancer Control Foundation
4,300 4,200 No Hospital-based 88% No data

Not generally available at Generally available in the Generally available in the Generally available in the
public primary healthcare level public health system public health system public health system

Public
activity
Declaration targets While Yemen is struggling to meet the NCCF contributes to the provision of medical
Yemen has made limited progress in fundamental needs of cancer patients, the services for cancer patients through the
addressing cancer control. The biggest country is able to provide a basic set of establishment of diagnosis and treatment
challenge is providing access to medicines, treatment options to patients who are able units in five cities in Yemen - Sanaa, Taiz,
alongside the diagnostic, imaging and to travel to Sana’a or Aden. However, this has Ibb, Alhudaidah and Aden. These sites offer
monitoring technologies that are considered become more difficult in light of the ongoing laboratory, diagnostic and radiology services
essential for cancer management. For conflict. as well as contributing to a proportion of
example, the national cancer centre in Sana’a treatment costs, particularly with regard to the
only has one radiotherapy machine that is not Key challenges more expensive chemotherapy agents.
always functional. This leaves patients with NCCF has also established two centres for
NCCF would like to see more concerted efforts
the option of seeking treatment in the private the early detection of breast cancer; the first
to strengthen the health system, including the
sector at high cost, or traveling outside of in Sana’a (2010) and the second in Ibb city
establishment of an electronic cancer registry
Yemen if their condition permits. (2012). Both provide free services to women
to track the national burden and help shape
The government runs just two treatment policy and investment in essential cancer and girls in secondary education and at
centres in Yemen for cancer patients, one services. university. These centres take a full patient
in Sana’a with 50 beds and the other in history and can provide clinical breast exams,
A second key step would be to establish a mammography and ultrasound scans when
Aden with 30 beds. While both provide
network of cancer centres with the facilities indicated, undertaken by female consultants.
chemotherapy, there are no surgery services
to undertake screening, early detection and
and state-of-the-art treatments are not yet Finally, NCCF continues to work to improve
treatment of early stage cancers. A crucial part
available. In Yemen’s largest city, there is no public and professional awareness and
of this will be working with the general public to
government hospital. The National Cancer understanding of cancer through outreach
educate people and make them aware of the
Control Foundation (NCCF) has been filling projects in schools and universities, as well as
signs and symptoms of cancer, in order to find
the gap through the establishment of The scientific seminars, conferences and training
cases as early as possible, and empower the
Charitable Hope Oncology Centre, which courses for medical professionals.
population to reduce their own cancer risks.
provides free diagnostic, chemotherapy and
in-patient services, as well as supportive drugs
to aprroximately 5,000 patients. The current
civil war in Yemen has doubled the struggle to
establish and maintain services.

Nutrition, healthy weight
and physical activity
More than one third of the Government policy is critical in shaping healthier
environments and food availability to enable people to
most common cancers can lead healthier lives.
be prevented through a The World Cancer Research Fund International’s
nutritious diet, maintaining NOURISHING policy framework shows that many
countries are already taking positive steps to promote
a healthy weight and cancer prevention through policy action.
undertaking regular physical
activity.
Target 3
“More research is needed on the

impact of policies, and a whole-of-
society, multi-sector approach should
be pursued by governments to get
Reduce exposure to cancer everyone on board to improve our
food system. Better collaboration is
risk factors
required across national ministries to
ensure policies work together to achieve
agreed government objectives. Such
policy coherence is particularly needed
between trade and nutrition policy.
Countries can learn from each other’s
experiences, successes and challenges.
In working together, and collaborating
highlights a suite of policy options
with other sectors such as civil society,
to tackle poor nutrition and physical
we can achieve Target 3 of the World
inactivity to reach the voluntary
Cancer Declaration.”
global targets, which include a
30% relative reduction in mean Kate Allen, Executive Director of
population intake of salt/sodium, a Science and Public Affairs, World
halt in the rise of obesity, and a 10% Cancer Research Fund International
relative reduction in prevalence of
insufficient physical activity.

NOURISHING Framework
Nutrition, healthy weight

and physical activity
Sugary drinks tax, City of Berkley, Healthier dining programme,

USA (2015) Singapore (2014)
• This is the first excise duty on • The Health Promotion Board (HPB)
sugar-sweetened beverages (SSB) partners with 45 widely known food
in the USA, passed by public vote service providers who offer lower
with a 75% approval rate, levying calorie and healthier meals across
US$0.01 per fluid ounce. 1,500 outlets (food courts, coffee
shops, restaurants) and food stalls.
• As a result of the tax, retail prices
of SSBs increased by an average • Healthier meals must comply with
of about US$0.005 per fluid ounce, nutrition guidelines set by the www.wcrf.org/NOURISHING
while the prices for other beverages HPB, requiring the use of healthier
remained the same compared to ingredients, such as whole grains
cities without an SSB tax. and oils with reduced saturated fat,
and the reduction of calories. Food
• Tax revenue goes into the general
service providers who implement
tax fund, but US$1.5 million – the
the nutrition guidelines for two
equivalent of the projected tax
years can apply for approval by
revenue of the first year - was
the HPB to use “Healthier Choice”
allocated from the general tax fund Physical activity programme, Brazil (2011)
symbols on their menus and
to school- and community based
marketing materials. • The Academia da Saúde (Health Academy) programme is present in about 400 cities across Brazil.
prevention programmes aiming to
reduce the consumption of SSBs • The number of healthier meals sold Health Academies are facilities that provide infrastructure, equipment, qualified instructors and free
and obesity. Of that, US$600,000 per month more than doubled, from physical activity classes to overcome structural barriers to physical activity (e.g. lack of public spaces to
was distributed to the school 525,000 to 1.1 million, between safely exercise in), particularly among low-income groups. Health academies are jointly funded by the
district for nutrition and gardening the launch of the programme in federal government and matched by state/local funds.
programmes while the remainder September 2014 and June 2015. • The programme is integrated with primary care. Participants need to be referred by their primary health
of the funds were awarded on a care unit based on medical reasons or for prevention purposes and all health academies have to be
competitive basis after receipt of located in areas covered by primary care.
proposals from community groups.
Future tax revenue is expected to • In the state of Pernambuco, where the programme is most widely available, an evaluation showed that
be similarly used, with a focus on the programme has a positive spill-over effect: people living in cities benefitting from the programme
school based programmes. were more active regardless of whether they participated in physical activity classes or not, compared
to those living in cities without the programme.
60
Armenia
Contributors: EuropaDonna Armenia

Generally available in the Generally available in the
primary healthcare level primary healthcare level No data
public health system public health system

Public
activity
Progress against the World Cancer Key successes Author’s achievements

Declaration targets In 2015, the cancer registry in Armenia was EuropaDonna Armenia is actively engaged
In Armenia, the World Cancer Declaration restructured and updated to comply with in health promotion activities relating to
targets are being actively addressed at the international standards. This significantly cancer prevention, as public awareness of
national and community level to combat improved the usability of the data collected the prevention, diagnosis, and treatment
cancer: and will simplify future work on clinical cancer of malignant tumours is a key challenge.
epidemiology. Myths about the inability to cure cancer
• Since 2015, Armenia has implemented are particularly common, which can lead to
mandatory screening for cervical cancer In 2016, the construction of a modern
patients refusing treatment. As a result, actions
among women aged 30-60. At the diagnostic centre will be completed in Armenia.
have been taken to improve public awareness
same time, the country has coordinated The centre will be able to produce isotopes for
about the benefits of early diagnosis through
education programmes to dispel harmful PET scanning as well as radioisotop research,
mass media, internet campaigns and lectures.
myths and misconceptions about cancer in more broadly it is hoped that national clinical
The ‘Առողջ-Կրծքագեղձ/ Breast Health’ Facebook
order to encourage earlier diagnosis research on breast and prostate cancers will
page1 is one such example that disseminates
begin in 2016. Armenia has developed a legal
• Periodic HPV vaccination programmes weekly articles on breast health, screening,
framework which provides a favourable but
are run for high-risk groups, and efforts diagnosis and therapies to its 17,500 followers.
strict regulatory environment for conducting
to reduce tobacco consumption, using The EuropaDonna website is also used
clinical research in oncology.
measures set out in the WHO FCTC, are to highlight health information, alongside
helping to reduce the population’s exposure Finally, the government is consistently working advertising events for fundraising and raising
to preventable risk factors to attract new charity organisations to carry out awareness, such as concerts, bicycle rides
• Simplified procedures for the prescription oncology projects. and flashmobs. EuropaDonna has assisted
and provision of analgesics for effective with the translation into Armenian of numerous
Key challenges international professional clinical guidelines
pain control of cancer patients have been
developed nationally to improve patient Armenia does not have mandatory state- and protocols on prevention, diagnosis,
access funded screening programmes or compulsory treatment, and rehabilitation of cancer
health insurance, and, as a result, the burden patients, as well as facilitated their adaptation
• Armenia has significantly enhanced for a wider audience. The organisation has
the learning opportunities for medical of treatment is often carried by the patient
through out-of-pocket expenditure. Greater also established a charity fund to support
personnel who wish to develop their low-income populations in need of expensive
understanding of cancer management. efforts should be targeted at designing a
detailed national cancer control plan, which treatment.
Efforts have also been made to engage
cancer patients in cancer control planning would be approved and adopted by parliament,
at local and national level. in order to increase the percentage of state
funds allocated to meet oncology needs within
the country.
Footnotes:
1. www.facebook.com/Առողջ-ԿրծքագեղձBreast-Health-735857959798237/

Austria
Contributors: Division of Clinical Oncology, University Clinic of Internal Medicine,
Medical University of Graz

Public
activity

Declaration targets The Austrian Society for Haematology and The Division of Clinical Oncology was one
Austria has worked to implement the National Medical Oncology (ÖGHO) launched a of the lead organisations in the creation
Cancer Action Plan under four core areas of campaign entitled ‘Don’t smoke’1 that aimed of the Comprehensive Cancer Centre
work: to improve public awareness of the health risks Graz, and remains an active member. This
associated with tobacco consumption. The interdisciplinary collaboration aims to improve
• Prevention activities, including
campaign has gained significant momentum and standardise the quality of cancer care
implementing tobacco control
nationally, including amongst leading political delivered to patients2. In the Division of Clinical
programmes, strengthening health literacy
figures, and, as a result, a law is being passed Oncology, an interdisciplinary approach to
around cancer risk factors, reducing traffic
through the Austrian parliament to create caring for the ‘whole’ patient (using the bio-
emissions, and delivering vaccinations to
smoke-free zones in 2018. This will apply to psychosocial model) is a central element of the
avoid infection-related cancers
public institutions and all restaurants. clinical work. Weekly interdisciplinary meetings
• Diagnosis, treatment and research focus on the different needs of the patients to
strategies focused on how to guarantee Key challenges ensure optimal treatment and care3.
high quality, demand orientated and
equitable access to evidence-based In order to achieve the Declaration targets by One of the priorities within the Division is
innovative treatments. Austria is also 2025, key priorities for Austria include: how to collaborate with other international
integrating quality assurance mechanisms Institutes of Oncology to conduct further
• Improving the quality of cancer statistics, clinical research into psychosocial care and
into all aspects of cancer care, promoting
developing a disease-specific data bank communication. The Division also actively
the participation of patients in clinical
and maintaining statistical analyses of works in collaboration with ÖGHO and other
trials and working to increase independent
cancer epidemiology cancer related societies. This networking
funding of cancer research
• The creation of opportunities for family- includes the organisation of national as well
• Psycho-oncology services, which are
orientated cancer rehabilitation, as well as as international meetings, and participating in
made available to all patients and relatives.
improvements in multi-professional care multicentre studies throughout Austria, such
This has involved defining and organising
for elderly cancer patients and improved as the Austrian Breast and Colorectal Cancer
different services for patients and delivering
research into ageing and cancer. Study group.
standardised psycho-oncology education
and training for all cancer professionals
• Palliative and hospice care. These services
are being actively developed by specialist
organisations, alongside the delivery
of basic training for palliative care, and
implementation of quality assurance
mechanisms for outpatient oncology
rehabilitation in particular.
Footnotes:
1. www.dontsmoke.at/initiative/
2. www.ccc-graz.at/
3. http://inneremedizin.uniklinikumgraz.at/onkologie

Denmark
Contributors: Danish Cancer Society
8,900 8,100 Yes Population-based No data Yes

Public
activity
Declaration targets In 2000, Denmark had the highest cancer The first two Danish Cancer Plans (developed
Denmark has taken a number of key steps mortality rate in Western Europe, which in 2000 and 2005) paved the way for the
in order to tackle the national cancer burden reflected the country’s poor prevention and introduction of cancer care pathways -
including: cancer care services. The Danish Cancer resources that identify the optimal cancer care
Society (DCS) worked with other stakeholders for specific tumour types at every step of the
• Development of the Danish Sun Safety to call for action, and by 2010 three national cancer journey. However, long waiting times for
Campaign that focuses on reducing the cancer plans had been developed and treatment have slowed their implementation.
incidence of skin cancer. The campaign launched. The implementation of these plans In response, in 2007, DCS and Danish cancer
has produced positive behaviour changes, has been tracked closely at the national, specialists launched a successful public
such as almost halving the number of regional and hospital level, and Danish cancer campaign: ‘Cancer is an acute condition –
Danes using sun beds, and a reduction care has improved significantly. untimely cancer care is fatal’, which resulted in
in the percentage of 15-64 years old that significant political and public support for more
are sunburnt, from 44% in 2008 to 32% in In 2015, in order to maintain momentum and
urgent action to be taken.
2014 1 improve areas which were still performing
poorly, DCS called for the development of a Today, Denmark has 30 disease-specific
• HPV vaccination was introduced into the
Cancer Plan IV – ‘The Cancer Patients’ Plan’. cancer pathways and cancer care has
Danish childhood vaccination programme
There was a one-year delay in its development, improved with fast track pre-booked diagnostic
on 1 January 2009, and is offered to girls
but the initiation of Cancer Plan IV was recently and treatment management plans; clinically
aged 12-15. Catch-up programmes were
announced by the Minister of Health and defined time limits for the various steps that are
introduced in 2014 for girls born in 1985-
Aging. consistently monitored; pathway management
1995
and control through a common national
• In March 2014, colorectal cancer screening Key challenges framework; and consolidated specialist units
for all persons aged 50-74 years was delivering diagnostic and therapy services.
introduced. In order to build on successes to date, DCS
would like to see:
• Guidelines that describe the best follow-up
care for cancer patients
• Initiatives that demonstrate how cancer
patients can become involved in decisions
about their treatment, including best ways
to inform patients about potential impacts
or side effects of available treatment options
• Improvements in data collection so that all
patient contact with the healthcare system
is registered (including contact with general
practitioners) to improve the quality of
cancer care given.
Footnotes:
1. www.skrunedforsolen.dk

Estonia
Contributors: Estonian Cancer Society

(clinical breast exam only) (VIA only)

Public
activity
Progress against the World Cancer Key successes The Estonian Cancer Society (ECS) would also
Declaration targets like to see work undertaken to strengthen the
In terms of primary prevention, the introduction role of cancer centres in coordinating cancer
Estonia has taken a number of key steps of new tobacco legislation in 2015 is expected care nationally and to improve patient access
including: to produce a dramatic decrease in the number to supportive therapy and rehabilitation.
of smokers in Estonia. The development
• Introduction of free breast and cervical of existing screening programmes and the Finally, the Estonian National Cancer Strategy
cancer screening services to women introduction of colorectal screening have been (2007-2015) expired at the end of 2015 and
covered by national health insurance, and significant achievements in terms of secondary work is urgently needed to extend or replace
the implementation of a national colon prevention. the strategy.
cancer screening programme in 2016
In January 2015, a new national health registry
• The Ministry of Social Affairs and the UICC Member’s achievements
for cancer screening was established. This
Estonian Health Insurance Fund are
registry will gather data from breast and In 2009, ECS purchased a new mammography
discussing the implementation of a national
cervical cancer screening and treatment bus using funds raised through charity events
HPV vaccination programme
services in a specially designed database to and sponsors. The aim was to improve access
• Draft legislation proposed in 2015 will analyse national trends. Colorectal cancer data to breast cancer screening, particularly for
restrict alcohol advertising and accessibility. will be added to this registry with the launch of populations in small towns in south and
Outdoor advertising of alcohol will be this screening programme. central Estonia. At the end of 2011, a digital
strictly forbidden, as will alcohol sales in mammogram was purchased to replace the
petrol stations and happy hour specials Key challenges old unit, improving the precision of results by
in eating establishments. The Ministry 30% and shortening the duration of screening.
of Social Affairs is also considering While cancer survival rates in Estonia have
giving authority to local governments to improved over the past ten years, it still lags With generous support from the general public
implement further alcohol restrictions far behind most other OECD nations. The and private corporations, ECS will be launching
disparities between survival rates in Estonia two new mobile diagnostic units in 2016
• New tobacco legislation prohibits underage
compared to other Scandinavian and Western specifically equipped for the early detection
use and possession of water pipes,
European countries are particularly significant. of skin and prostate cancer. Both units will be
e-cigarettes and snus
travelling Estonia to improve access to these
• Palliative care services have been There is a need to improve cancer screening key screening and diagnostic services in
established in cancer centres. participation in Estonia. Unfortunately, many previously underserved regions.
people without national health insurance
cannot afford to attend screening clinics and
those with insurance receive invitations too
infrequently as offers are based on narrow and
restrictive age categories.

Finland
Contributors: Cancer Society of Finland
6,100 5,600 Yes Population-based No data No data

Public
activity
No data
Declaration targets Finland has taken key steps in developing The 2011 Health Care Act of Finland outlined
Across Finland a number of actions have been national cancer control plans. In 2010, the the principles for national cancer screening
taken: ‘Development of Cancer Care’ report was programmes. These national screening
published by the Ministry of Social Affairs and programmes for breast, cervical, prostate and
• In 2014, the Ministry of Health issued a plan
Health (MSAH). The report made estimates of colon cancers have been delivered nationally
for a comprehensive national cancer centre
the future cancer burden; set national targets and The Cancer Society of Finland has played
(FICAN). As Finland has been undertaking
for diagnoses, care and follow up; outlined an active role in assessing their effectiveness.
major healthcare reforms FICAN has not
the division of labour between healthcare Recent results suggest that prostate screening
yet been established, but regional cancer
levels and geographic regions; and made has not been effective and an assessment of
centres are in place
recommendations for information systems and the effectiveness of colon cancer screening is
• An update to the national burden of for palliative care. still ongoing. Overall participation in national
cancer is underway by Cancer Society of cancer screening programmes is still high,
Finland. One of the key findings has been In 2014, a plan on Cancer Prevention, Early
although there has been a recent decline.
that smoking prevalence is declining as a Detection and Rehabilitation was published
result of preventing smoking and snus use by the National Institute of Health and Welfare, The Cancer Society of Finland has been
among youth, targeting the illegal import which reviewed prevention to date and made advocating at the European level, and is a
and sale of snus, and multiple tobacco recommendations for future development. In partner in the European Guide on Quality
tax increases. The 2010 tobacco law the same year the MSAH published a report Improvement in Comprehensive Cancer
established an endgame target for 2040 recommending FICAN. The Cancer Society of Control (CanCon) Cancer Control Joint Action1
and a new deadline of 2030 is currently Finland was actively involved in the preparation initiative that aims to reduce the cancer burden
being discussed of these reports and is closely tracking in the European Union.
implementation of these plans nationally.
• In 2015, it became illegal to advertise
alcohol in public places and this ban
extends to social media Key challenges
• Nutrition guidelines have been revised Cancer Society of Finland would like to see the
and in 2011 a sugar tax was introduced, establishment of a national cancer centre that
however it is being abolished due to a can coordinate good quality and accessible
European Commission ruling cancer care, and develop an evidence-base
• HPV vaccination have been included in the for cost-effective and high quality care
national immunisation programme for all interventions following current reforms.
girls. An equitable, integrated health system must
start with prevention and early detection.
Cancer Society of Finland would therefore
like to see measures to reach the tobacco
endgame by 2030, curb national alcohol
consumption and reduce the incidence of
Footnotes: obesity nationally.
1. www.cancercontrol.eu/index.php

France
Contributors: French League against Cancer; Institut National du Cancer

(Pap smear only)

Public
activity
No data
Progress against the World Cancer • Developing evidence-based Key challenges

Declaration targets recommendations for lung cancer and the
prevention and management of side effects The authors would welcome further efforts to:
France has taken a number of key steps1: of oral chemotherapy, introducing a new • Increase tobacco control measures
• Introducing electronic patient records to cancer centre accreditation system, and nationally to reduce rates of smoking
improve care coordination optimising the national network of MRI units • Development of comprehensive health
• Concerted measures to reduce tobacco • Reforming health insurance to ensure that education including the key risk factors for
consumption through the introduction patients can access insurance and loans cancer; such as alcohol consumption, low
of plain packaging from May 2016, after a cancer diagnosis by implementing physical activity, and poor diet
development of smoke-free spaces and a ‘right to forget’ and the erasing of data for • Improve equitable access to innovative
cities in France children and adults that are cured, after five cancer treatments and care
and ten years respectively
• Educating children about the dangers • Conduct further epidemiological research
of tobacco consumption. In 2014, 6,036 • Development of a ‘Business Club on Cancer into risk factors for cancer, other than
sessions were held for 135,962 students and Employment’ to highlight challenges tobacco.
and identify best practices for individuals
• Playing a crucial role in the banning of the
returning to work after cancer treatment2. UICC Member’s achievements
herbicide glyphosate within the European
Union
Key successes The French League against Cancer (La Ligue)
• Launching web campaigns, including a quiz is a national alliance of regional committees
on individual risk factors and a ‘two-click’ • Introduction of plain packaging for tobacco dedicated to the fight against cancer. Focus
guide to inform individuals which screening control areas include; funding clinical, epidemiological
programmes are available to them • Promotion of HPV vaccination among and social research; conducting education
• Updating screening programmes with new young girls and screening sessions; and offering financial,
immunological tests for colorectal cancers • Creation of the National Cancer Screening psychological, social and technical support to
within the national colorectal screening Programmes for breast, colorectal and cancer patients and carers. La Ligue also works
programme cervical cancers to change attitudes to cancer and engage
• Ensuring that high-risk women have free with other organisations, particularly within
• Trialling of personalised pathways for Francophone countries, to improve cancer
access to mammography services within patients, with cross-disciplinary meetings
the national screening programme, with a control internationally.
to help take treatment decisions for each
citizen conference held to improve uptake patient In recent years, La Ligue’s key achievements
of services have been conducting advocacy at the
• Development of dedicated networks
• Improving the equity of access to or centres for paediatric, geriatric, European level in partnership with French
individual genetic diagnosis identifying oncogenetic and rare cancers to improve authorities to reduce the cost of cancer
pre-dispositions to cancer; genetic care quality. medicines, particularly for new and innovative
consultations on cancer; molecular testing medicines. La Ligue has also advocated for a
national law to ensure that cancer survivors
and targeted therapies
do not need to include their cancer diagnosis
when applying for bank loans.
Footnotes:
1. http://www.e-cancer.fr/Plan-cancer/Plan-cancer-2014-2019-priorites-et-objectifs/Deuxieme-rapport-au-president-de-la-Republique
2. http://www.e-cancer.fr/Plan-cancer/Plan-cancer-2014-2019-priorites-et-objectifs/Club-des-entreprises-Cancer-et-Emploi

Georgia
Contributors: Association of Oncologists of Georgia; Fight against cancer

Public
activity

Declaration targets The major achievement in Georgia has been The Association of Oncologists of Georgia
Georgia has taken a number of key steps to improvements in the early detection of cancers, would like to see the further extension and
reduce premature deaths from cancer and following the rollout of the National Screening strengthening of the Georgian population-
make improvements in cancer survival rates: Programme. Patients presenting with third based cancer registry in order to ensure that it
and fourth stage cancer have fallen from 56% produces the most accurate information about
• A national cancer screening programme
of cases to 18% over the last five years. In the cancer burden. They would also like to see
has been launched in all regions of
particular, Georgia has seen a significant rise greater use of these data in the development
Georgia since 2011, following the success
in the detection of pre-cancerous lesions and and evaluation of national cancer programmes,
of a regional programme in Tbilisi. This
other precursor states enabling patients to such as the national screening programme, to
has been implemented by the National
seek treatment earlier, with better potential ensure that these programmes are focused on
Screening Centre. The programme includes
outcomes and fewer severe side effects. tackling the more urgent national priorities.
breast, cervical, bowel and prostate
screening, and cancer risk management
services for patients across the country
• Georgia has developed a population-based
cancer registry that provides updates on
the national cancer burden. In 2015, the
data suggested that lung, prostate, larynx
and colorectal cancers accounted for 50%
of new diagnoses in men. Breast cancer
alone accounted for 25% of new cancer
cases among women, followed by cervical
and uterine cancers.

Germany
Contributors: Deutsche Krebsgesellschaft

Public
activity
Declaration targets In 2008, the German National Cancer Plan was With more than 7,500 individual members,
In Germany, there are approximately 480,000 launched by the Federal Ministry of Health. The DKG is the largest network of oncology experts
new cancer cases every year and due to plan focuses on: in Germany. They also act as an umbrella
demographic changes an increase of at least organisation for 16 cancer societies that
• Developing cancer screening
20% is expected by 2030. However, the survival provide regional support to cancer patients.
prospects of cancer patients in Germany • Improving oncology care and quality Activities include:
have significantly improved over the past 30 assurance structures
• Certification of cancer centres and
years. One of Germany’s key health system • Ensuring access to effective treatments,
development of annual reports on quality to
successes has been balancing the differences initially focusing on drug therapy across
ensure patients are offered treatment based
in cancer survival rates between the states of Germany
on high quality standards
former East Germany and West Germany. • Strengthening patient orientation in cancer
• Development of clinical practice guidelines
The most significant survival improvements care.
as part of the German Guideline
have been achieved for breast, colon and The adoption of a federal law setting out the Programme in Oncology, launched in 2008
prostate cancers, which are mainly attributed framework for comprehensive clinical cancer • Cancer prevention activities as part of the
to progress in diagnosis and treatment. Several registries in 2013 was a major National Cancer German Non-Smoking Alliance, which
years will need to pass before it is possible to Plan milestone. Establishing clinical cancer supports reductions in tobacco use, and
effectively assess to what extent breast cancer registries is an important tool to improve the as part of the German Alliance for UV
screening has contributed to these outcomes. quality of cancer care, and under the new Protection
law certain screening examinations will be
• Influencing health policy as one of the co-
conducted through organised programmes.
founders of the German National Cancer
Plan, which was launched in 2008 by the
Key challenges Federal Ministry of Health
Deutsche Krebsgesellschaft e.v. (DKG) would • Networking through various national and
like to see the development of effective European initiatives, including with UICC.
programmes to support those willing to
address their cancer risk through lifestyle
changes, notably to tackle tobacco use, obesity
and physical inactivity. There is also a need for
research into how to effectively raise public
awareness about preventable cancer risks.
This should be coupled with policy changes,
such as the law to implement the 2014/40/EU
Tobacco Product Directive, which is currently
under development.

Greece
Contributors: Hellenic Society of Medical Oncology; International Institute
of Anticancer Research

Public
activity
Declaration targets Public awareness of cancer risk factors and HESMO has developed a public awareness
It is difficult to objectively determine progress symptoms is good. This is in part due to a campaign challenging the stigma associated
against the Declaration targets because good level of education amongst the general with cancer and the assumption that a cancer
Greece currently lacks reliable health statistics, population, as well as the energy and breadth diagnosis means death. Launched in 2015,
although an initiative is being developed to of campaigns to raise cancer awareness. the campaign’s core message is that ‘the war
establish a population-based cancer registry. against cancer can be won’. It emphasises
Greece has also taken important steps to
the need for early diagnosis, calls for the
The healthcare system has also been shaken ensure a high skill level amongst cancer care
early involvement of medical oncologists in
by a series of structural problems stemming providers, and particularly medical oncologists,
treatment, and empowers patients to request
from the country’s economic crisis. The in line with international guidelines.
cancer services. The campaign is running on
number of doctors and nurses is declining, and TV and radio, and has been actively taken up
social and economic support structures are Key challenges by the media and general public.
being dismantled, leading to significant health
The development of a cancer registry has HESMO has also contributed to strengthening
impacts across the Greek population. Finally,
the potential to have significant impact by awareness and uptake of screening for breast
funding limitations are further exacerbating
providing key statistics on the national cancer and cervical cancer through the Women in
these structural problems within the health
burden in order to guide investments in cancer. Oncology (W4O) initiative1. This initiative offers
system.
Given the current difficulties, the Hellenic free screening for cervical cancer and free
Nevertheless, Greece has taken a number of genetic testing for breast and ovarian cancers
Society of Medical Oncology (HESMO) would
measures to address the Declaration targets nationally.
like to see the promotion of multidisciplinary
including:
care in order to meet the needs of cancer
• Launching a number of national campaigns patients. This will require medical oncologists
tackling cancer risk factors. However, the alongside supportive and palliative care
success of tobacco control measures services. In order to achieve universal access
have been limited by weaknesses in law to quality care, there is the need for the
enforcement restructuring of the health system.
• Vaccination programmes are now Finally, HESMO would like to see further
reimbursed by public insurance development of national screening
• Improvements in quality of care through programmes, as well as stringent measures to
measures to recruit well-trained medical control tobacco and manage obesity nationally.
oncologists, and development of innovative Effective evaluation mechanisms are also
education and training programmes for needed in order to determine their impact on
young oncologists health outcomes over the coming years.
• Ensuring the availability of pain medication
and that the regulatory system supports
pain specialists.
Footnotes:
1. http://w4ohellas.org/

Hungary
Contributors: Hungarian League Against Cancer
18,300 14,900 Yes Population-based No data No data

Public
activity
Declaration targets Hungary’s leading success has been the MRL is an alliance of 4,500 organisations from
Hungary has taken a number of actions development and implementation of national across the country that works on five priority
towards achieving the Declaration targets: screening programmes for the cancers that areas:
have the highest burden of disease.
• Mammographic screening is available • Health education for the general public,
free of charge for all women aged 45 to 65 teachers, healthcare specialists and
years, however uptake rates remain at 38% Key challenges volunteers to help individuals reduce their
to 40% Hungary is still struggling with a comparatively cancer risk, identify signs and symptoms,
• Screening services for HPV, prostate- high burden of cancer and high mortality rates and dispel misconceptions around cancer
specific antigen, and colorectal, skin and due to low investment in cancer prevention and • Improving screening access, including
oral cancer are available nationally, but once care. In order to address this, the Hungarian mobile units targeting rural areas
again uptake rates remain low League Against Cancer (MRL) would like to
• Delivering treatment information to patients
• HBV vaccination is available through the see:
to ensure they are aware of the options
national vaccination programme • Active investment in the education and available to them
• Measures to reduce tobacco control have recruitment of oncologists • Supporting rehabilitation through patient
been introduced, with a particular focus on • Further work to reduce the myths around groups and anonymous psychological
educating young people about the cancer cancer and encourage participation in support services
risks. screening programmes • Promotion of patient rights, particularly
• Development of new policies to address their right to choose treatment options and
the national cancer burden, in particular to locations.
address key risk factors for cancer, such as
MRL also takes the opportunity to mark a
tobacco, alcohol consumption, poor diet
number of cancer-related days throughout the
and physical inactivity.
year, including World Cancer Day, in order to
engage the general public, for example through
anti-smoking events in Budapest.

Ireland
Contributors: Irish Cancer Society

Public
activity
Progress against the World Cancer Key successes A lack of radiographers has meant that rollout
Declaration targets of breast cancer screening has been delayed,
There have been major successes in public while bowel cancer screening has only reached
Alongside the landmark passing of the tobacco health legislation on alcohol and tobacco in 40% of the target population. It is understood
plain packaging legislation, Ireland has taken Ireland, with a ban on in-store advertising that efforts are being made to improve
a number of important steps to address its of tobacco in 2013, a ban on smoking in awareness of the bowel cancer screening
national cancer burden: cars from 1 January 2016, and successive programme, especially among ‘hard to reach’
increases in excise duty on both products. areas of the population.
• The National Cancer Control Programme
has been successful in centralising cancer The HPV vaccine was introduced into the Finally, claims about the adverse impacts of
treatment and improving rapid access to national immunisation programme in 2011 as the HPV vaccine persist and so emphasising
diagnostics for certain cancers. A new part of the national cervical cancer strategy. the safety of the vaccine and its importance in
Cancer Strategy for the next ten years has Rollout of the vaccine has progressed reducing long-term cancer risks remains a key
been drafted and will be published shortly significantly, and since September 2011 focus.
all girls in their first year of secondary level
• Important public health campaigns1 have
education have been offered the HPV vaccine,
helped promote awareness of cancer risks, UICC Member’s achievements
with catch-up programmes for those up to the
including physical inactivity, and stigma
age of 16, running until 2013. ICS has lobbied, in alliance with other
associated with cancer
health organisations, for the introduction of
• Legislation2 identifying minimum Key challenges standardised tobacco packaging in Ireland
unit pricing for alcohol, and structural since 2012. This was passed into law in
separation of alcohol and health labelling on A recent report3 highlighted shortcomings in 2015 after concerted campaigning and
alcohol products has been drafted access to diagnostics in the Irish public health commissioned research on the potential
• The extension of population-based system, with vast discrepancies between impacts amongst teenagers; and it is likely that
screening programmes has progressed Ireland’s public and private health systems. the law will come in to force in 2016.
significantly recently with the inclusion of 88.5% of general practitioners surveyed
said that ability to pay determined access to Additionally, ICS has pursued the extension of
women aged 65-69 to the breast screening
cancer diagnostics. The Irish Cancer Society screening programmes for breast, bowel and
programme. Biennial bowel cancer
(ICS) will work with the National Cancer cervical cancer to wider populations. This has
screening was established in 2012 for the
Control Programme to address this, as well had notable successes, with the extension of
60-69 age group.
as campaigning for universal access to the country’s free breast screening programme
healthcare. to women aged 65–69 beginning in the past
year. Full rollout is expected by 2021.
Footnotes:
1. www.quit.ie/campaign/
2. http://alcoholireland.ie/uncategorized/public-health-alcohol-bill/
3. www.cancer.ie/sites/default/files/content-attachments/icgp_irish_cancer_society_report_-_access_to_diagnostics_to_detect_cancer.pdf

Israel
Contributors: Israel Cancer Association

Generally available at
public primary healthcare
level (Pap smear only)

Public
activity
Declaration targets A consistent decrease in smoking rates in Israel ICA, in collaboration with the MoH and local
Israel has implemented several measures to has been observed since the 1980s, when Health Maintenance Organisations, initiated
tackle the national cancer burden including: they were at 45%. By comparison, in 2008, the and implemented the National Mammography
smoking rate among Jewish men was 28.1%, Screening project.
• Implementation of a national cancer control and amongst women, it was 18.7%. These
programme by the Ministry of Health One of the significant achievements of the
rates have since continued to fall, with 2014
(MoH), which includes the Israel Cancer project has been the delivery of a mobile
figures of 23.1% and 14% respectively.
Association (ICA)-supported National mammography unit, which has helped reduce
Cancer Registry Since the implementation of the National the gaps in screening compliance between
Mammography Screening Project, the survival different populations and completely eradicate
• Launching national media campaigns
rates for breast cancer have increased and the disparity between Jewish and Arab women.
and distributing information materials to
mortality rates have dropped by 25%, among
promote healthy lifestyles, dispel myths and An intensive ICA ‘sun smart’ public information
Jewish and Arab women alike.
break the silence around cancer campaign was conducted amongst all age
• Early detection campaigns, such as breast, A MoH circular, issued in 2009, mandated the and population groups in Israel, aiming to
skin, and colorectal cancer awareness establishment of a palliative care framework in improve awareness of the potential risk that UV
programmes hospitals and within the community. exposure poses. Israel subsequently dropped
from third among the 20 countries with the
• Inclusion of the HPV vaccine in the National Finally, the MoH annually reviews the drugs
highest melanoma incidence rates worldwide,
Healthcare Package and technologies available within the National
to 13th place for male incidence, and to 20th
• Enhancement of treatment rehabilitation Healthcare Package to ensure fulfilment of
place for female incidence.
modalities for cancer patients and survivors patient needs. This package is available to
(ICA serves as a “watchdog” to safeguard every Israeli citizen free of charge.
patient rights, while working to expand the
National Healthcare Package) Key challenges
• Support for ongoing professional education Whilst ICA looks back with great satisfaction
for multi-disciplinary oncology staff. on the achievements detailed above; there is
still a long road ahead. ICA looks forward to
the cancer community in Israel continuing
to reduce cancer morbidity and mortality,
acting to alleviate the pain of cancer patients,
supporting survivors and their families
and improving the quality of life of patients
throughout the disease trajectory. ICA will also
continue to advocate for patient rights.

Italy
Contributors: Regina Elena National Cancer Institute of Rome; Centro di Riferimento
per l’Epidemiologia e la Prevenzione Oncologica; Soleterre-Strategie di Pace Onlus

Public
activity
Progress against the World Cancer Key successes There are also a number of challenges in Italy
Declaration targets with regards to childhood cancer. In order to
Italy’s greatest success has been improving adequately address childhood cancer, it will be
• Development of a population-based cancer the rates of screening across the population. In important to ensure that there are dedicated
registry drawing on regional data sources the last survey, conducted 2011-2012, it was departments and spaces for children and
found that screening invitations were sent to adolescents within health facilities, including
• Italy ratified the WHO FCTC in 2008,
20 million residents, of which 10 million took recovery rooms, and tailored areas where
building on measures taken earlier to ban
part. For cervical cancer screening, 77% of adolescents and children can play and
smoking from public transport and public
25-64 year olds have received a Pap smear continue their education during treatment.
places (although there is a provision for
or HPV test in the last three years. National Oncology wards for adults and children also
smoking rooms), and to significantly limit
screening programmes tested 38% of the need increased funding in order to include
tobacco advertising and sponsorship
eligible population for colorectal cancer and psycho-oncologists and/or psychologists in
• A national prevention plan (2014-2018) 70% of the population received mammography their permanent staff.
has been developed which highlights key screening1.
measures relating to diet and physical
activity, reducing alcohol consumption and UICC Member’s achievements
Key challenges
tobacco use nationally. It also calls for the The aim of the Regina Elena National Cancer
scale-up of HPV-DNA testing by 2018 One of the greatest challenges in Italy is the Institute (RENCI) of Rome is to improve general
• Italy was the first European country to offer disparity in screening coverage between awareness about the prevention, diagnosis
the HPV vaccine free of charge to 12 year northern, central and southern Italy. This and treatment of cancers nationally. To achieve
old girls in 2007 disparity may be due to differences in this, RENCI organises meetings for the general
education and awareness of cancer risk public and cancer patients on key prevention
• The Ministry of Health has developed factors and services, economic issues, or an
guidelines for cervical, colorectal and measures, including the risk associated with
influx of migrants and refugees in the south HPV infection and tobacco use, as well as the
breast cancer screening programmes, in of the country. In regions with comprehensive
line with the European Commission’s 2003 signs and symptoms for breast, colorectal and
organised screening programmes, test skin cancers. In parallel, RENCI holds seminars
recommendation coverage was higher and there were smaller for general practitioners and a congress for
• National implementation of cervical, disparities based on socio-economic status. cancer specialists.
colorectal and breast cancer screening.
Footnotes:
1. Zappa M, Carozzi F, Giordano L, Sassatelli R, Federici A (eds.). The National Centre for Screening Monitoring. Eleventh Report. Epidemiol Prev 2015; 39(3) Suppl1: 1-125

Kazakhstan
Contributors: The Kazakh Institute of Oncology and Radiology
Generally available at public Generally available at public Generally available in Generally available in Generally available in
primary healthcare level primary healthcare level the public health system the public health system the public health system

Public
activity
Declaration targets The cancer control plan for 2012-2016, the KIOR coordinates national research, education,
• The national health system is being development of a population-based e-cancer treatment and policy development as well
developed to meet the goals set out in the registry, and the implementation of a tobacco as operating the Kazakh population-based
cancer control plan for 2012-2016, and a control plan have been three of Kazakhstan’s cancer registry. Key achievements have
new plan will be developed in 2016 major successes. been collaborating on the creation of the
national guidelines on the standard of cancer
• A population-based e-cancer registry was • The cancer control plan included 67 actions
care delivery in Kazakhstan, and leading the
established in 2012 and work is ongoing to and EUR 1 billion (USD 1.1 billion) of funds
preparation of the 2012-2016 cancer control
make the data more reliable to implement the changes identified. It
plan.
• The Kazakh Institute of Oncology and also included the creation of psychosocial
Radiology (KIOR) collaborates with the services in each cancer hospital with at The Institute has also led on the
Centre for Healthy Lifestyles to reduce least one psychologist and one social implementation of six cancer screening
exposure to cancer risk factors worker. programmes for breast, cervical, colorectal,
• The national population-based e-cancer gastric, liver, and prostate cancers. From
• HBV vaccination is already in place for all
registry facilitates online data entry from all 2013, four regions started implementing
newborns in Kazakhstan; HPV vaccination
18 cancer hospitals and simplifies follow- HPV vaccination as part of a national project
is covered in four regions with plans to
up, cancer statistics analysis, research etc. which will be incrementally scaled-up.
make it nationally available in 2017
Multidisciplinary groups have opened in all 18
• Six cancer screening programmes have • Kazakhstan has now implemented most
cancer hospitals to help support cancer care.
been implemented nationally of the measures set out in the WHO FCTC
including banning smoking in all public
• The Kazakh cancer control plan includes
places (including education and healthcare
equipment and education for different
facilities) and cigarette packs now have
specialists from all cancer hospitals in order
graphic warnings.
to improve access to cancer care nationally.
Key challenges
KIOR would like to see the continuation of
cancer screening programmes and overall
efforts for cancer prevention. Treatment
outcomes would also be improved by the
development of facilities to deliver high
precision diagnostic and treatment methods in
all regional cancer hospitals, as well as further
research in these two areas. Better access
to specialised oncology training courses
(such as those for medical oncology, surgery,
radiotherapy, medical physicists), and the
development of palliative care services with
increased access to pain medication are also
critical.

Kosovo
Contributors: Kosova Task Force for Cancer Control
WHO cancer country profile 2014
No data No data No data No data No data No data
WHO NCD progress monitor 2015

Public
activity
No data No data No data No data No data No data No data No data No data No data
Declaration targets Within Kosovo, the development of surveillance KTCC is actively working to reduce the national
Kosovo has taken a number of steps to tackle systems, including reporting on cancer cancer burden through international and
cancer including: and registering data, has been a major national collaborations. As a member of the
achievement. Alongside this, the following MTCC, KTCC works with 24 Mediterranean
• Conducting training sessions for staff measures are contributing to a more cancer- countries to strengthen cancer control
involved in cancer care in order to build aware environment within the country: activities. There is a particular focus on
skills, including how to improve surveillance building professional and public awareness
systems, reporting on cancer, and data • Clear policy commitment to tobacco
about prevention and the importance of early
registry control, including banning smoking from all
detection, alongside developing the technical
public spaces, banning tobacco advertising
• Promotion of equal access to cancer and policy environment to deliver accurate
and sponsorship, and developing graphic
control measures, for example through the diagnoses and treatment. As part of this,
warnings on tobacco product packets1
cervical screening programme that actively KTCC has organised workshops for Kosova
includes Roma, Ashkali and Egyptian • Development of screening and early family doctors and Security Forces’ doctors
vulnerable groups living in Kosovo detection programmes to improve their understanding of different
• Education activities to improve professional malignant disorders and to improve cancer
• Work to reduce stigma, myths and care.
and public understanding of cancer and its misconceptions associated with cancer.
impact on Kosovo and all Mediterranean KTCC closely collaborates with the Kosovo
citizens. Brochures have been developed Health Institutes and policy groups in order to
Key challenges
and translated into different languages advocate for and influence policy to promote
for distribution by the countries in the A number of challenges remain in Kosovo high quality cancer prevention, early detection
Mediterranean Task Force for Cancer and the Kosova Task Force for Cancer Control and state-of-the-art treatment facilities
Control (MTCC). These resources include (KTCC) considers the most pressing to be: for patients. Since its inception, KTCC has
guidelines on preventative diet and lifestyle worked closely with a range of institutions
behaviours, as well as guidelines for cancer • Tackling cancer-causing infections by
and developed a strong national network of
screening and early diagnosis. ensuring that HPV and HBV are covered by
governmental representatives, civil society
universal vaccination programmes
participants, and volunteers from the general
• Developing effective pain control and public to support activities.
distress management services
KTCC has also explored the role of art in
• Working to sustain screening programmes
helping cancer patients’ recovery through
• Building the capacity of the health sector to an initial project with Kosova artists2. This
deliver accurate cancer diagnosis, quality programme brings breast cancer survivors
multimodal treatment, rehabilitation, and together with the philosophy that creating
supportive care art – no skills required – has a complementary
• Ensuring the availability of affordable role in healing; given that a patient’s emotional
essential medicines and technologies in wellbeing can have a real impact on overall
Kosovo. health. There has been a particular focus on
Footnotes: engaging young patients in these programmes.
1. www.euro.who.int/en/health-topics/disease-prevention/
tobacco/news/news/2013/05/kosovo-adopts-strong-
and-comprehensive-tobacco-control-law
2. www.tkkk-ktcc.com/

Netherlands, the
Contributors: Dutch Cancer Society
Not generally available at Not generally available at Generally available in the Generally available in the Generally available in the
public primary healthcare level public primary healthcare level public health system public health system public health system

Public
activity
No data
Progress against the World Cancer Key successes • Develop a new, sustainable funding system
Declaration targets for cancer care
The Netherlands has had a number of key
successes in tackling cancer risk factors • Achieve a smoke-free generation by 2035
The Netherlands has developed a focused
strategy to help address cancer nationally. Key and treatment. The Smokefree Netherlands • Address the cost of anti-cancer drugs
areas of progress include: Alliance, of which DCS is a member, has internationally
played a crucial role nationally in advocating • Integrate psychological healthcare for
• Implementation of tobacco control
for stronger tobacco control with the final cancer patients within the national system.
measures including a significant rise in
aim of a ‘smoke-free generation’ by 2035.
tobacco taxes, following on from active
In line with this, the Dutch government has UICC Member’s achievements
advocacy efforts by the Smoke-free
introduced measures to make the hospitality
Netherlands Alliance
sector smoke-free; increasing the age limit DCS is one of the leading investors in cancer
• Development of a research and for purchasing tobacco from 16 to 18; heavily research in the Netherlands. They recently
implementation programme to accelerate increasing the excise tax on roll-your-own launched their research and implementation
the translation of research into practice tobacco; and introducing graphic warnings programme to fast track results from
• Continued development of a patient- on cigarette packets in accordance with the scientific research to clinical application. All
focused cancer knowledge platform1 European Tobacco Product Directive. project proposals are reviewed by patients,
experts and scientists according to the
• Development of an advisory report on In 2016, in their role as EU chair, the Dutch following three criteria: scientific quality,
improving the availability of anti-cancer Minister of Health raised awareness about feasibility, and relevance. Once a project is
medicines within the Netherlands the cost of, and access to, cancer drugs as a approved for funding, DCS remains heavily
• Involvement of the Patient Advisory critical issue. This followed a report entitled involved and their coordinators liaise closely
Committee in the development of cancer ‘Effective new anti-cancer drugs, but the with researchers. DCS is convinced that
activities, including the assessment of funding is creaking at the seams’, published it can create a ‘win–win–win’ situation by
several financing rounds in 2015, and led to the establishment of a launching this programme: more flexibility for
• Substantial investment of over USD 100 European Cancer League taskforce on equal researchers, more tangible results for patients
million in improving prevention, research access to cancer medicines. and the general public, hence more impact.
and patient support activities, with support
Key challenges DCS actively invests in national and
from the Dutch Cancer Society (DCS).
international partnerships, with organisations
While the Netherlands has taken significant and individuals that support its mission,
steps to improve cancer control and care, a lot including the European Cancer League,
of work remains and the DCS would like to see International Cancer Research Partnership and
further measures to: TRANSCAN – a European research network.
• Improve awareness of cancer signs and
symptoms among the general public
to improve rates of early detection and
improve the potential for successful
treatment
Footnotes:
1. www.kanker.nl

Norway
Contributors: Norwegian Cancer Society

Public
activity
Progress against the World Cancer Key challenges UICC Member’s achievements
Declaration targets There are still bottlenecks in the health system The NCS has worked on several areas in
Figures from the National Cancer Registry and as such the Norwegian Cancer Society line with the Declaration’s overall objective
of Norway suggest that close to seven out of (NCS) would like to see further work done of reducing cancer deaths and improving
ten people diagnosed with cancer are alive including: quality of life for those affected by cancer1. It
five years after their diagnosis, and the trends • Improvements in effective cancer diagnosis has been a strong advocate for – and helped
shows a significant increase in cancer survival. as the foundation for treatment. Due to an develop and implement – standardised clinical
At the same time, it is evident that increasingly aging population, it is expected that the pathways for cancer treatment.
more people are being diagnosed with cancer. number of cancer patients will increase in In order to further prevent the uptake of
The main cause is an aging population, but the years ahead and more cancer patients smoking or other tobacco products, the
unfortunately there is also an unfortunate will suffer from co-morbidities. Co- NCS has worked closely with national health
increase in preventable cancers, like lung morbidities typically make diagnosis and authorities to introduce plain packaging for
cancer and melanoma. However, overall, from treatment more difficult tobacco products, in line with the WHO FCTC.
a global perspective, cancer care in Norway is • Increasing the recruitment and training for
good. Access to new cancer medicines has been –
cancer specialists in order to enable the
and continues to be – a hot topic of concern in
health system to provide treatment to the
Key successes Norway and the NCS has taken an active role in
increasing number of patients – as well as
the public debate on this.
Norway’s key success has been the people suffering from other diagnoses
implementation of standardised clinical • Development of new ways of organising Furthermore, in 2015, the NCS supported
pathways on cancer diagnosis for 28 types of the health system to cope with future cancer research with USD 27 million of
cancer. These clinical pathways are expected challenges within the health sector. The funding.
to contribute to faster and better treatment by adoption of innovations and the use of
clearly identifying next steps and the expertise new technologies will be important in this
required to treat cancer cases. regard.
Even in a relatively egalitarian country like
Norway, there are increasing social inequalities
related to cancer risk factors, such as tobacco
use and physical inactivity. This is likely to
contribute to increased differences in patient
outcomes in the years to come.
Footnotes:
1. https://kreftforeningen.no/PageFiles/24/Eng_%C3%A5rsrapport_2015.pdf

Portugal
Contributors: Portuguese League Against Cancer

Public
activity
No data
Declaration targets Portugal’s major successes have focused on LPCC is the only national organisation working
Portugal is constantly updating the guidelines improving access to early detection services across the spectrum of cancers to improve
for diagnosis and treatment in order to improve and prevention materials, such as the national access to accurate diagnosis and effective
care and ensure diagnoses are accurate and breast cancer screening programme. Tobacco treatment. LPCC is currently advocating for
timely. Screening is available nationally for control is also a key focus, and in 2017 equality in access to the national breast cancer
breast, skin and oral cancers. Health education Portugal will host the European Conference on screening programme, that reaches almost
and prevention are core national priorities Tobacco or Health 2017. 100% of Portuguese women. An education
and there are several national and regional project, developed with the Health and
Portugal is also developing its national
projects targeting tobacco use, healthy diets Education ministries, has helped to deliver
palliative care services further in order to
and sun exposure, as well as HPV vaccination. crucial information about cancer within schools
support patients throughout the cancer care
A curriculum has also been developed for and other organisations, and LPCC’s social
continuum.
healthcare professionals, and psycho-oncology media platforms are some of the most widely
services are being developed to support visited in Portugal.
Key challenges
patients and their families. Alongside this, LPCC has developed a psycho-
In order to achieve the Declaration targets, the oncology service that supports not only
Work has been done to reduce stigma and
Portuguese League Against Cancer (LPCC) cancer patients, but also families and carers. In
dispel myths about cancer, with a particular
would like to see further work on: addition, LPCC has been invited to be part of
focus on promoting intergenerational
interventions that bring together people • Reducing the inequalities in access to and several consultative meetings about cancer.
throughout their life course, and reaching uptake of services nationally
previously underserved groups, particularly • Tackling the stigma and myths which
the blind. persist around a cancer diagnosis through
more creative solutions
• Scaling up colorectal and cervical
screening to achieve population-based
screening
• Steps to ensure that palliative care and
home care support are available for all
patients, as this is a growing area of need.

Russian Federation, the
Contributors: N.N. Blokhin Russian Cancer Research Centre; National Society
of Pediatric Hematologists and Oncologists

(Pap smear only)

Public
activity
Progress against the World Cancer Key successes planning for paediatric patients, as would the
Declaration targets development and use of common standards
• Russia acceded to the WHO FCTC in 2008, for diagnosis and treatment of malignant
Russia is making cancer a priority and has and a federal law banning smoking in public tumours in children. These should be based
taken a number of key steps including: places entered into force in 2013 on best practices, drawn from international
• Adoption of the ‘Priority National Health’ • Russia has created clear national examples where needed, with special attention
project and a national project for the frameworks within the federal national paid to pre-malignant syndromes and
modernisation of the healthcare system to target programme ‘Control of NCDs’ and symptoms, as well as rehabilitation for children
develop a three-tier cancer control system sub-programme ‘Oncology’, which was with cancer.
completed in 2012. This was followed
• Federal laws on tobacco control, banning
by the National Health Project, which UICC Member’s achievements
smoking from all public areas; regulating
included cancer control. The roadmap
cancer care for children and adults; and The N.N. Blokhin Russian Cancer Research
for cancer control was adopted by the
improving the availability of palliative care, Centre (Blokhin Centre)1 has improved
government in 2012, reviewed in 2014, and
including for children diagnostics, including CT, MRI, PET, radiology,
provides monitoring of cancer incidence,
• Adoption of guidelines for HPV vaccination survival, death, care, quality and other key endoscopic, genetic and immunological
• Development of screening programmes parameters analyses, and specialised anti-tumour
for cervical, breast, colorectal, lung and therapies utilising high-tech services, such
• Russia has increased the number of cancer
prostate cancers as surgery, radiation, chemotherapy, targeted
hospitals and professional oncologists,
and immunotherapy, that result in increased
• Leveraging World Cancer Day and and the availability of specialist cancer
survival rates; and the Blokhin Centre now
Melanoma Day to raise public awareness diagnostics equipment available nationally,
manages 58,600 outpatient visits per year.
and understanding of risk factors and the number of deaths attributable to
Improving paediatric services is a key
• Organisation of continued medical cancer has been gradually decreasing since
focus and the Blokhin Centre maintains the
education on cancer care for individuals at 2009.
paediatric cancer registry, manages 45,000
all professional levels; paediatric outpatient visits per year, and
Key challenges has worked to dramatically enhance post-
• Publication of annual editions of ‘Cancer
Statistics of Russia and Commonwealth of The authors would like to see an integrated transplantation survival in paediatric patients
Independent States (CIS) Region’. national programme for cancer screening, with poor prognosis.
alongside an increase in the pathological and The Blokhin Centre has increased the number
molecular genetic diagnostics facilities that of research projects conducted, involving ‘next-
are necessary for a personalised anti-tumour generation sequencing’ and microRNA arrays,
therapy approach. and the use of international clinical protocols.
Enhanced financing for anti-tumour drugs They have also increased the number of
will be essential to achieve equality in access training fellowships and projects dedicated to
to cancer care and for the development of building national good clinical practice centres.
modern radiation therapy. In order to achieve Finally, the Blokhin Centre issues annual
this, the authors would welcome prioritising of cancer statistics for Russia and the CIS region,
Footnotes: the national cancer control programme. alongside organising regional conferences
1. www.ronc.ru
Alongside this, the extension of the current such as the RUSSCO and CIS cancer
paediatric cancer registry would assist in congresses , and topical cancer conferences.

Serbia
Contributors: The Faculty of Technical Sciences, University of Novi Sad

Public
activity
No data

Declaration targets • The Ministry of Health and the Office The Faculty’s main activities are education,
Cardiovascular diseases and cancers are the for the Prevention of Malignant Disease research and applied research. Courses are
most common causes of death in Serbia, established the ‘Dr Milan Jovanovic Batut’ run at undergraduate, master and doctoral
and there has been a steady increase in the Institute of Public Health. The Institute has level to train engineers, with a strong
incidence of malignant diseases every year. In organised and implemented programmes emphasis on radiation protection related to
response, Serbia has developed its national in prevention and early detection of environmental exposures and exposures within
cancer programme, which includes the cervical and breast cancers, and colorectal medicine, and medical quality assurance.
following key areas of work: carcinoma at the national level. Research and education in the field of ionising
radiation has a particularly important place at
• Improving public awareness about cancer • Screening started in 2013 and over a five-
The Faculty.
risk factors at home and in the workplace year period, the programmes aim to test
45% of women aged from 45 to 69 years for The Faculty conducts research into low-dose
• Development of screening programmes
breast cancer, 75% of women aged from 25 ionising radiation, with a focus on cancer risk
for cervical, breast, and colorectal cancers,
to 69 years for cervical cancer, and 40% of assessments given the current uncertainty in
which have been rolled out nationally,
men and women aged from 50 to 70 years this area. Seminars on radiation protection, and
accompanied by a strategy to improve the
for colon cancer. quality assurance for diagnostic imaging are
efficacy of diagnostic methods
organised for students, health professionals
• Development of a research framework Key challenges and for interested members of the public, as
spanning the cancer control spectrum, with part of continuing education courses.
a focus on improving oncology treatments The Faculty of Technical Sciences, University of
and available prevention strategies Novi Sad (The Faculty), feels that one of the key
• Development of continuous medical priorities for Serbia would be to strengthen the
education programmes for health capacity of health institutions to improve the
professionals, in order to support accuracy of cancer diagnostics and efficacy
improvements in early detection, treatment of treatment options for malignant diseases.
and prevention. A core element of this will be building the
capacity of the health system to increase the
number of patients that can receive efficient
treatment within facilities delivering secondary
and tertiary prevention.

Slovakia
Contributors: Slovak League Against Cancer

Public
activity
No data

Declaration targets Slovakia has developed its national cancer SLAC would like to see;
Slovakia has taken a number of key steps to control plan, which should be published in • Improvement in the frequency and quality
reduce the national burden of cancer including: early 2017. Alongside this, the National Cancer of data collected as part of the National
Registry is now publishing high quality data Cancer Registry
• Improving early detection of breast, cervical on a regular basis, although with a few years’
and colorectal cancers in partnership • Further work around primary prevention,
delay.
with international organisations such as in particular more effective national
With regards to prevention mechanisms, a lot campaigns focused on schools
WHO, the Association of European Cancer
of work has been done to pass tobacco control
Leagues, and UICC • Development of population-based
legislation including a non-smoking policy for
• Building awareness of cancer risks through screening programmes for breast, cervical
public institutions and public places. Public
public campaigns, leveraging World Cancer and colon cancers, and streamlining of
campaigns have also targeted other well-
Day and the European Week Against the process of starting treatment following
known risk factors, specifically highlighting
Cancer and using recommendations from screening
the need for good nutrition, reduced alcohol
the European Code Against Cancer consumption and increased physical activity, • Improvement in the national introduction of
• Strengthening the national cancer in partnership with schools, the Slovak Media, and access to innovative therapies.
registry through improved data recording Slovak League Against Cancer (SLAC) and the
strategies. Slovak Public Health Authority. UICC Member’s achievements
Although Slovakia does not have a population- SLAC has achieved great progress in cancer
based screening programme, the availability prevention through a school-based cancer
of preventive examinations is very good, education project, launched in 1999. As
and a significant increase in breast cancer part of this, annual training sessions and
stage I cases and a steep decrease in workshops have been held for teachers and
advanced stages has been observed. students to enable them to take part in national
campaigns.
In recent years, SLAC has developed
a psychosocial care programme with
the objective of providing professional
psychological services to patients and their
families, within and external to cancer institutes
and hospitals across the country. In its role as
chair of the European Cancer League’s patient
support working group, SLAC adopted the
Psychosocial Rehabilitation Programme as
a priority within its own work. The aim of this
programme is to help patients to maintain the
physical, social, psychological and vocational
aspects of their life both during and after
treatment.

Spain
Contributors: Asociación Española Contra el Cancer

Public
activity
Progress against the World Cancer Key successes UICC Members’ achievements
Declaration targets There have been two major cancer control AECC has developed a comprehensive
Spain has made progress in two key areas: successes nationally: strategy to achieve a major goal in Spain,
• The extension of the previous law on population-based colorectal cancer screening
• Addressing the need for early detection
tobacco control to ensure more places are programmes as a right for all persons in the
through the provision of universal coverage
smoke-free from 2010 target population. In 2009, only six out of 19
of high quality breast cancer screening
regions had started screening programmes. By
programmes • Inclusion of population-based screening
2015, 17 out of 19 regions had them in place.
• Establishing cancer committees in programmes for colorectal cancer in
hospitals and developing regional the National Catalogue of Public Health The AECC strategy includes several elements:
cancer and palliative care plans in every Services in 2014.
• Establishment of a large alliance
autonomous community, which has helped of scientific organisations, patient
to improve cancer care management. This Key challenges associations and other non-profit entities
follows the standards set out in the National working together to advocate for the
• One of Spain’s major challenges with
Cancer and Palliative Care Strategies. programmes
regards to cancer prevention is the
country’s increasing obesity rates. • Investment in a research project on
• Another challenge is achieving an effective colorectal cancer prevention
model of comprehensive cancer care, one • Lobbying the national and regional health
which is multidisciplinary and integrates authorities to establish the programmes
services that respond to the various needs
• Annual awareness campaigns to inform
that a cancer patient and their family may
people of colorectal cancer and their right
have (physical, psychological, social, work,
to have access to screening programmes
spiritual, rehabilitation, etc.) along the
cancer journey, including palliative care. • An intense campaign mobilising people
This needs to be done in coordination with to sign a petition for the inclusion of these
other sectors including social services and programmes in the National Catalogue
voluntary organisations. of Health Services, which has amassed
more than 560,000 signatures.
• Finally, the Asociación Española Contra
el Cancer (AECC) would like to see Spain
take action to boost cancer research, both
translational and clinical research, as well as
evaluating access to cancer care. It is also
worth noting that Spain does not yet have a
National Cancer Registry.

Sweden
Contributors: Swedish Cancer Society

(Mammogram only) (Pap smear only)

Public
activity
Progress against the World Cancer Key successes Furthermore, action is needed to address the
Declaration targets scarcity of oncology specialists, as evidence
The establishment of six Regional Cancer suggests that age, gender, geography and
Sweden is performing relatively well in the Centres (RCCs) is one of the key successes socioeconomic status have an impact on a
areas of prevention, early detection, treatment of the national cancer strategy in Sweden. In patient’s access to care.
and research. partnership with county councils, these centres
are responsible for creating more patient- Finally, for SCS it is crucial that all cancer
Population-based screening programmes focused and equitable cancer care. Many of patients are offered rehabilitation with suitable
have been developed for breast and cervical the Declaration targets are being met through investments to support these services, as
cancers, and similar programmes for colon, these centres. effective rehabilitation facilitates cancer
prostate and lung cancers are being explored. patients remaining as independent and
The RCCs have also become hubs for productive as possible.
National guidelines for breast, prostate, developing improved processes concerning
colorectal and lung cancers have been cancer, such as defining and implementing
developed as well as clinical practice UICC Member’s achievements
investments targeted at reducing waiting lists
guidelines for several diagnoses. for cancer treatments, and exploring how to For the last ten years, SCS has been
A system has also been established for concentrate the undertaking of advanced advocating for a National Cancer Plan to
incorporating lessons learned into new procedures to a small number of centres. guide cancer control. While cancer outcomes,
programmes and large investments have been particularly mortality and survival rates are
made in building population-based cancer Key challenges good compared to international standards, the
registries. national healthcare system has faced many
The Swedish Cancer Society (SCS) would challenges including shortages in specialised
Approximately 10% of the Swedish population like to see further investments in reducing health workers, fragmented care and long
smoke daily and the government recently risk factor exposure. For example, building waiting times.
endorsed the tobacco endgame target, a on national tobacco control successes
‘Smoke Free Sweden 2025’. It is also exploring and applying measures to reduce alcohol In response, SCS developed an annual report1
plain packaging, point of sale display bans, consumption, unhealthy eating habits, and media campaign2 to highlight the need for
and extended smoking bans in outdoor physical inactivity and exposure to UV a National Cancer Plan to effectively coordinate
environments. radiation. Alongside this, the extension of HPV cancer prevention, education, care, and
vaccination to boys would be a key measure. research. The government decided to hold an
Finally, the HPV vaccination is now universally inquiry tasked with developing proposals for
offered to girls aged 10 to 12 years. Secondly, it will be of great importance for a National Cancer Strategy, and in 2009, the
Sweden to increase the investment in clinical commission submitted the report, ‘A National
and implementation research. New knowledge Cancer Strategy for the Future’3. This included
and new treatments need to reach the patients wide-ranging proposals, the implementation of
faster and more equitably. which are currently ongoing with the support
of SCS.
Footnotes:
1. https://res.cloudinary.com/cancerfonden/image/upload/v1418299886/global/dokument/cancerfonden/cancerfondsrapporter/cancerfondsrapporten2006.pdf
2. www.dn.se/debatt/bostadsorten-avgorande-for-cancersjuks-chans-att-overleva/
3. www.cancercentrum.se/globalassets/vara-uppdrag/a_ational_cancerstrategy_summary.pdf

Switzerland
Contributors: Swiss Cancer League

Public
activity
No data
Progress against the World Cancer Key successes • Develop a cancer survivor programme for
Declaration targets Switzerland’s expected 500,000 survivors
There are several successful prevention and by 2025. These cancer survivors have
Switzerland has focused action on five key early detection communication tools including new and diverse needs that must be met
areas: the ‘prevention bus’ and a ‘smoothie bus’ appropriately
that promotes the consumption of fruit and
• Counselling and training sessions have
vegetables. • Improve the integration of healthcare
been developed to tackle cancer stigma
services and build the competencies of
alongside a ‘cancer and work’ programme. Federal tobacco control and cancer healthcare professionals to deliver these
Switzerland has also used World Cancer registration laws have been passed, and nine services.
Day to demystify cancer, and run a solidarity of the 26 Swiss cantons now have breast
campaign during breast cancer awareness screening programmes.
month
Nationally, there has been a focus on improving
• Information on mammography is freely The Swiss Cancer League has been mandated
cancer information services, which are
available and works in tandem with a to implement the country’s National Strategy
accessible by phone or email and include a
national ‘prevention bus’. Switzerland also against Cancer 2014-2017. To achieve this,
chat service, which is currently used around
has 12 quality certified breast centres the Swiss Cancer League has supported the
4,500 times annually. In addition to this,
following projects:
• External oncology care teams have been personal counselling is available in 19 cantons.
developed along with ‘Madame Tout-le- • Development of a federal law on cancer
Monde’1, which provides resources and Key challenges registration and the building of registries
a chat option for children with questions including data on treatment quality
about cancer. Switzerland has also The Swiss Cancer League would welcome
work in the following areas: • Strengthening the structure and
developed a stop smoking helpline and a
capacities of early detection and
distress fund for cancer patients • Further development of prevention and screening programmes for breast and
• Development of palliative care services, early detection programmes on skin, breast colon cancer including assisting with
information brochures on pain and colon cancers the introduction of breast screening
management and psycho-oncology • Wide use of e-health platforms and programmes and development of a
counselling digital collection of patients’ data to national early diagnosis expert group.
• Education and training for healthcare improve retrieval and assessment. Given • Fostering patients’ self-efficacy
professionals including psychological demographic changes, it would be used • Development of patient care pathways
counselling and seminars for paediatric to track co-morbidities and potential alongside clear guidelines for treatment
oncologists. medication interactions to improve quality and multidisciplinary cancer care teams
of care as well as building greater capacity
for personalised medicine nationally • Health services, clinical and translational
research, epidemiology and monitoring in
order to translate knowledge into effective
practices and policies.
Footnotes:
1. http://madame-tout-le-monde.ch/?lang=fr

Turkey
Contributors: The Turkish Association for Cancer Research and Control;
Turkish Society of Medical Oncology

(Pap smear only)

Public
activity
Progress against the World Cancer Key successes Palliative care investments are due to continue
Declaration targets and there are plans to increase the 1,500
• Development of Turkey’s first national palliative care beds currently available to
Turkey has taken a number of key steps cancer control plan in 2008 2,500. Additionally, it would be important for
towards achieving the World Cancer • The Ministry of Health, in collaboration Turkey to align with the global targets set out
Declaration targets including: with a number of NGOs, has led significant in the WHO Global Action Plan for NCDs, as
• Development of the country’s first national improvements in the number and coverage well as focusing efforts on the newly adopted
cancer control plan in 2008, which was of cancer registries to include 81 cities. This Sustainable Development Goals.
updated in 2013, with the aim of reducing means there is at least one registry in every
major city, which now covers 62% of the UICC Member’s achievements
cancer incidence by 5%
country’s population. Two of these registries TACRC has focused on tobacco control as a
• A 13% reduction in the smoking rate
are already accredited by IARC and it is key area of work since the mid 1970s. Between
from 2008 to 2012 as a result of targeted
expected that a further 20 will be accredited 2012 and 2014, TACRC led the national
legislation and public awareness-raising
by 2025. Moreover, the registry located in coalition against tobacco, which saw the
• Introduction of national salt reduction, İzmir has become a regional training hub expansion and enforcement of tobacco control
obesity control and physical activity for the Global Initiative for Cancer Registry legislation, including smoke-free environments.
programmes by the Ministry of Health Development National statistics showed that tobacco use
• Screening rates have reached 30% for • The government has collaborated closely nationally dropped from 32% in 2008 to 28%
breast cancer, and 80% for cervical cancer with civil society organisations to address in 2012.
• In 2014, Turkey organised a cancer control cancer regionally and internationally
The second pillar of TACRC’s work has
workshop in collaboration with the National • A palliative care programme has been a key been convening and outreach. In 2014, the
Cancer Institute, United States of America. focus of work for the Turkish government European Conference on Tobacco or Health
• The establishment of a National Cancer was organised by TACRC in Istanbul, and
Institute (NCI) in 2015, to coordinate cancer in 2015, Istanbul hosted the World Cancer
research as part of the National Institute of Leaders’ Summit. TACRC has also participated
Health. NCI also coordinates the National in the annual Cancer Patient Conference since
Cancer Programme, which conducts 2006. In parallel, TACRC works to raise public
and supports research across the cancer awareness of cancer, focusing on cancer
control spectrum. prevention in the first week of April each
year and leveraging World Cancer Day on 4
Key challenges February to reach around 15 million people.
The Turkish Association for Cancer Research TACRC also advises the Turkish Ministry of
and Control (TACRC) would like to see Health as part of the National Cancer Council,
further improvements in the implementation supports professional oncology education, and
of tobacco control legislation in cafés and the translation of key oncology resources, such
restaurants to ensure 100% compliance. as the TNM classification of malignant tumours
TACRC would also welcome an increase in and the Cancer Atlas.
the screening rates for breast and colorectal
cancers to achieve 80% national coverage.

United Kingdom of Great Britain and Northern Ireland, the
Contributors: Cancer Research UK; World Cancer Research Fund International

healthcare level (Pap smear only)

Public
activity
Progress against the World Cancer • Ban on tobacco vending machines in 2012, mass media campaigns; reducing the
Declaration targets and creation of ‘Stoptober’ as an annual influence of the tobacco industry; and
mass quitting campaign. In 2015, plain reducing obesity rates in children and
Progress against the targets has been packaging legislation was developed adults
underpinned by National Cancer Plans for
• In 2015, new guidelines were issued stating • A national ambition to achieve earlier
England, Scotland and Wales. The three key
that, in terms of cancer, there is no safe limit diagnosis for cancer patients
areas of progress have been:
for alcohol consumption. The suggested
• Screening and early diagnosis – the • Giving equal weight to patients’ experience
units for men have been reduced, and
‘National Awareness and Early Diagnosis of care, clinical effectiveness and safety
pregnant women have been advised not to
Initiative’ in England and ‘Detect Cancer drink • Transforming support for people living with
Early’ in Scotland both aim to improve cancer and cancer survivors
• Public Health England launched a new
overall five year survival by tackling barriers • Investing in modern high quality services
Eatwell Guide to help promote healthy
to accessing cancer diagnoses, such as
diets, in line with World Cancer Research • Overhauling the way the National Health
awareness of symptoms, and streamlining
Fund recommendations stemming from the Service commissions and provides
the referral process from general
‘Continuous Update Project’ services, including addressing waiting
practitioners
• In 2008, the ‘National Awareness and times and sourcing data on access to
• In both England and Scotland, treatment.
Early Diagnosis initiative’ was launched
governments have launched strategies
in England, followed by the ´Be Clear
on alcohol and tobacco to reduce cancer
on Cancer´ series of public awareness UICC Member’s achievements
risks, with the Scottish Government also
campaigns in 2010
setting a tobacco-free generation ambition. Cancer Research UK (CRUK) plays a leading
Moreover, in 2013, the UK Government • 2011 saw the launch of the ´Improving role in beating cancer sooner by conducting
introduced voluntary front of pack colour- Outcomes´ national cancer plan in research into all 200 types of cancer,
coded labelling for food and drink products England, followed in 2015 by the launch of educating the public, engaging with healthcare
and will develop an obesity strategy in 2016 a subsequent plan, ‘Achieving World-Class professionals and informing government policy.
Cancer Outcomes’ In 2015, Sir Harpal Kumar, CEO of CRUK, led
• The Radiotherapy Innovation Fund has
improved access to radiotherapy. • In 2016, the UK National Screening the taskforce that produced England’s new
Committee issued updated cancer strategy – ‘Achieving World-Class
recommendations, including using the Cancer Outcomes’. CRUK also co-chaired
Key successes
Faecal Immunochemical Test for bowel the ‘National Awareness and Early Diagnosis
The UK has taken a number of key actions cancer screening, and HPV as the primary initiative’.
covering risk factors, public awareness and test for cervical cancer.
Alongside this, CRUK has campaigned to
establishing frameworks for treatment, these
reduce exposure to risk factors, for example
include: Key challenges through standardised packaging of cigarettes
• Introduction of HPV vaccination for 11-12 The authors would welcome work on the and a ban on the use of sunbeds by under
year old girls in 2008, and a ban on the use following priority areas: 18s. Another campaign has helped to ensure
of sunbeds by under 18s in all countries of targeted investment in innovative radiotherapy
the United Kingdom, between 2009 and • A renewed focus on prevention and a across the UK, which has significantly
2012 public health approach to cancer including; increased uptake.
achieving a tobacco free UK; securing
funding for public health services including

Ukraine
Contributors: The National Cancer Institute

Not generally available in Not generally available in
primary healthcare level at public primary No data
the public health system the public health system
(clinical breast exam only) healthcare level

Public
activity

Declaration targets Cancer control in Ukraine has made major NCI has developed a national plan entitled
Ukraine has undertaken a number of key headway through the development of: ‘50 steps against cancer in Ukraine’ alongside
actions to improve cancer prevention and • A National Cancer Registry working with the government to pass the
control nationally: ‘National programme for the fight against
• National mobile clinics that can perform
cancer by 2016’ into law. One key measure has
• HPV and HBV vaccination are covered by diagnostics and offer treatment for cancer
been the provision of mobile clinics nationally
universal vaccination programmes and patients have significantly improved access
which provide screening services, and the
public lectures are held to provide people to cancer care nationally
development of new national standards for the
with further information. Lectures are also • New nano- and biotechnologies for diagnosis and treatment of patients.
held on cancer prevention, and signs and diagnostics and treatment of cancer
symptoms in order to improve rates of early The National Cancer Registry is coordinated by
patients1 offers exciting new opportunities
diagnosis NCI and documents cancer cases nationally,
to tackle cancer nationally.
contributes to worldwide cancer statistics
• Mass media campaigns on television and
and provides monitoring data on the quality
in newspapers have focused on dispelling Key challenges of diagnosis and treatment of cancer patients.
damaging myths and misconceptions
The National Cancer Institute (NCI) would like NCI also provides training and workshops
about cancer
to see a further focus on screening and early for oncologists, develops standards for the
• Ukraine is also working to develop nano- diagnosis and treatment of cancer patients
detection for cancer in order to build on the
and biotechnologies for more effective and has developed a new magazine entitled
work that has already taken place. NCI would
diagnostics and treatment of cancer ‘Clinical Oncology’ to provide oncologists with
also like to see further work on environmental
patients. regular updates.
cancer risks.
Footnotes:
1. Orel V, Shevchenko A, Romanov A, Tselepi M, Mitrelias T, Barnes CH, Burlaka A, Lukin S, Shchepotin I. Magnetic properties and antitumor effect of nanocomplexes of iron oxide and
doxorubicin. Nanomedicine. 2015 Jan;11(1):47-55

Percentage of Cancer Cases Attributable to Infection
HPV Vaccination Many of the most common cancers are

at least partly attributable to infection.
PERCENTAGE OF NEW CANCER CASES CAUSED BY INFECTION
AND TOTAL NUMBER OF NEW CASES
HPV infection is responsible for
approximately 630,000 cancer cases
The two leading Worldwide, infectious agents are responsible for an Not attributable to infection
per year, with a disproportionate burden
estimated 2.2 million cancer deaths annually. The in low- and middle-income countries8.
cancer-causing infections burden of infection-related cancers is much higher in Number of cases
Given that 70% of cervical cancers and
attributable to infection
are Hepatitis B (HBV) and less developed regions; estimates suggest that up to
precancerous lesions are attributed to
50% of cancers in sub-Saharan Africa are attributable
the Human Papillomavirus to infections7.
infection by two strands of HPV9, the
immunisation of adolescent girls has
(HPV), which are both vaccine the potential to significantly reduce
preventable. Cervix
Nearly 100%
Liver national cancer burdens and mitigate the
of 530,000 77% of 750,000 devastating impact on patients and their
families.
“Very high-coverage programmes have

Target 4 been demonstrated to be achievable in
less developed countries like Rwanda Estimated Incidence of Cervical Cancer (Age Standardised Rate [World]
and Bhutan. However greater efforts Per 100,000) In Females, 2012
are necessary to improve coverage and
bring cheaper HPV vaccines to less
developed countries especially in Sub-
10.0 or less 41.9 or more No Data
Saharan Africa and Asia.”
Universal coverage of HPV Silvia Franceschi, Head Infections
and HBV vaccination and Cancer Epidemiology Group, Resource: RHO Cervical
International Agency for Research Cancer
on Cancer (IARC) PATH’s RHO Cervical Cancer
website is designed to provide
easy access to science-based
information for health programme
managers and decision-makers
seeking to prevent cervical cancer
Prevention and Control of NCDs in low-resource settings. The site
calls for vaccination against By 2016, 65 countries had introduced includes an action planner and
human papillomavirus, as HPV vaccines, although these were a library of key cervical cancer
appropriate if cost-effective and predominantly high-income countries. resources.
affordable, according to national Across countries, coverage rates vary
programmes and policies. from less than 30% to more than
80%, highlighting serious barriers for
adolescents to access the HPV vaccine10. 7
Plummer et al. (2016) Global burden of cancers attributable to infections in 2012: a synthetic analysis http://www.thelancet.com/journals/langlo/article/
PIIS2214-109X(16)30143-7/abstract [Accessed 19.08.16]
8
9
WHO, HPV and cervical cancer http://www.who.int/mediacentre/factsheets/fs380/en/
10

Estimated Incidence of Liver Cancer (Age Standardised Rate [World]
HBV Vaccination
Per 100,000) In Males, 2012
6.8 or less 40.3 or more No Data
Safe, effective and affordable HBV infection is responsible for approximately

420,000 cancer cases per year, infections are broadly
vaccines are available, and distributed in line with global income levels, with
programmes have been higher incidences of HBV infection seen in low- and
middle- income countries11.
shown to be highly cost-
effective in preventing some
of the most common cancers,
across a range of income
settings.
“A highly effective HBV vaccine for
infants was introduced nationwide
Target 4 in 184 countries by the end of 2014.
A birth dose, which is essential to
prevent mother-to-child transmission,
was introduced in 96 countries and
global coverage was estimated at 38%,
reaching 80% in the Western Pacific
region, but only 10% in the Africa region,
Universal coverage of HPV suggesting that high coverage rates are
and HBV vaccination achievable, but concerted efforts are
needed by countries to achieve this.”
Silvia Franceschi, Head Infections
and Cancer Epidemiology Group,
International Agency for Research
on Cancer (IARC)
Getting involved: Gavi
Gavi, the Vaccine Alliance, has played a catalytic role in supporting country demand for two key anti-
cancer vaccines - HBV and HPV. Between 2000 and 2014, the Gavi-supported pentavalent vaccine, which
calls for prevention of liver cancer includes HBV, was introduced by 73 low-income countries into their routine immunisation programmes.
through Hepatitis B immunisation. Through its 2016-2020 strategy, Gavi will continue to support countries to increase the HBV coverage.
Since 2013, with Gavi support, one million girls have been reached with the HPV vaccine that protects
Globally, it is estimated that there against two strains of the HPV virus, which cause 70% of cervical cancer cases. Gavi’s efforts help to ensure
is 82% coverage with three that adolescent girls, a group often facing challenges when accessing health services, are protected from
doses of the HBV vaccine, cervical cancer and are receiving other essential health services.
and this is as high as 92% in the

Western Pacific Region12.
11
12
Plummer et al. (2016) Global burden of cancers attributable to infections in 2012: a synthetic analysis http://www.thelancet.com/
journals/langlo/article/PIIS2214-109X(16)30143-7/abstract [Accessed 19.08.16]

Argentina
Contributors: Liga Argentina de Lucha Contra el Cáncer

Public
activity
Declaration targets The most significant achievement for Argentina Liga Argentina de Lucha Contra el Cáncer
Argentina has addressed several of the is the provision of free access to healthcare. (LALCEC)1 has one of the strongest and most
Declaration targets through national cancer The country has legislated to protect the extensive national networks, which works to
laws, as part of a strategy to achieve universal rights of patients in accessing diagnostic, ensure that the entire population has access
access to cancer services. Alongside this, treatment and rehabilitation services, with to timely and accessible cancer screening and
the specific activities of the National Cancer the aim of ensuring that individuals from all early detection services. LALCEC also aims
Institute (INC) have contributed to progress socio-economic backgrounds have equitable to improve patient records, provide health
made against other Declaration targets. access to essential medicines, mandatory education and ensure that campaigns reach
vaccinations and transplants. the whole population.
Furthermore, Argentina has in place national
cancer control plans, that support the A further success has been the devolution LALCEC’s advisory board is comprised
implementation of cancer control strategies of cancer control activities to the INC, which of a multidisciplinary group of national
and efforts to reach the Declaration targets. has subsequently been able to manage and experts, which offer recommendations to the
The most high-profile plans are those relating give focused attention to the establishment Government and health planners, particularly
to maternal health, colorectal and cervical of cancer registries, cancer education and around the reform of health legislation. It also
cancers, with the aim of improving prevention, national cancer research. helps to support and conduct cancer research.
diagnostic and treatment services. To help Finally, for many years, LALCEC has actively
achieve the targets, the plans include the Key challenges engaged with international organisations to
development of a cancer registry and an improve national cancer control2. For example,
The key challenge for Argentina is to ensure
emphasis on the need to invest in training of recently, LALCEC worked with the American
that there is continued action including in the
healthcare professionals and researchers. Cancer Society, UICC and IARC to produce the
following areas:
A number of national campaigns have been Spanish edition of the Cancer Atlas3.
• Enforcement of laws to ensure that the
run to deliver education to the general public
population has access to timely and
on cancer risk factors, when and how to access
efficient cancer services
health services, and to dispel myths and
misconceptions around cancer. • Ratification of the WHO FCTC. Argentina
is one of the few countries to sign, but not
ratify the convention
• Improving the coverage of cancer
programmes, as many of the most
effective projects or campaigns have been
implemented only in large cities
• Empowering cancer patients to take
advance of the services and legal
protections available to them.
Footnotes:
1. www.cancer.org.ar
2. www.alicc.org
3. http://canceratlas.cancer.org/

Barbados
Contributors: The Myeloma, Lymphoma and Leukaemia Foundation of Barbados;
Ministry of Health of Barbados; Barbados National Registry; SickKids Caribbean Initiative
300 300 Yes Population-based 87% No data

Public
activity
Progress against the World Cancer Key successes the dangerous misuse of hazardous
Declaration targets chemicals, fertilizers, pesticides and the
• The establishment of the population- improper disposal of waste material that
• The Ministry of Health (MoH)1 focuses on based Barbados National Registry and its can cause cancer, as well as the effect
NCDs, including cancer, as a budgeted surveillance system to monitor cancers of poor nutritional habits, bad lifestyle
item within the National Strategic Plan and and inform new and innovative methods of choices, illicit drugs and alcohol.
NCD Action Plans. Work has started on a healthcare delivery
draft National Cancer Plan concentrating • The 2010 legislation on tobacco control UICC Member’s achievements
on breast, colon, cervix and prostate has maintained a relatively low rate of
cancers smoking and concomitant low rate of lung The Myeloma, Lymphoma and Leukaemia
cancer revealed by successive NCD risk Foundation focuses on education, advocacy
• The Barbados National Registry
factor surveys (2007-2012) and data from and the welfare of the patient and their families.
retrospectively reports on cancer cases
the Queen Elizabeth Hospital Awareness and educational workshops are
from information compiled from multiple
held regularly across Barbados through
sources2. The MoH also collaborates with • SickKids-Caribbean Initiative is a
schools, churches, service clubs, health
NGOs to provide case finding services partnership between The Hospital for
fairs, and with the general public. Information
• Barbados has a well developed healthcare Sick Children-Canada, the University of
is delivered by print and electronic media,
system providing care to all citizens free the West Indies, Ministries of Health and
handouts, and by interaction with the public.
of cost hospitals from six Caribbean countries. It
works to create an educational forum for Twice weekly routine visits are made to the
• Legislation has been passed that bans
specialists to share information that will, haematology clinic at the Queen Elisabeth
smoking in public places and the sale of
and has, impacted the lives of children with Hospital to educate, counsel and monitor the
tobacco to and by minors
paediatric cancers and blood disorders in patients’ needs. The Foundation collaborates
• HBV vaccinations are part of routine Barbados and the Caribbean3. with doctors and the MoH on the patients’
childhood immunisations and the HPV behalf and also with other NGOs to share best
vaccine has been offered to pre-teen boys Key challenges practices. Upon request, financial assistance
and girls since 2014 is given to patients to purchase medicines
• Barbados is planning to implement • Completion of the National Cancer Plan and to meet other medical and non-medical
population-based screening for cervical and implementation of its activities for expenses.
cancer. Currently, screening for cervical prevention, population-based screening
for the most common cancers, as well The Foundation served on the Barbados
cancer is opportunistic or voluntary
as improving timelines for diagnosis, National Registry Technical Advisory
with Pap smears, with mammograms or
improved treatment and care committee from 2011-2013.
ultrasound for breast screening, PSA or
digital testing for prostate cancer and • High pricing of cancer drugs by the
follow-up of suspicious symptoms for manufacturers is of deep concern, and a
colon cancer. global approach is warranted
• NGOs must continue to raise awareness
and provide health education.
Communities must be made aware of
Footnotes:
1. www.health.gov.bb
2. www.bnr.org.bb

Belize
Contributors: Belize Cancer Society
90 60 No No 95% Yes


Public
activity

Declaration targets Cancer is now acknowledged to be a problem BCS has built effective partnerships with the
• Belize provides a cancer prevention in Belize and the country is moving ahead Ministry of Health to help deliver cancer control
package to the proportion of the with activities for a cancer control plan. Major initiatives including:
population (approximately 50%) that successes include: • The development of a draft cancer plan
benefit from national health insurance • Development of preventative packages of and supporting the development of the
coverage care, as well as cancer screening, which is NCD Strategy and Action Plan. The BCS
• The diagnostic capacity of the country has offered at all public health centres President is a commissioner on the NCD
improved, with an increase in the human Commission
• The country has taken on the
resources available to manage cancer responsibility, with support from the Social • stablishing a National Cervical Cancer
E
diagnoses and interventions Security Board, to provide funds for the Committee
• Chemotherapy was introduced to the management and treatment of cancer in • Engaging in advocacy and discussions on
country by two philanthropists, oncologist children in Mexico and the procurement of the establishment of a cancer registry
Dr. Ellsworth Grant and Dellone Pascascio HPV vaccines. • Supporting national Pap smear
RN, who have provided training to local campaigns.
nurses on chemotherapy. This has enabled Key challenges
increased access to cancer treatment for BCS has also conducted fundraising activities
poor people, who would have otherwise BCS has identified the following three priorities to ensure that they are able to sustain their
been unable to access treatment services that will be critical to achieving the Declaration work, and partnered with the Belize Family Life
targets by 2025: Association and other NGOs, to carry out joint
• Education on cancer risk factors and
vaccinations has been provided by the health promotion activities. The partnerships
• The establishment of a national cancer
Belize Cancer Society (BCS) and other with the Healthy Caribbean Coalition and
plan and the urgent development of a
partners. The Ministry of Health will add UNESCO have enabled the BCS to build its
population-based cancer registry
the HPV vaccine to the national vaccination capacity and thereby sustain a number of
• Educating a critical mass of healthcare activities on cervical cancer. BCS is currently
schedule in September 2016, targeting professionals to manage cancer and
girls aged nine throughout the country the only organisation that is able to provide
deliver care, with a particular focus on information on cancer on a regular basis.
• The national drug formulary for Belize resident oncologists and oncology nurses
includes morphine and other medicines • Establishing an NCD Secretariat with
required to treat and manage cancer. focal points responsible for cancer and
dedicated budgets.

Bermuda
Contributors: Bermuda Cancer and Health Centre

Public
activity
Declaration targets In 2011, the Bermuda Health Council reported The Centre is a leading mammography facility
Through national collaboration between the that the island had the lowest daily smoking that offers the latest digital technology. As one
Department of Health, Bermuda Hospitals rate of all countries in the OECD . This was of the island’s oldest charities, the Centre is
Board, Bermuda Cancer and Health Centre attributed directly to the introduction of pleased to be able to offer all of the available
(the Centre) and other NGOs, a number of the 2006 no-smoking legislation. Recent services to uninsured or underinsured men
projects have been delivered contributing legislation has been passed that imposes and women through its Equal Access Fund.
to progress towards the Declaration targets. additional restrictions, including the use of Services provided include screening and
These include awareness campaigns, notably e-cigarettes. diagnostic mammography, breast and prostate
focusing on breast, cervical and colorectal biopsy, as well as ultrasound examinations of
NGOs are actively involved in raising cancer
cancers, and educational presentations to soft tissue including the pelvis, abdomen and
awareness, such as the Centre’s school-based
both health professionals and the general thyroid. By ensuring these examinations are
prevention programmes for sun protection
public. By partnering with the Health Insurance available to everyone, the Centre provides the
(SunSmart) and the dangers of tobacco
Association of Bermuda, the Massachusetts best opportunity for early detection; which in
(LungSmart). Through these programmes,
General Hospital and Partners International, turn improves patient treatment options and
cancer education is offered to thousands
the island has been able to deliver the Bermuda long term survival. The Centre also provides
of school children each year. It appears that
Cancer Genetic Risk Assessment Programme coverage for uninsured women who attend the
through consistent awareness campaigns,
since 2006, which provides screening for high- Department of Health Women’s Clinics for their
the stigma surrounding a cancer diagnosis
risk families with breast and/or ovarian cancers. gynaecological exams and Pap smear tests.
is declining, evidenced by the numbers
Furthermore, in 2006, legislation was enacted of persons openly sharing their stories via
to prohibit smoking in enclosed public spaces newspapers and other media.
including restaurants, bars and hotels. Most Finally, a collaboration between Bermuda
recently, through a partnership with the Hospitals Board and the Centre means the
Department of Health, the Centre has provided country is now poised to offer radiation therapy
access to the HPV vaccine for those unable to on the island for the first time.
afford it.
Key challenges
One of the key challenges in Bermuda is the
lack of mandatory reporting. While most
physicians and other relevant reporting
agencies do submit data to the Bermuda
National Tumour Registry, there are a number
of facilities from which data is either not
reported at all, or not submitted in a timely
manner. Systematic collection and analysis
of data is essential to developing an accurate
Footnotes: assessment of the cancer burden in a
1. www.oecd.org/about/
population group.

Bolivia, Plurinational State of
Contributors: Fundación Contra el Cáncer


Public
activity
Progress against the World Cancer Key successes population-based screening for cervical
Declaration targets cancers. Finally, the absence of suitable
Bolivia’s major success has been in improving equipment for the treatment of cancers,
The Bolivian government has implemented awareness of, and participation in, cervical resulting in suboptimal or a lack of treatment,
a series of measures aimed at reducing the screening activities. This has seen civil society perpetuates the fear and stigma around a
high incidence of cervical cancer. These groups and the government work to improve cancer diagnosis, particularly for cervical
measures include a Maternal and Child Health the general public’s understanding of the cancer.
Programme that provides free care and need for periodic cervical screening in order
financial remuneration to pregnant women who to reduce women’s risk of contracting cervical
attend all prenatal checkups, including a Pap cancer. Integration of screening services with
smear. By law, all employers are required to more routine health checks has helped to From 2010 to 2014, with support from the
provide female staff with a day off every year for increase uptake. American Cancer Society, FCC conducted a
a Pap smear, and mammography if necessary. series of activities including education talks,
Key challenges health fairs, and workshops. These activities
Provisions have also been made for the resulted in improved awareness in both
establishment of a national cancer registry with The main challenge in Bolivia is the need to rural and urban areas regarding the need for
the support of Sociedad de Lucha Contra el address shortfalls in cancer services. For regular cervical cancer screening, as well as
Cancer in Ecuador. cervical cancer, as an example, this will require the establishment of a coalition of institutions
improving education and public awareness to who have worked together to introduce annual
help individuals reduce their own risk factor cervical examinations across the country. By
exposure, and for the signs and symptoms of 2014, approximately 8,500 Pap smears had
cancer to be recognised early. Poor awareness been performed within medical facilities and
leads to late or no formal diagnosis for cervical over 26,000 women had been screened in their
cancers in many instances. Cervical cancer communities, with 1,037 positive results.
prevalence in Bolivia is currently 56 cases per
100,000 population. There are also key socio-
cultural and economic barriers to accessing
services at health centres, particularly in
rural areas. It is estimated that only 13% of
the at-risk population are screened, falling
short of the goal of 90% screening coverage.
Fundación Contra el Cáncer (FCC) would
welcome efforts by the Bolivian government to
improve the distribution of health centres, and
ensure appropriate data collection and referral
systems to ensure that patients receive an
accurate diagnosis and the care they require
in a timely manner. There is also a need for
national programmes that focus on regular

Brazil
Contributors: Instituto Nacional de Cancer; FEMAMA; Fundação do Câncer

(Pap smear only)

Public
activity
Progress against the World Cancer Key successes is older, with greater economic development
Declaration targets and an incidence of cancer two or three times
Brazil has made important advances in higher. Thus, the greatest challenge would
Key actions that have been taken in Brazil tobacco control that have resulted in a be to develop specific action plans tailored
include: considerable reduction in smoking prevalence. to address these regional cancer profiles. An
Since 2008, these measures include: example of a regional plan was developed
• Development of the Strategic Action Plan
to address NCDs in Brazil (2011-2022), • Educational activities about the harms of by the state of Rio de Janeiro in 2013, in
which sets targets for cancer control tobacco use collaboration with the state Health Secretariat,
the Instituto Nacional de Cancer (INCA) and
• Updating of the National Policy for • Improvement of the law to establish
the Fundação do Câncer.
Prevention and Control of Cancer to smoke-free environments
strengthen the guidelines for organisation • Ban on advertising of tobacco products,
of the healthcare network, including UICC Member’s achievements
including at the point of sale
revision of the parameters and criteria for Since the late 1980’s, INCA has been
oncology services, which help identify • Adoption of minimum price for cigarettes
and a tax increase responsible for the management and
where services should be developed based governance of tobacco control in Brazil,
on registry data • Improving access to tobacco cessation overseen by the Ministry of Health. INCA
• Tobacco control measures have reduced treatments in the public health system. coordinates the National Tobacco Control
the prevalence of smoking from 34.8% Brazil has also made some significant Programme and acts as the Executive
(1989) to 14.7% (2013) and increased the improvements in the quality of their Secretariat for FCTC implementation in Brazil.
provision of treatments to help tobacco population-based cancer registries. According INCA has also joined the team established by
cessation to IARC criteria, 84% of these registries in the World Health Organization to eradicate
• The national coverage of HBV in Brazil is Brazil are classified as high quality (A and B). childhood obesity, due to evidence of the
more than 97% in individuals under 15 The 26 population-based registries cover 90% relationship between obesity and cancer.
years of age. Since 2014, the quadrivalent of the population living in capitals and 25% of INCA also formulates evidence-based
HPV vaccine is offered for girls aged 9-13 the Brazilian population in total. Also, 93% of guidelines, such as for breast and cervical
years oncology hospitals have operating registries cancer, as well as developing and managing
• Investments have been made to improve with consolidated country data, and their information systems to support surveillance,
the quality of the Pap test and treatment of coverage rose from 35,000 cases in 2007, to 2 such as the population-based and hospital
precancerous lesions. million cases in 2015. cancer registries. It assesses quality in
radiotherapy in Latin America using postal
Key challenges audits, and offers courses for workers of the
Across Brazil’s five geographical regions, there Unified Health System, including Master’s
are unique patterns of mortality and morbidity and Doctoral programs in Oncology. Finally,
for chronic diseases, including cancer. it coordinates the national registry of bone
This is due to differences in demographic marrow donors, which includes more than 4
structure, access to health services, speed million individuals.
of socioeconomic change, and quality of
information and lifestyle. In comparison to
the north region, the population of the south

Canada
Contributors: Canadian Cancer Society; Alberta Cancer Foundation; Canadian Partnership Against
Cancer; Public Health Agency of Canada; Department of Oncology at McGill University

(mammogram only) (Pap smear only)

Public
activity
Progress against the World Cancer • Canada offers universal HBV vaccination and • Support and services for patients, families
Declaration targets all provinces and territories now offer HPV and survivors
vaccinations to girls; some provinces also • Infrastructure, including diagnostic and
Canada continues to make strides in reducing offer this to boys treatment facilities, cancer care centres and
exposure to cancer risk factors. The new
• All provinces offer organised cervical and community-based care
federal government has made commitments
breast cancer screening programmes, and • Implementation of screening programmes
to introduce plain packaging rules for tobacco,
many have introduced colorectal cancer
extend a federal ban to menthol flavoured • Provision of education and training for health
screening programmes
tobacco products, promote healthier eating by and medical specialists
restricting the marketing of unhealthy foods to • Data partners, such as the Society, Statistics
• Research on cancer care planning and
children, strengthen regulations on trans-fats Canada, and the Public Health Agency of
effective policy development.
and salt, and improve food nutrition labels. Six Canada, monitor and report on Canadian
provinces are now in the process of implementing cancer statistics. The Canadian Partnership Continued collaborative action is also needed
bans on flavoured tobacco, including menthol. for Tomorrow Project portal offers access to to ensure sustainability of cancer control and to
All provinces have introduced or announced longitudinal data to help understand cancer minimise dispartities in patient experience and
legislation to ban the use of indoor tanning beds and other NCD causal factors. More broadly, access to services.
by minors. cancer system performance reporting has
been improved through the more effective UICC Member’s achievements
Collaborative pan-Canadian action is also helping
use of existing data sources such as registries
to drive system-level change. Examples include Last year, the Society released Canadian Cancer
the Canadian Strategy for Cancer Control that • New initiatives at the federal and provincial
Statistics 20151 with a focus on the future burden
brings together different cancer control actors to level have improved financial and employment
of cancer in Canada. There will be a dramatic
reach common goals, and the Canadian Cancer support for those affected by cancer and their
rise in the number of cancer cases by 2030 as
Society’s (the Society) advocacy work to improve families
a result of an aging and growing population.
Canada’s palliative care services. • The establishment of the Canadian These projections can help plan and set priorities
Partnership Against Cancer has brought in prevention, early detection, treatment,
together national and regional authorities psychosocial, palliative and medical care, and
Key successes and organisations across Canada to optimise research. The understanding of the future burden
• Canada has made significant progress in effectiveness and efficiency of action across was also the foundation of the Society’s federal
tobacco control since 2008, demonstrated by the cancer control continuum election priorities2, which called for a stronger
its lowest smoking rate to date of 15% • A collaboration with First Nations, Inuit and tobacco control strategy, guaranteed access
Métis partners has been developed and is to palliative care3, and long-term investment in
Footnotes: helping to implement the First Nations, Inuit health research.
1. www.cancer.ca/~/media/cancer.ca/CW/cancer%20
information/cancer%20101/Canadian%20cancer%20
and Métis Action Plan on Cancer Control.
The Society also funds cancer research, with
statistics/Canadian-Cancer-Statistics-2015-EN.pdf?la=en
2. www.cancer.ca/~/media/cancer.ca/CW/for%20media/ $38 million (USD 29 million) invested in 20154.
Media%20releases/2015/ccs-election-platform-June- Key challenges This included $6.3 million (USD 4.8 million)
2015-EN.pdf?la=en
3. www.cancer.ca/~/media/cancer.ca/CW/get%20involved/ The aging and growing Canadian population that focused solely on prevention research and
take%20action/Palliative-care-report-2016-EN.pdf?la=en
4. https://issuu.com/canadiancancersociety/docs/ccsri_ will lead to a dramatic increase in the number $3.5 million (USD 2.66 million) for quality of life
rir2015_en_jul2016_hires-fori?e=1256214/37135090 of cancers diagnosed. Given this, there is an research.5
5. https://issuu.com/canadiancancersociety/docs/ccsri_
rir2015_en_jul2016_hires-fori?e=1256214/37135090 urgent need for coordinated and comprehensive
planning to improve:

Chile
Contributors: Ministry of Health of Chile

(Pap smear only)

Public
activity

Declaration targets The incremental introduction of cancer related Chile has worked extensively since the 1980s
Chile has developed many public health conditions within Plan GES has been the to develop its cancer control strategies,
policies to reduce exposure to cancer risk most remarkable policy development of the including seminal programmes for the early
factors, including those on: past ten years. Plan GES includes cancers detection and treatment of breast, cervical
such as; breast, cervical, stomach, prostate, and childhood cancers, alongside palliative
• Tobacco free spaces, tax increases and testicle, colorectal, epithelial ovarian, bladder, care. In the mid-2000s, there was a significant
advertising regulations osteosarcoma, leukaemia, lymphoma, and all improvement in cancer treatment, particularly
• Obesity control through front-of-package cancers for children aged 15 years or less. It since the introduction of Plan GES. This
labelling of food, advertising regulations, also includes a preventive cholecystectomy ensures timely access to quality services and
restrictions on sale of food in schools, and for people between 35 and 49 years old, financial protection for a list of 80 prioritised
a sugary drinks tax and treatments for risk factors such as health conditions, including 17 related to
• Strict regulations on air and soil alcohol dependency, hepatitis B and C, and cancer, palliative care and pain control.
contaminants helicobacter pylori infection. For all these Following on from its implementation, the
elements, Plan GES ensures access, quality Ministry of Health has witnessed an increase
• Universal coverage of HPV vaccination for standards (clinical guidelines and accreditation in incidence and a decrease in both total age-
all girls between nine and ten years old. of services), financial protection (virtually adjusted mortality and inequities in mortality
Screening services for cervical and breast free in the public sector for almost 80% of outcomes.
cancer are available for all women in the the population), and timeliness by defining
country within defined age groups maximum waiting times for each condition.
• A national plan for medical specialists has
been developed that covers all cancer- Key challenges
related specialists.
Chile is in the process of revising its cancer
Chile has six population registries (three of control structure through the development
which are accredited by IARC) and one is a of a new National Cancer Prevention and
national registry for childhood cancers. Chile Control Plan for the upcoming years. This will
also has robust vital statistics and health address a diverse range of areas including
system information infrastructure. Finally, the promotion, prevention, early detection,
Plan of Explicit Guarantees in Health (Plan treatment, rehabilitation and palliative
GES) has built on this through ensuring access care. The plan is being developed with an
to cancer care. integrated healthcare networks perspective,
a patient-centred approach, and a social
determinants action-oriented framework. The
plan also covers cross-cutting issues, such
as human resources, knowledge generation
and management, and financing. Whilst this
is a challenging task, the Ministry of Health is
developing this plan with the support of other
key stakeholders and international partners.

Colombia
Contributors: Instituto Nacional de Cancerología; Instituto de Cancerología S.A;
Liga Colombiana Contra el Cáncer; Registro Poblacional de Cáncer de Cali de la Universidad del Val

Public
activity
Progress against the World Cancer Key successes • Removing administrative barriers causing
Declaration targets delays in diagnosis and initiation of
• Colombia has established four population- treatment
Colombia has made significant progress based cancer registries in Cali, Manizales,
Pasto and Barranquilla, and contributed • Implement the HPV DNA test in line with
in tackling cancer with legislation outlining
data to the ‘Cancer Incidence in Five Ministry of Health recommendations
citizens’ rights to cancer services. Laws also
define obesity and NCDs as public health Continents’ report1 • Further research on carcinogen exposure
priorities, support implementation of the FCTC • These registries have been unified within leading to tailored policy responses
recommendations, including public policies for a national information system on cancer • Improving coverage of screening
tobacco control (such as tobacco-free spaces), (SinCan). Through CAC, these data programmes nationally
and outline the obligation to establish tobacco are used to report on cancer progress
• Improving acceptability and coverage
cessation services. nationally. Further work has been done
of the HPV vaccine, which has fallen
to monitor clinical outcomes and survival
In addition, Colombia has developed and significantly, through a coalition between
determinants for children with cancer
adopted the National Cancer Control Plan the Ministry of Health, Instituto Nacional de
through the Vigicancer project2
2012-2021, in conjunction with legislation Cancerología (INC) and Liga Colombiana
that establishes standards for comprehensive • The implementation of tobacco control Contra el Cáncer
cancer control services, including palliative measures, including the creation of
care. Development of a health information smoke-free public places to protect non- UICC Member’s achievements
system on cancer has also been a key priority. smokers and a ban on selling cigarettes to
The Colombian High Cost Disease Fund – High underage persons INC has provided training for general doctors,
Cost Account (CAC) is a technical agency that • Colombia has also reached its aim of radiologists, pathologists and technicians in
collects and validates data to help evaluate and reducing cervical cancer mortality, with 6.5 14 major cities, focused on quality control
inform policy decisions nationally. cases per 100,000 women in 2013, in line of mammography services and screening
with the world standardised mortality rate techniques. In line with this, INC has conducted
HPV vaccination for all girls aged nine and HBV a review of the availability of mammography
vaccination for newborns is now obligatory, and • Civil society groups are coordinating to services across Colombia with the intention
Colombia has achieved reasonable coverage track the implementation of adult and of developing a national network for quality
of Pap smear tests, with improved access to childhood cancer service provision, and control of mammography services. INC has
diagnosis and treatment for abnormal test action on tobacco control. also produced manuals and course materials
results and treatment of cervical lesions. to build the capacity of general physicians in
Key challenges the early detection of prostate and colorectal
The authors would like to see significant cancers.
improvements in the early detection of breast, INC provides ‘see and treat’ training across
cervical, prostate and colorectal cancers by: the five regions in Colombia with the lowest
• Educating general physicians on the population density, and has helped to
early symptoms and signs of cancer implement HPV DNA tests and visual detection
Footnotes:
and enabling general physicians to refer techniques. Finally, INC continues to provide
1. www.iarc.fr/en/publications/pdfs-online/epi/sp164/
2. http://rpcc.univalle.edu.co/uicc/Contenido/index. patients to diagnostic services without the support to Colombia’s population-based
php?accion=mostrar_inicio cancer registries.
need for mediation by a specialist

Costa Rica
Contributors: Fundación Dra. Anna Gabriela Ross

Generally available at public Not generally available in Not generally available in Generally available in the
primary healthcare level the public health system the public health system public health system

Public
activity
Declaration targets Costa Rica’s major success in cancer control Fundación Dra. Anna Gabriela Ross works in
Costa Rica has made significant progress has been the approval and implementation of many areas of cancer control, from prevention
against the Declaration targets with particular the Tobacco Control Law. Provisions within this and early detection, to providing support for
focus in the area of tobacco control. include the designation of all workplaces and families and patients and also in advocacy.
public places as smoke-free environments, They have been working to build networks
warning labels that take up at least 50% of with both the public and private sectors to find
the principal display area of packages, and solutions to address national issues related to
banning tobacco advertising and promotion1. cancer risk factors, incidence, and mortality.
The legislation’s provisions have helped to One of their activities includes education and
change national attitudes towards tobacco information campaigns that reach over 60% of
consumption, and whilst there is limited Costa Rica’s population every year.
data available, it is expected that it will have
As a result of concerted advocacy work, cancer
profound implications on cancer incidence and
now features prominently on the national
public health in the future.
agenda with corresponding improvements in
public awareness and resources available for
Key challenges cancer management.
Fundación Dra. Anna Gabriela Ross would like
to see structural reforms to improve access to
care for patients throughout the cancer care
continuum. This will require further training and
investment in human resources, improvements
in available resources and equipment, and
access to essential medicines.
There is also an increasing need to maintain
the quality of cancer data collected and to
ensure that this is effectively analysed in order
to accurately inform decision making and
policy planning.
Footnotes:
1. http://www.who.int/fctc/implementation/news/news_costarica/en/

Dominica
Contributors: Dominica Cancer Society; Ministry of Health of Dominica
No data No data No No 96% No data

Generally available at public Not generally available in Generally available in the Generally available in the
primary healthcare level the public health system public health system public health system
(Pap smear only)

Public
activity
Progress against the World Cancer Key successes • Establishing tumour boards to enhance
Declaration targets patient care
Dominica’s new oncology unit has enabled the
delivery of clinic services for five days per week • Establishing a palliative care centre and
Dominica has taken a number of actions
and it is staffed by two oncologists, two nurses, hospice at the National Hospital, which
to improve the prevention, diagnosis, and
and a nursing assistant. In 2015, a councillor could be achieved through public-private
treatment of cancer including:
and a social worker joined the team to broaden collaboration.
• Development of a draft NCD strategic
the services provided, and one of the nurses
plan that outlines cancer management. UICC Member’s achievements
received training to deliver palliative care. In
Dominica is also in the process of
addition, junior doctors are assigned to the unit In relation to Target seven of the Declaration, to
establishing a national NCD commission
throughout the year as needed. improve access to services across the cancer
• Collection and analysis of cancer data
The government also provides a grant to the care continuum, the Dominica Cancer Society
through the National Surveillance System
Dominica Cancer Society to facilitate overnight has embarked on a programme that helps
at the Health Information Unit
stays to enable patients living outside of the patients to access screening and treatment
• Development of legislation to implement services that are not currently available
capital to access care.
Article 8, Article 11 and Article 13 of the on the island. These include radiotherapy,
WHO FCTC Dominica is actively engaging with chemotherapy and PET scans. Most patients
• Ensuring the availability of HBV international and regional networks of who approach the organisation requesting
vaccinations, although HPV is not yet organisations to assist with the diagnosis, assistance are from low socioeconomic
available in the public health sector treatment and care of cancer patients. backgrounds and rely on the organisation to
• Commissioning of a new oncology unit in The statutory rule and order (no. 28) imposed assist them in raising funds for their treatment.
2014 a 10% increase in the tax levied on cigars, The Dominica Cancer Society partners with
cigarettes, and alcoholic beverages, as well as regional treatment centres and facilitates
• Ensuring that clinical breast exams,
food and drinks with high sugar content. the transfer of medical information, patient
prostate gland examinations and Pap
referrals, patient literacy, and treatment, as
smears are all free in the public sector.
well as organising accommodation and any
Support for other diagnostic tests can Key challenges
other assistance that the patients need. The
be offered through the Social Welfare
Dominica faces a number of challenges that Dominica Cancer Society works with both the
Department for low income individuals.
could be addressed through: private and public sectors to source financial
The government also provides a grant to
assistance for patients.
the Dominica Cancer Society to provide • Improved data collection and analysis
support to patients. to shape the development of cancer
policy, including the development and
implementation of a national cancer
control plan
• Development and implementation of
policies to standardise costs between the
public and private sectors and streamline
the referral of patients for specialist care

Dominican Republic, the
Contributors: Liga Dominicana Contra el Cáncer


Public
activity
Progress against the World Cancer Key successes Alongside these, dedicated cancer
Declaration targets programmes, particularly those focused on
The Ministry of Health has been taking action cervical and breast cancer, would help to
The Dominican Republic established a National to strengthen primary healthcare services, improve rates of early detection and diagnosis,
Commission for the Prevention and Control alongside broader government efforts to and treatment outcomes.
of Cancer in 2009, which draws together a implement a social protection programme that
number of key NGOs, government agencies would increase access to these services by
and commissions to deliver cancer prevention providing thousands of low-income families
and control activities. Between 2009 and 2010, with subsidised health insurance. The LDCC has:
the Commission also took on the responsibility The government has also developed a health • Leveraged World Cancer Day to deliver
of developing the Dominican Republic’s strategy that includes prioritising access to key cancer messages through the media.
National Cancer Control and Prevention Plan, high-quality medicines through the creation of In recent years, the focus has been
building on the WHO Global Action Plan on a National Solidarity Fund for Healthcare. This on motivating the general public to be
NCDs and the Sub-regional Plan for Prevention was approved by the Chamber of Deputies and physically active, eat healthily and avoid
and Control of Cancer in Central America and will provide an annual fund of RD$ 500 million alcohol and tobacco consumption. This
the Republic of Dominica. The plan outlines (USD 10.88 million). The aim of the fund is to has been accompanied by educational
a number of key activities to help reduce sustainably guarantee access to medicines for talks for patients at the National Oncology
exposure to risk factors by fostering healthy patients suffering from complex diseases that Institute
lifestyles, and building up early detection, require expensive care and treatment, under • Implemented ongoing education and early
diagnosis, treatment, and palliative care the supervision of the Ministry of Health. detection programmes for cervical cancer.
services.
These include primary and secondary
Key challenges prevention activities, with a focus on rural
communities where healthcare access is
Liga Dominicana Contra el Cáncer (LDCC) often limited. These programmes include
would welcome measures to improve cancer the distribution of information brochures
prevention and education in the Dominican and conducting Pap tests. In 2015, LDCC
Republic. Organisations across the health completed 18,604 Pap tests, 18 of which
sector will need to implement education identified cases of cervical cancer
campaigns that promote healthy lifestyles
and provide the general public with further • Finally, LDCC has provided financial
information about cancer risk factors, signs, support of RD$ 44,924,663 (USD 977,800)
symptoms and the importance of screening. towards the cost of diagnostic procedures,
These campaigns could take advantage of treatment including surgery, radiotherapy
key international commemorative days in and chemotherapy, and pain relief. In 2015,
order to raise awareness amongst the general they contributed to the care of 587,014
population. patients.

Ecuador
Contributors: Sociedad de Lucha Contra el Cancer


Public
activity
Declaration targets Ecuador has succeeded in establishing six SOLCA has been working to develop a set of
Since 2010, the Government of Ecuador has population-based cancer registries, which are five national guidelines on the diagnosis and
implemented a new health policy that helps crucial in collating data to inform national-level treatment of cancer in conjunction with the
to ensure that patients have greater access planning and policy development. SOLCA Ministry of Health. These are in the process of
to cancer control and care services, and as a expects that four of them will be part of the being approved, with a further five guidelines
result, services are now available to almost all next edition of ‘Cancer Incidence in Five in development. SOLCA has also contributed
patients nationwide. Continents’1. In the previous edition, only one directly to training healthcare professionals
registry was able to report data. The increase through several postgraduate programmes in
Ecuador has a number of well-established has been incremental, with three of the areas such as: pathology, oncology, surgery,
palliative care units, which help manage the registries participating in the CONCORD-2 anaesthesiology and palliative care.
symptoms of cancer and end of life care. The cancer survival study.
Sociedad de Lucha Contra el Cancer (SOLCA)
unit in particular has been a leader in terms Key challenges
of developing educational programmes for
nurses and doctors in this field. SOLCA would like to see improvements in
cancer screening and early detection through
the development of national guidelines.
Footnotes:
1. www.iarc.fr/en/publications/pdfs-online/epi/sp164/

El Salvador
Contributors: Asociación Salvadoreña para la Prevención del Cáncer
2,600 3,400 Yes No 92% No data

Generally available at pubic

Public
activity
Declaration targets One of the key successes in El Salvador has Asociación Salvadoreña para la Prevención
El Salvador has made significant progress in been the development of legislation and del Cáncer coordinated the ‘Initiative against
the following areas: policies to support cancer control, with the Cervical Cancer in El Salvador’ in partnership
establishment of the Intersectoral Alliance with UICC, the Ministry of Health, and the
• The Ministry of Health developed and for the Cancer Prevention and Control, and Salvadoran Demographic Association. The
approved the National Cancer Control approval of a tobacco control law. cervical cancer initiative was developed in the
Policy and created a comprehensive west of the country and its main components
cancer care unit In 2014, El Salvador also conducted a
were community education, provision of early
country-wide situational diagnosis of cancer.
• The National Cancer Registry Committee detection services, strengthening the national
Subsequently, in 2015, the National Unit of
was created as a result of the First policy for the control of cancer, and advocacy.
Cancer Prevention and Control was created.
International Congress of Bioinformatics Around 5,000 men and women received
The National Policy on Cancer Prevention
in Cancer. The Committee designed the education about HPV and cervical cancer, and
and Control and the Strategic Plan for Cancer
technical guidelines for hospital-based 3,500 women were screened.
Prevention and Control (2015-2020) have
cancer registries and is currently working
since been developed. The project strengthened the national cancer
on the design of the technical guidelines
policy through international consulting forums
for population-based cancer registries
Key challenges on ‘Organisation and the Information System
• The Tobacco Control Act was approved of the National Program for the Prevention
• A population-based screening programme El Salvador has the capacity to improve cancer and Control of Cancer’; ‘Integrated Networks
for cervical cancer was implemented in the care through: of care for Cervical Cancer’ and ‘Population
Paracentral region • Strengthening screening programmes for Based Cancer Registries’. Forums were also
• Six palliative care and pain management cervical and breast cancer held with the Parliamentary Group of Women,
units were established and regionally resulting in the allocation of funds for the
• Strengthening the cancer care system for
distributed in health centres nationwide. prevention and control of cervical cancer.
patients, incuding palliative care units
• Strengthening education programmes for
professionals and leaders in cancer control
• Designing and implementing population-
based cancer registries
• Introduction of the HPV vaccine into the
national immunisation schedule
• Creation of a national centre for radiation
• Development of a National Cancer Control
Programme, including formulation of a law
on cancer prevention and control.

Haiti
Contributors: Innovating Health International

Public
activity
Progress against the World Cancer • Ongoing work to establish a national IHI is also working with local partners
Declaration targets cervical cancer prevention programme, to launch a national women’s cancer
based on VIA and HPV testing. Each awareness programme. The awareness and
Haiti has made significant progress towards departmental hospital will have VIA/ engagement toolkit will be specific to Haiti,
the World Cancer Declaration targets cryotherapy as a minimum, and larger but the community-based participatory
including: units will also have colposcopy/LEEP research and human-centred design aspect
services. These pathology improvements will be replicable in other countries. A pilot
• Expansion of chemotherapy services
will be large steps forward for Haiti and for programme for breast reconstruction
• evelopment of new pathology and
D cancer care nationally. for women with breast cancer has been
immunohistochemistry laboratories launched alongside a national cervical cancer
• Training of health professionals in cancer Key challenges prevention programme that delivers VIA and
treatment HPV screening. This programme involves 12
The greatest challenge in achieving universal partners including Qiagen who have made
• The provision of health education to
cancer care coverage in Haiti will be the the CareHPV test widely available through this
journalists to enable them to report on
creation of effective screening programmes, network.
cancer prevention and care, alongside
and ensuring awareness of the availability and
events to raise awareness with patients, Furthermore, a new pathology laboratory
effectiveness of treatment. Services have been
partners and the government is due to open shortly in the north of the
available for some time, but the associated
• A grass-roots campaign to raise awareness travel, costs, power differentials for women, country and it is the first outside of the
of women’s cancers. and other factors have limited their uptake. capital, Port-au-Prince. It will increase
Violence and discrimination against women in access to pathology services for the entire
Haiti will continue to be a significant barrier to northern half of the country. In addition,
Key successes
treatment uptake in the future. the telepathology programme will allow
Across Haiti, the leading successes have been: pathologists outside of Haiti to interpret results,
Financing for healthcare through governmental provide second opinions, and teach local
• Establishing a national chemotherapy mechanisms is severely lacking in Haiti. As pathology residents. Finally, IHI are opening
network at five public hospitals. Whilst it such, long-term sustainability of programmes an immunohistochemistry laboratory at the
has only treated a small number of patients that rely on government funding will be National Laboratory. This will be the first lab
to date, all patients are currently within a dependent on individuals to champion them in Haiti to perform immunohistochemistry,
three-hour drive of a chemotherapy centre and locate resources. including for the oestrogen receptor for breast
• Training of 20 doctors and 32 nurses to cancers.
administer chemotherapy and treat breast Author’s achievements
cancer
Innovating Health International1 (IHI) has
treated more than 300 women with breast
cancer since July 2013. Since 2015, IHI has
Footnotes:
worked with the Haitian government to expand
1. http://www.innovatinghealthinternational.org/ the availability of chemotherapy nationally to
2. www.youtube.com/watch?v=mqmEcyo6oaA
3. www.youtube.com/watch?v=WVV2wKWKTmk five public hospitals, which represents a huge
4. www.youtube.com/watch?v=uIOFDhUyTkM step forward for a small and under-resourced
5. www.youtube.com/watch?v=jqcekOoxAwk
6. www.youtube.com/watch?v=JbvWUnn5TwE country. For francophone countries, IHI has
developed a series of chemotherapy training
videos for doctors and nurses2,3,4,5,6.

Mexico
Contributors: Instituto Nacional de Cancerología
33,900 38,000 No Hospital-based 82% Yes

Generally available at public Generally available in the Generally available in the
public health system public health system
No data
(Pap smear only)

Public
activity

Declaration targets Between 2009 and 2011, the tax on tobacco In order to make progress towards the
Mexico’s focus has been predominantly products was increased to 7 pesos (USD 0.37) Declaration targets, the Instituto Nacional de
on reducing key cancer risk factors, most per pack, raising the average price of a pack by Cancerología9 (INCan) would like to see:
notably through the implementation of the 36%5. Over this time, cigarette sales declined
• Development of a sustainable and strategic
‘National Strategy for Prevention and Control by almost 30%, from 1.81 billion packs in 2009
national cancer control plan based on
of Overweight and Obesity’1. Increases in the to 1.27 billion in 2011. Government revenues6
Mexico’s cancer burden, prevalence of
prevalence of obesity in Mexico are among from tobacco taxes increased 38%, even as
risk factors and taking into account the
the fastest documented at the global level. As sales declined.
resources available for implementation and
a result, in 2013, the government launched During 2011 and 2012, four new cancers the healthcare system context
a comprehensive series of strategies2 to were included in ‘Seguro Popular’7, a social
address this including; public education • Establishment of a cancer registry that
protection programme designed to provide can provide accurate data to support
and awareness-raising, a comprehensive affordable health care to the 50 million
healthcare model, and regulatory and fiscal and inform health planning, research and
uninsured people in Mexico. The cancers improvements in patient care and cancer
measures3. A sugar-sweetened beverage tax included were prostate, ovarian, colorectal
was implemented in 2014 raising the price of control.
and non-Hodgkin lymphoma. Results suggest
beverages by 10%, which led to an average that this has increased access to care8.
of 6% reduction4 in the purchase of these UICC Member’s achievements
The incidence of catastrophic spending
beverages. has fallen by 20%, alongside overall out-of- INCan has worked to keep cancer on the
pocket spending particularly for the poorest political agenda and in 2014, the President
households, and abandonment of treatment is appointed the Secretary of Health to create
approximately 6%. a National Cancer Control Programme that
would reduce cancer incidence and mortality,
and improve the life of patients through the
implementation of evidence-based strategies
for prevention, early detection, diagnosis,
treatment, and palliative care.
INCan has also built a new hospital facility,
which has been designed to optimise the
Footnotes:
patient experience and physician collaboration.
1. http://mexicosalud.com/the-sectorial-program-for-health-2013-2018/ The focus is on delivering multidisciplinary
2. http://oment.uanl.mx/good-state-practices-derived-from-the-national-strategy-for-the-prevention-and-control-of-
overweight-obesity-and-diabetes/?lang=en care alongside the most advanced diagnostic,
3. http://iris.paho.org/xmlui/bitstream/handle/123456789/18390/978-92-75-31871-3_esp. therapeutic and surgical technologies, as well
pdf?sequence=5&isAllowed=y
4. www.insp.mx/epppo/blog/3666-reduccion-consumo-bebidas.html as providing services to care for the general
5. www.fctc.org/images/stories/success_Mexico_en.pdf wellbeing of patients. Innovative clinical
6. www.controltabaco.mx/publicaciones/the-impact-of-taxation-on-tobacco-consumption-in-mexico
7. www.worldbank.org/en/results/2015/02/26/health-coverage-for-all-in-mexico research is an integral component of INCan’s
8. www.paho.org/hq/index.php?option=com_content&view=article&id=9418%3A2014-in-mexico-safety-net- facility and the new building has designated
women&catid=1443%3Aweb-bulletins&Itemid=135&lang=es
9. www.incan.salud.gob.mx/ space for research and Phase I clinical trials
specifically.

Nicaragua
Contributors: Fundación Movicáncer

Public
activity

Declaration targets The development and implementation of Sivipcan Fundación Movicáncer has worked to make
Nicaragua has taken a number of key steps has been one of the major national successes, cancer a priority item on the national political
including: and is an outcome of the commitments made by and social agenda by organising events such as
the Council of Ministers of Central America and the ‘Hope for Life’ awards, which highlight the
• Introduction of new low-cost technologies for the Dominican Republic (COMISCA) in Antigua, social commitment of individuals, companies and
early detection of cervical cancer, including Guatemala in 2011. COMISCA agreed to develop institutions to cancer1.
HPV DNA testing, which so far has covered a series of monitoring tools for the prevention and
110,000 women in three regions Movicáncer has also supported the Ministry of
control of NCDs, and cancer more specifically,
Health through technical assistance, workshops,
• Development and implementation of a with the aim of improving the evidence base for
conferences and courses to strengthen the
surveillance system, Sivipcan, focused on decision making, particularly for cervical and
capacity of doctors and nurses who lead the
prevention and early detection of cancer in breast cancers.
National Cancer Control Programme. The focus
women
A further success has been strengthening the has been on building their capacity to manage
• Communication and awareness-raising implementation of the 2012-2015 Regional Plan strategies for cancer prevention, detection
campaigns to promote healthy lifestyles for Health Promotion by COMISCA. Paragraph and early diagnosis with a focus on childhood,
and improve the early detection of cancer 2.4 addresses the development of a surveillance hepatopancreatobiliary, cervical2 and breast
amongst the population system for key NCDs, their risk factors, and the cancers3,4. Alongside this, Movicáncer helped to
• Delivery of training for healthcare responses of healthcare services to meet these develop the software for Sivipcan, which provides
professionals to improve their awareness of needs. Countries are working to build regional an online platform to register cancer screening
cancer signs and symptoms, and to ensure data collection and comparison instruments, activities with women, which is accessible to all
the provision of quality prevention services. alongside a new model for accessing preventative health facilities (private and public) and can be
healthcare services for breast and cervical used to evaluate cancer prevention programmes,
Footnotes:
1. www.movicancer.org.ni/movicancer-entrega-reconocimientos- cancers. enable follow-up and ensure timely treatment5,6,7,8.
esperanza-por-la-vida-edicion-2016/
2. www.movicancer.org.ni/exitoso-workshop-sobre-control-del- Movicáncer has trained more than 89 doctors
cancer-del-cuello-uterino/ Key challenges and nurses to manage cervical and breast cancer
3. www.movicancer.org.ni/movicancer-presenta-nuevo-estudio-sobre-
mujer-cancer/ programmes in 8 of the 19 health districts, thereby
4. www.movicancer.org.ni/exitoso-foro-preparatorio-del-curso-pro- Fundación Movicáncer would welcome actions
supporting the expansion of health services9,10,11.
salud-mamaria/ to strengthen the country’s public health system,
5. www.movicancer.org.ni/workshop-nacional-sobre-sivipcan-en-el- It has also developed health promotion campaigns
auditorio-de-opsoms/ with a particular focus on:
6. www.movicancer.org.ni/fundacion-movicancer-recibe-
focused on tobacco risks, and the early detection
reconocimiento-nacional-a-la-innovacion/ • Tackling risk factors, including tobacco of cervical and breast cancers12,13,14,15,16,17,18,19.
7. www.youtube.com/watch?v=e0CwdqfSS9E
8. www.movicancer.org.ni/tecnologia-para-una-mejor-gestion-del- consumption, unhealthy diets, alcohol intake Finally, building on existing efforts to rollout HPV
programa-para-el-control-del-cancer-en-la-mujer/ and physical inactivity
9. www.movicancer.org.ni/nicaragua-avanza-en-el-fortalecimiento-del- DNA testing, Movicancer plans to expand the
programa-de-control-del-cancer-de-la-mujer/ • Strengthening immunisations, including the use of this technology to one additional region
10. www.movicancer.org.ni/minsa-y-movicancer-nicaragua-desarrollan-
curso-de-gestion-en-control-del-cancer-en-la-mujer-en-la-raan/ national introduction of HPV to provide the service to 7,000 women aged
11. www.movicancer.org.ni/segundo-curso-nicaraguense-en-gestion- between 25 and 49 who have never had a Pap
de-programas-de-control-del-cancer-en-la-mujer/ • Improving timely access to effective cancer
12. www.movicancer.org.ni/sin-tabaco-vivimos-mas-y-mejor/ smear test.
13. www.movicancer.org.ni/movicancer-lanza-campana-contra-el-
diagnosis, treatment and care
cancer-de-senos/
14. www.movicancer.org.ni/movicancer-lanza-la-campana-hablemos-
• Improving the training available to healthcare
claro-sobre-el-cancer-de-la-mujer/ professionals on cancer.
15. www.movicancer.org.ni/cancer-de-mama-2030-el-futuro-ya-nos-
alcanzo/
16. www.youtube.com/watch?v=szG6kpEIin0
17. www.youtube.com/watch?v=Bm-2kAzu2F0
18. www.elnuevodiario.com.ni/nacionales/369858-cancer-prostata-
mata-mas-hombres/
19. www.youtube.com/watch?v=50NylpVpF9Q

Panama
Contributors: Asociación Nacional Contra el Cáncer; Hospital del Niño
Dr. José Renán Esquivel
1,700 1,500 No Hospital-based 80% Yes


Public
activity
Declaration targets Panama has developed guidelines for the Asociación Nacional Contra el Cáncer
• Panama is taking continuous action to prevention, early diagnosis and treatment (ANCEC) participates in the Health
strengthen the facilities at the National of cervical and breast cancer through Commission of the Panamanian National
Oncology Institute, which is the only collaborations between the Ministry of Assembly. As part of the Commission and
dedicated cancer unit nationally, and is Health and other public and private health together with the National Coalition against
working to develop cancer services in institutions. The Ministry of Health has also Tobacco, which comprises a number of
other public hospitals. Private hospitals established a national commission on cancer, non-governmental organisations, ANCEC
have also increased equipment available with a sub-commission for each of the most has helped to achieve reforms to the tobacco
for cancer treatment. A new national prevalent types of cancer nationally. These laws. These reforms regulate the selling of
hospital-based cancer registry has been sub-commissions coordinate the development cigarettes, including tax increases to reduce
created that draws on data from all public and update of the relevant guidelines. consumption, and the creation of smoke-free
hospitals and many of the private hospitals spaces in all enclosed public areas and private
Key challenges spaces such as offices, shops and restaurants.
• Tobacco control measures have been
In 2015, the WHO recognised Panama for
implemented, and exposure to tobacco Both authors would welcome further action to its efforts in developing some of the strictest
smoke and the number of smokers have improve: tobacco control legislation globally.
both been reduced
• The education of the general public
• The national vaccination programme
concerning the prevention and the early
covers 30 vaccines, including those for
detection of cancer. This is the top national
HBV and HPV, the latter of which is offered
priority in order to reduce the long-term
to boys and girls aged nine and ten in all
burden of cancer and improve treatment
public and private schools free of charge
outcomes
• There are a number of ongoing campaigns
• Training and retention of additional
on cancer in the media and across social
healthcare professionals to meet the
networks
resulting increase in demand for cancer
• There has been a push to improve the early services and specialities.
detection of cervical, breast and prostate
cancers, as well as access to effective and
appropriate treatment services, although
pain control has not been a priority so far
• The number of medical students and other
allied health professionals in universities
has been growing.

Peru
Contributors: Liga Peruana de Lucha contra el Cáncer

healthcare level (Pap smear only)

Public
activity
Declaration targets The national plan for cancer control, ‘Plan In 2015, the Government of Peru won 280,000
Peru has made strong progress against the Esperanza’, is one of Peru’s notable successes. free doses of the HPV vaccine to vaccinate
Declaration targets in particular with regard to: girls in the fifth and sixth grades. The Liga
Peru acknowledges that cancer is a disease
Peruana de Lucha contra el Cáncer supported
• Universal coverage of HPV and HBV that affects not only the patient, but the whole
this activity by running a national awareness
vaccination. Peru now has an awareness family and it is estimated that the annual
campaign on the vaccine as well as cancer
campaign at the national level that aims incidence rate in Peru is increasing. An
prevention more broadly, entitled ‘Yo cambio
to educate girls and their parents about increased number of new cases per year are
la Historia1’. The campaign initially targeted
cervical cancer and the HPV vaccine diagnosed in late stages (III and IV), resulting
eight regions, and ten schools in each of these,
in lower rates of survival, less chance of being
• Improving access to services across holding workshops for 1,690 teachers, 11,005
cured and higher costs of treatment. Plan
the cancer care continuum. Peru students, 6,631 parents and 200 civil servants
Esperanza includes a budget to support early
has developed a national plan for alongside health professionals and community
diagnosis and vaccination, and therefore, aims
comprehensive cancer care and improving leaders. It also made use of social networks
to reduce mortality and morbidity from cancer.
access to cancer services called ‘Plan and the media to achieve greater dissemination
The plan aims to progressively improve access
Esperanza’. The focus is to try to reduce of the messages and maximise acceptance of
to cancer services from early diagnosis to
the cost of cancer care for patients and the vaccine.
palliative care, dependent upon the availability
families, define strategies to improve
of resources and developments in technology.
public access to services that help
promote healthy living, prevention and
early diagnosis of cancer, as well as plans Key challenges
to strengthen health services to achieve At the national level, Liga Peruana de
effective diagnosis and timely care. It Lucha contra el Cáncer would welcome
also includes details for monitoring and improvements in access to and availability
evaluation of these activities. of cancer care services in the public health
system to ensure timely diagnosis and
treatment for cancer patients.
Also, improving cancer registries in Peru, and
strengthening the training of professionals
through education programmes aimed at the
faculty of each school, would improve cancer
control and patient care.
Footnotes:
1. www.yocambiolahistoria.com/cambio.html

Suriname
Contributors: Technical Working Group Cancer Control Plan (Ministry
of Health of Suriname and Lobi Foundation)
200 200 Yes National 86% Yes

Public
activity
Declaration targets Suriname has made a number of important The Lobi Foundation, a member of the
Suriname has taken a number of steps to achievements in cancer control: Technical Working Group Cancer Control Plan,
improve the planning, prevention, treatment has been providing cervical cancer screening
• The approval of tobacco legislation in
and care for cancer nationally including: using Pap smears since 1978. In 2003, a pilot
2013, which bans smoking in public places
research project was developed to introduce
• Development of a cancer control plan, • The development of a draft cancer plan, VIA and since 2007, this method has been
which includes an analysis of the national that is in the process of being finalised with adopted nationally as one of the screening
cancer burden stakeholders methods for cervical cancer.
• Approval of tobacco control legislation in • The introduction of a HPV vaccination
The Lobi Foundation works to deliver a
2013 that bans smoking in public places, programme in 2014 as part of the national
comprehensive and integrated approach to
tobacco advertising, sponsorship and immunisation schedule2.
the delivery of cancer screening services, for
promotion; introduced inclusion of pictorial
example, providing cervical cancer screening
warnings; and created the mandate for a Key challenges and breast examination in one visit with pre-
body to monitor the implementation of the
Suriname is committed to: and post-test counselling. A pilot project to
law1
increase cervical cancer screening coverage
• A national NCD risk factor survey to • Finalising the draft cancer control plan, through a context or area specific community
evaluate lifestyles in 2014 ensuring the engagement of all relevant approach is being developed and will be
• Introduction of the HPV vaccine in 2014 stakeholders, and the installation of a implemented once funding is secured. Part
National Cancer Board to oversee the of this project will be to review the barriers to
• Broadcasting of information films about
successful implementation of the cancer screening and perform an evaluation of current
cancer on television
control plan approaches. The data gathered will be used
• Introduction of multidisciplinary oncology to develop a national evidence-based cervical
• Development and establishment of a
meetings to improve the quality of cancer screening programme.
national cancer registry, alongside systems
care. The focus has been on improving
for monitoring and evaluation of cancer
adherence to cancer guidelines and
interventions, focusing initially on the HPV
reducing delays in cancer care
vaccination programme
• A basic healthcare plan has been
• evelopment and implementation of
D
introduced to lay the foundations for
a national cervical cancer screening
universal access to screening and early
programme.
detection. The National Committee
for Essential Medicines has also been
reinstated to update the national essential
medicines list and expand access to
anticancer drugs and analgesics.
Footnotes:
1. www.who.int/fctc/implementation/news/news_sur/en/
2. http://apps.who.int/immunization_monitoring/globalsummary/
countries?countrycriteria%5Bcountry%5D%5B%5D=SUR&commit=OK

Trinidad and Tobago
Contributors: The Trinidad and Tobago Cancer Society
1,100 900 Yes Population-Based 92% Yes

Public
activity
Declaration targets The government’s national cancer strategy Over the past 45 years, the Society has worked
• Government and civil society groups utilises the three specialist cancer treatment relentlessly towards its mission of increasing
have actively worked together by pooling centres: the National Radiotherapy Center awareness to reduce the national cancer
resources and expertise to strengthen at the St. James Medical Complex, a new burden through screening.
existing education and screening systems, National Center for Non-Communicable The Society provides free cancer awareness
while actively developing new systems Diseases and the National Oncology Center lectures and brochures to communities,
to be located at the Eric Williams Medical organizations and schools nationwide as we
• Numerous national and community health
Sciences Complex. Through the Ministry of seek to help dispel myths and misconceptions
fairs have addressed cancer control issues
Health, all citizens of Trinidad and Tobago have that would deter people from either leading
such as risk factors, stigma surrounding
at their disposal free and full management of healthy lifestyles or getting screened.
those diagnosed with cancer, and
cancer treatment utilising both primary and
screening methods The Society’s in-house and mobile clinic
secondary healthcare facilities, from diagnosis
• The Ministry of Health launched the HPV provide screening for cervical, breast and
to advanced management and palliative care
Vaccine National Educational Programme prostate cancer at subsidized costs which
at all Regional Health Authorities. To date, the
on September 11th 20121 makes screening both accessible and
cancer registry has published statistics up
affordable to all citizens in rural and urban
• Free or subsidised screening for prostate, to 2009 and continues to advise and guide
areas of Trinidad and Tobago.
cervical and breast cancer is available at healthcare professionals with evidence-based
the national and community levels. information, which would effectively assist
in understanding and addressing cancer in
Trinidad and Tobago.
Key challenges
Areas that require further emphasis include;
• The formulation of policies, procedures
and guidelines that would aid in the
efficient and effective running of the
Cancer Registry
• Mobilisation of resources for, and the
expansion of, the cancer drug formulary in
Trinidad and Tobago require
There should be future plans to decentralise
chemotherapy services to the Regional Health
Authorities and Tobago’s Oncology Unit.
Footnotes:
1. http://health.gov.tt/news/newsitem.aspx?id=382

United States of America, the
Contributors: American Cancer Society; American Association for Cancer Research;
George Washington University; LIVESTRONG Foundation; National Cancer Institute;
St Baldrick’s Foundation

(Pap smear only)

Public
activity
Progress against the World Cancer Key successes diagnosed with 595,690 projected deaths,
Declaration targets with rates highest amongst low socioeconomic
The USA’s key achievement has been the 23% groups and black men in particular.
The USA has made significant progress drop in cancer mortality rate between 1991
towards the Declaration targets, including a and 2012, which equates to approximately The authors would welcome action to:
reduction in mortality rates from cancer. Other 1.7 million lives saved. It is thought that this is
• Increase screening participation,
key areas of progress include: attributable to steady reductions in smoking,
particularly for colorectal cancers among
combined with advances in cancer prevention,
• The Affordable Care Act, which requires adults aged 50-75 years (currently 55%)
early detection and treatment.
that all health plans cover any U.S. • Improve HPV vaccination rates among
Preventive Services Task Force-approved Other successes include: adolescent girls and boys
immunisation or cancer prevention
• Creation of the Comprehensive Cancer • Further reduce tobacco use and exposure
measure without out-of-pocket payments
by the insured Control National Partnership comprised of • Deliver access to palliative care and
17 leading national cancer organisations coordinated care management for cancer
• Initiation of the Cancer Moonshot , an 1
working in collaboration to develop and patients and survivors of all ages
initiative to accelerate cancer research, implement state, tribe and territory cancer
improve access to therapies for more control plans
patients and increase the ability to prevent UICC Member’s achievements
and detect cancer early • Establishment of partnerships between
government agencies and NGOs to help The American Cancer Society (ACS) works in
• Federal regulation of tobacco products, implement key actions, including the collaboration with partners in the public and
state and local legislation to increase National HPV Vaccination Roundtable that private sector, and steady progress has been
tobacco taxes, increased coverage is dedicated to reducing the incidence of made to achieve the Declaration targets and
of tobacco-cessation programmes, and mortality from HPV-associated cancer, identify critical gaps in cancer control. In 2015,
expansion of smoke-free workplace laws, and the National Colorectal Screening a coalition of four organisations, including ACS,
and increased access to pain medication Roundtable that is working to achieve an published the Annual Report to the Nation
• Restoration of federal funding to cancer 80% testing rate by 2018 on the Status of Cancer, which showed that
research to pre-2010 levels. In 2015, mortality rates from cancer continue to decline
• Under the Affordable Care Act, for children and for the most common types of
Congress passed a budget including a approximately 90% of Americans now have
USD 2 billion increase for medical research cancer; lung, colon, breast and prostate. ACS
access to quality health services (including have also released new guidelines for breast
at the National Institutes of Health, of cancer prevention, treatment and care)2,
which USD 264 million will go directly to cancer screening.
although approximately 32 million remain
cancer research. uninsured. In addition, ACS has a strong base of
approximately 2.5 million volunteers, who help
contribute to cancer control activities. They
Key challenges
also run national fund- and awareness-raising
Footnotes: The cancer burden remains unequal both events amongst the general public, and fund
1. https://www.whitehouse.gov/CancerMoonshot
2. http://www.cancer.org/myacs/eastern/areahighlights/ in terms of incidence and survival, with research. Notably, ACS also provides financial
affordable-care-act-six-ways geographic and socioeconomic disparities and accommodation support to patients and
continuing to persist with regards to cancer their families through their network of Hope
prevention and control. In 2016, an estimated Lodge facilities, and have provided 4 million
1.6 million new cases of cancer will be nights of free lodging since 1984.

Uruguay
Contributors: Comisión Honoraria de Lucha Contra el Cáncer

(Pap smear only)

Public
activity
No data
Progress against the World Cancer • A significant decline in the prevalence • Improve the monitoring and evaluation
Declaration targets of daily smokers, from 32.7% in 2006 of cancer prevention, diagnosis and
to 28.8% in 2013. The 2008 tobacco treatment activities
The goal of reducing premature cancer legislation has contributed to this success • Strengthen access to expensive
mortality has been included in the national as it incorporates almost all elements of technologies
health objectives for 2015-2025. Across the WHO FCTC
Uruguay, the focus of action for cancer control • Encourage and support the development
• New legislation has helped to increase of academic research, prioritising
has been:
access to Pap smear tests and epidemiological studies aimed at
• Development of a national health policy mammography services by making it identifying cancer control strategies and
that prohibits tobacco consumption compulsory for employees to be given solutions that best respond to the needs of
(law 18256) and reduces excess alcohol a paid vacation day to have the tests, the Uruguayan population.
consumption, as well as campaigns to and for the tests to be included in every
prevent obesity employee’s health record
• Implementation of a free universal HPV • National rollout of cervical and breast
screening, and faecal immunochemical CHLCC has helped to:
vaccination scheme for those aged 12 to
15, as part of the routine immunisation test screening services for populations • Develop the population-based cancer
programme, which has also included HBV with a moderate risk of developing registry, which includes IARC Class A
vaccination since 1999 colorectal cancer certified incidence data
• Developing clinical practice guidelines for • Universal access to cancer treatment, • Develop educational programmes
the early detection of cervical, breast and including expensive treatments, and the targeting the general population and
colorectal cancers development of clinical practice guidelines health professionals across the spectrum
tailored to the Uruguayan population and of cancer control actions
• Strengthening the population-based
its health system. • Implement a national cervical cancer
cancer registry, and developing electronic
clinical records in oncology prevention programme that uses Pap
Key challenges smear testing
• Developing palliative care services at the
national level Comisión Honoraria de Lucha Contra el • Accredit gynaecological cytology
Cáncer (CHLCC) would welcome measures to: laboratories in the national health sector
• Supporting cancer research.
to external quality control standards (ISO/
• Expand tobacco control policies, with IEC 17043)
Key successes a particular focus on reducing tobacco
• Research the prevalence of different
use amongst women. According to the
Uruguay has seen a sustained decline in strains of HPV present in healthy women,
Adolescent Drug Consumption Survey,
standardised premature cancer mortality compared to those found in the tumours
9.2% of youth are smokers, of which a high
rates for both sexes, by approximately 0.9% of women diagnosed with cervical cancer
proportion are women
annually. This decline is due to a significant fall and precancerous lesions
in breast and cervical cancer for women, and • Strengthen prevention programmes
• Develop a national breast cancer screening
lung cancer for men. There are a number of targeted at cervical, breast and colorectal
programme, which has introduced digital
contributing factors to this success: cancers through public and professional
mammography and created a referral
education focused on detecting the
centre for breast imaging.
signs of cancer, increasing coverage of
screening programmes, and improving
follow-up with patients to ensure timely
and appropriate diagnoses and treatment
Venezuela, Bolivarian Republic of
Contributors: Sociedad Anticancerosa de Venezuela

Public
activity
Declaration targets The most notable success in Venezuela has SAV has developed a number of successful
Venezuela has seen a decline in the prevalence been a decline in the cancer incidence rate by activities over the last couple of years. One of
of adult smokers from 17% to 16% and a 13 points per 100,000 inhabitants in 20151. the leading campaigns has been ‘My Child’s
similar decline in the prevalence of adolescent Lunchbox’ that delivers education to pre-
Unfortunately, this success was not reflected
smokers from 5.6% to 4.6%. There has also school and school aged children on good
in cancer mortality rates, which actually
been an increase in the use of smoking nutrition.
increased by four points per 100,000
cessation services, which now cover 30% of inhabitants in 20152. Alongside this, another programme called
the smoking population. This figure is in line ‘Help Cancer Patients’ has been created to
with international norms for smoking cessation support patients and their families, with a
Key challenges
services. website providing first-hand information on
The Sociedad Anticancerosa de Venezuela cancer, as well as related studies, and events
(SAV) would welcome further measures by the taking place in each region of Venezuela3.
Government of Venezuela to support cancer
control nationally including engaging with civil Finally, SAV has developed a programme
society organisations, such as SAV, to unite of educational talks on cancer prevention
cancer control efforts across the country. In targeting public and private sector
addition to this, there is a need to: organisations, as well as the general
population.
• Strengthen anti-smoking laws and their
implementation
• Extend the coverage of centres that offer
smoking cessation services
• Raise awareness of the HPV vaccine
among the general public and civil society,
so that when the HPV vaccine is approved
by the government, it can be effectively
rolled out at national level, with a high
uptake.
Footnotes:
1. Statistical study on morbidity and mortality by the Cancer Society of Venezuela (Sociedad
Anticancerosa de Venezuela (SAV) – Centro de Estadísticas y Matemática Apilcada / Universidad
Simón Bolívar y Laboratorio NOLVER
2. Statistical study on morbidity and mortality by the Cancer Society of Venezuela (Sociedad
Anticancerosa de Venezuela (SAV) – Centro de Estadísticas y Matemática Apilcada / Universidad
Simón Bolívar y Laboratorio NOLVER
3. www.ecancerlatinoamerica.org

Red de Institutos Nacionales de Cancer:
Regional collaboration to strengthen health systems
Regional progress against the World Key challenges RINC’s key achievements
Cancer Declaration targets Most countries still face a major challenge in In 2011, the Union of South American
The impact of cancer is rising steadily in Latin re-orientating health policies to respond to Nations (UNASUR) established the Network
America, both central and south. The incidence NCDs, such as cancer, becoming the leading of National Cancer Institutes and Institutions
of cancer is increasing as a result of the cause of morbidity and mortality. Health (RINC). The aim of the collaboration was to
epidemiological transition taking place across systems have so far been slow to respond to create a platform to promote cooperation
the region, alongside a change of lifestyle in notable disparities in access to and quality and technical coordination among health
most of the countries and inequities of access of care, especially in remote or sparsely organisations across Latin America. RINC-
to prevention and primary health services. populated regions with varying levels of literacy. UNASUR leverages the current political will
Higher mortality from cancer is generally Challenges include: to incorporate governmental bodies within a
attributed to late diagnoses and patients regional cancer control community. By sharing
• A lack of adequate funding for NCD
presenting with advanced stage disease. best practices, encouraging the exchange of
services
information and identifying common interests
Over the past years, Latin American • Inequities in the number, distribution, related to cancer control, RINC aims to
governments have shown a growing interest in and training of human resources and strengthen cancer control across the region.
committing themselves to cancer control, with equipment
remarkable achievements in: Promising areas for collaboration have been
• Low socio-economic status of many
• Argentina with a successful programme cervical and breast cancer control planning,
cancer patients, with ethnic and cultural
to improve access to cervical cancer and cancer registration. RINC and UNASUR
traditions potentially limiting access to
prevention services have a joint programme aimed at eliminating
services
cervical cancer regionally through effective
• Brazil which has worked to reduce the • High prevalence of risk factors poses prevention strategies, providing technical
prevalence of smoking from 34.8% to future challenges. assistance and knowledge exchange to roll
14.7%
out VIA and a ‘see and treat’ strategy. Regional
• Chile with the development of the Plan In Latin America, 17 out of 33 countries have
work has also opened new opportunities for
of Explicit Guarantees in Health that has a national plan or specific cancer control
Latin American countries to benefit from the
improved overall access to cancer care programs, but only a few of these can be
support of regional and global organisations
considered comprehensive cancer strategies.
• Peru with a National Comprehensive like PAHO, with their focus on women´s
In many countries cancer control plans are
Cancer Care Plan - Plan Esperanza. cancers, and UICC and IARC, who have
integrated within broader NCD policies.
established a Latin American cancer registries
It is critical to establish the most effective hub that is now producing reliable, high-quality
strategy for each country as a one-size- information on the regional burden of cancer.
fits-all approach will not work. The region
A final important cooperation initiative fostered
has significant differences in the resources
and led by UNASUR, is the development of a
available for health and the structure and
mechanism for the joint purchase of high-cost
complexity of individual health systems. Some
and high-demand medicines for the treatment
countries, such as Bolivia, Paraguay, Equador,
of diseases including rare cancers, in order to
Guyana, Suriname and Venezuela, face
supply national health systems and make the
considerable challenges investing in effective
most of limited resources.
policies for health education, comprehensive
national screening programs, and in effective
treatment modalities. As a result, many of
these actions are now being fostered by
regional networks coordinated by multilateral
government entities.

Trends in Cervical Cancer Age-Standardised Incidence Rate (World), 1953-2002
Cancer screening and 1515
11.4 11.5
13.1
14.5
10.7
1010
early detection
7.4
6.7 5.7
55
5.0
3.9
00 Canada USA Finland UK, England Australia

1978—2002 1975—2002 1953—2002 1985—2002 1983—2002
Countries with Large-Scale Cervical and Countries with Large-Scale Colorectal

Breast Screening Programmes, 2014 Screening Programmes, 2014
Strategies for equitable National cancer burdens have been significantly reduced
by ensuring the availability, accessibility and acceptability
access to screening services of affordable early detection programmes. A single cervical
Cervical Breast No large-scale screening program Has a large-scale screening program No large-scale screening program
cancer screening test for women between the ages of 30
for the early detection of high and 40 can reduce a woman’s lifetime risk of developing
impact cancers should be cervical cancer by 25-31%13.
implemented in all resource In several high-income countries, cervical cancer incidence

has substantially declined with the introduction of screening
settings and integrated in all programmes. Such programmes enable the detection of
health settings. precancerous lesions, or early stage cancer, giving time

for effective treatment which significantly improves patient
outcomes. This in turn helps to dispel myths that cancer is
an untreatable condition.
Target 6 79% of countries reported availability of cervical screening,
with breast screening available in 76% of countries. However,
colon screening was only available in 40% of countries, and
screening for oral cancer was not reported14.
Few of these programmes were described as population-
based and access to screening services varies greatly
across low-, middle- and high-income countries. Emerging opportunity: Cervical 1. Advocacy for informed policy making and
Cancer Action funding for HPV vaccination, cervical screening
Universal access to screening and preventive treatment
Cervical Cancer Action (CCA) is a diverse
and early detection for cancer community of organisations dedicated to taking 2. Mobilisation of champions from diverse groups,
“One of the greatest cancer control challenges cervical cancer prevention to scale and eliminating including youth and advocates for cancer,
of the 21st century is to bring the benefits of preventable cervical cancer deaths. CCA advocates women’s health, sexual and reproductive health,
effective interventions to as many people as for cervical cancer prevention be integrated into and HIV/AIDS to support comprehensive
possible, including low- and middle-income existing health services to ensure that they are cervical cancer prevention
countries.” universally accessible and affordable to women. 3. Coordination between partners to ensure the
The Global Action Plan for the The coalition focuses on four key areas of work, effective use of resources and share lessons
Christopher Wild, Director, International
which were discussed at an inaugural meeting in learnt
Prevention and Control of NCDs Agency for Research on Cancer (IARC)
London, to ensure that individuals, organisations 4. Collaboration with international agencies,
calls for population-based
and countries generate the maximum impact from government donors and private foundations
screening for cervical, breast, “In many countries, women are not diagnosed cervical cancer investments: to mobilise resources to take national
colorectal and oral cancers, linked until they have late stage disease. In these
programmes to scale.
to timely treatment. settings, the promotion of early detection
strategies followed by prompt effective
treatment is critical.”
13
Goldie et al. (2005) Cost-Effectiveness of Cervical-Cancer Screening in Five Developing Countries www.nejm.org/doi/full/10.1056/NEJMsa044278#t=article
Benjamin Anderson, Chair and Director, [Accessed 19.08.16]
Breast Health Global Initiative 14

Bangladesh
Contributors: Bangladesh Cancer Society; Professor Dr Obayedullah-Ferdousi
Foundation Cancer Hospital and Research Institute; Eminence Association
48,800 41,900 Yes No 97% No data

Public
activity
Progress against the World Cancer Key successes cancers amongst men. To achieve this, multi-
Declaration targets stakeholder partnerships need to be developed
One of the key successes in Bangladesh has to plan and deliver public education through
Bangladesh has taken a number of actions to been the development of a legal and policy different channels.
reduce the national cancer burden including: framework to support cancer control, which
includes national plans on cancer control Another key action would be the enforcement
• Development and endorsement of a and NCDs, and laws on tobacco control. of current legislation, particularly around
tobacco control act designating all public Bangladesh ratified the WHO Framework tobacco control.
places as smoke-free zones Convention on Tobacco Control in 2004 and
Finally, it is essential that there is an increase
• The government has actively engaged in the Smoking and Tobacco Product Usage
in the allocation of funds for HPV and HBV
multi-stakeholder partnerships to deliver (Control) Act was amended to include a
vaccination, as well as an improvement in
cancer care, including UICC members, comprehensive ban on tobacco advertising,
screening, treatment, rehabilitation and
such as the Bangladesh Cancer Society promotion and sponsorship; sale to and by
palliative care services to meet national needs.
(BCS), the Professor Dr Obayedullah- minors; health warnings on tobacco packages;
Ferdousi Foundation Cancer Hospital and the use of misleading information on
and Research Institute, and Eminence tobacco packs. Smokeless tobacco products, UICC Member’s achievements
Association. The government has which are also widely consumed in the BCS has a longstanding involvement in raising
encouraged private facilities to develop country, are included under this law so that the public awareness of cancer risk factors, signs
their own cancer diagnosis, treatment and regulations apply to all tobacco products. and symptoms. They currently run information
palliative care facilities sessions in schools and colleges on a weekly
Bangladesh has also developed cervical and
• Taxes on medical imports, most notably breast cancer screening programmes across basis, as well as for imams and cultural
HPV and HBV vaccinations and diagnostic the public and private sectors of the health leaders, in order to help dispel myths and
equipment, have been reduced in order system. A programme for cervical screening, misconceptions around cancer. They are also
to minimise the financial barriers to using VIA and treatment, has been in place developing regional branches to help develop a
establishing cancer management facilities since 2004. There are trained health workers national movement to support cancer patients
in all districts, and a referral system is in place and raise further awareness.
• Training for cancer specialties has been
introduced in conjunction with international for diagnosis and treatment of pre-cancerous BCS has been developing a Hospital and
organisations such as IAEA to expand lesions. Welfare home, increasing the number of beds
radiotherapy services available and improving the quality of services
• The formation of a National Cancer Control Key challenges through new pathology laboratories, an
Council. operating theatre and rehabilitation services to
There is a strong need for further education
support cancer patients.
and public awareness about the risk factors,
signs and symptoms of cancer and to
dispel myths about cancer treatment. This
information needs to be tailored to reflect
the different risk profiles of men and women
in Bangladesh, for example, the prevalence
of cervical and breast cancers are highest
among women, compared to lung and throat

Bhutan
Contributors: American Bhutanese Associates for Health Foundation; RAD-AID
International
200 200 No No 97% Yes

Generally available at public Not generally available in Generally available in the Not generally available in
primary healthcare level the public health system public health system the public health system

Public
activity
No data

Declaration targets Since the Alma Ata Declaration in 1976, The ABAH Foundation and RAD-AID
Bhutan has taken a number of steps to improve Bhutan has worked to improve the coverage International would like to see the development
cancer control including: of basic health services, which now cover 90% of a national programme dedicated to tackling
of the population. Alongside improvements breast cancer, with funds dedicated to the
• Tobacco control acts in 2010, 2012, and in access to clean drinking water and basic acquisition of equipment.
2014, which ban smoking in public places sanitation, Bhutan has seen a rise in life
and set strict limits on the importation and Bhutan has the 13th highest age-
expectancy from 37 to 68 between 1960 and
taxes levied on tobacco products standardised incidence rates of stomach
2012.
cancer (17.2/100,000) and extremely high
• Passing of Alcohol Control Regulation,
Bhutan has developed an effective national rates of Helicobacter pylori infections, with
which imposes taxes on alcohol
vaccination scheme. Cervical cancer regional estimates ranging from 68% to
• Implementation of free national HPV represents the most common cancer among 97%2. As such, the ABAH Foundation would
and HBV programmes. These are being females in Bhutan1, and in response, Bhutan welcome the development of an effective and
expanded to reach the final 10% of the became the first low- and middle-income affordable control strategy including public
population that are largely located in rural country to introduce a national vaccination education and environmental measures
areas and have so far been unable to programme against HPV. to curb infection rates. This would require
access services international academic collaboration to
In 2010, over 130,000 doses of quadrivalent
• Introduction of a national tumour registry address Bhutan’s needs, alongside improved
HPV vaccine were administered, primarily
• Introduction of a palliative care programme access to screening, diagnostic imaging, and
through schools.
delivered through primary healthcare treatment3,4.
facilities. Hepatitis B monovalent vaccination was
introduced in 1997, and subsequently the Author’s achievements
tetravalent vaccine in 2004, with 97% coverage
The ABAH Foundation has worked with RAD-
achieved for infants.
AID International, WHO and the Bhutanese
In 2014, the Royal Ministry of Health, in Ministry of Health to complete ‘Radiology
partnership with the American Bhutanese Readiness Assessments’ for the two major
Associates for Health (ABAH) Foundation, referral hospitals in Bhutan. For Bhutan’s
initiated a palliative care programme delivered population of 760,000, there are currently no
through primary healthcare units. radiotherapy and mammography facilities with
which to screen and treat cancer patients.
Diagnoses are dependent on one digital x-ray,
one CT and one MRI scanner, which are all
located in the Jigme Dorji Wangchuck Referral
Hospital in Thimphu. The Ministry of Health are
therefore seeking to develop mammography
Footnotes:
1. www.hpvcentre.net/statistics/reports/BTN.pdf
services and purchase key equipment
2. Dendup T, Richter J et al, 2015, geographic distribution of the incidence of stomach cancer including CT and MRI scanners for the 20
in Bhutan. World Journal of Gastroenterology. Oc 14, 21(38): 10883-10889 regional hospitals.
3. www.who.int/countryfocus/cooperation_strategy/ccs_btn_en.pdf
4. www.who.int/countryfocus/cooperation_strategy/ccsbrief_btn_en.pdf?ua=1

India
Contributors: Tata Memorial Hospital; Dharamshila Cancer Hospital and Research Centre
Generally available at the Generally available at the Generally available in the Generally available in the Not generally available in

Public
activity
Progress against the World Cancer Key successes • Strengthen health systems to ensure
Declaration targets access to timely and appropriate treatment
• The National Cancer Registry Programme, for patients diagnosed with cancer,
India is amongst the few low- and middle- which provides clear data on the incidence particularly in semi-urban and rural India.
countries that have had a national cancer of, and geographical variation in cancer Telemedicine could play a powerful role in
control programme in place since 19751. Three cases, and reasonable coverage of survival improving diagnosis, but this would need to
key areas of progress stemming from this are: data with good internal validity be complemented by streamlined referrals
• The National Tobacco Control Programme, for treatment and improved access to
1. An established National Cancer Registry
and the banning of gutka and pan masala in treatment modalities, ideally at the regional
Programme that was initiated by the Indian
14 states, which has resulted in a downward cancer centres
Council of Medical Research in 1981. This
programme has continued to develop and trend in the incidence of oral cancers, as • Deliver universal access to pain control
now includes over 40 cancer registries, the documented by the major registries3 through community health centres and
majority of which are population-based and district hospitals.
• Improvements in women’s awareness of the
cover both urban and rural areas. This work signs of cervical cancer and preventative
also contributed to the creation of a national practices. Notably, data from the UICC Member’s achievements
cancer atlas that provides information population-based registries indicates that Tata Memorial Hospital (TMH) is a tertiary
about cancer incidence in a particular the incidence of cervical cancer appears to cancer centre that has been committed to all
geographic area be on the decline in India. aspects of cancer care for over 75 years, from
2. The provision of support to 85 oncology prevention and early detection, to treatment
wings in medical colleges, which includes Key challenges and palliative care.
27 tertiary cancer centres across the
country The authors would welcome work to: TMH spearheaded the creation of the
National Cancer Grid (NCG), which was
3. Launch of the National Tobacco Control • Deliver a tobacco-free India as whilst there
formed in August 2012 with the mandate
Programme by the Ministry of Health is strong legislation in place and taxation
of linking cancer centres across India. The
and Family Welfare in 2007-8 with the policies for cigarettes, there needs to
NCG originally had 14 cancer centres, but
objectives of improving public awareness be further work to implement this fully
has rapidly grown to include 52 major cancer
of the harmful effects of tobacco use and control the use of bidis and chewing
centres that almost cover the entire country.
and introducing supporting legislation to tobacco. There is a particular need to
It is now one of the largest cancer networks in
facilitate effective implementation of the reduce tobacco use amongst young people
the world.
national tobacco control law2. • Implement a National Cancer Screening
Programme to enable early detection of Funded by the Government of India and the
the three most common cancers in India, Indian Department of Atomic Energy, the NCG
namely oral, breast and cervix. NGOs could has the mandate to develop uniform standards
have a crucial role to play in delivering of care across India by adopting evidence-
mass education campaigns alongside based management guidelines, which can
Footnotes: training for community health workers and subsequently be implemented throughout
1. www.mohfw.nic.in/showfile.php?lid=324
related health professionals, like dentists, to these centres. It also works to facilitate the
2. www.mohfw.nic.in/index1.php?lang=1&level=2&sublinkid=671&lid=662
3. http://ctchp.org/index.php?option=com_content&view=article&id recognise the early signs of cancer exchange of expertise between centres and to
=603:state-governments-notification-on-the-ban-of-gutkhapan- create a network for collaborative research in
masala&catid=220&Itemid=246 • Improve awareness around the cancer
4. https://tmc.gov.in/ncg/docs/PDF/NCG%20IJMPO.pdf cancer. The network is strongly supported by
risks associated with obesity and set up a
the leadership of the various cancer centres4.
programme to tackle obesity in urban areas
Indonesia
Contributors: National Cancer Control Committee; National Cancer Institute (USA)

Public
activity
Progress against the World Cancer Key successes • Reducing exposure to cancer risk factors,
Declaration targets such as efforts to reduce tobacco
Since 2008, Indonesia has taken steps forward consumption. More than 70% of men in
Indonesia has made progress in three key in institutionalising cancer control into the Indonesia smoke tobacco, which places
areas. First, the National Cancer Control federal government. Within the MoH, the the country at serious risk of NCD co-
Committee (KPKN in Bahasa Indonesia) has formation of an NCD unit, with a specific sub- morbidities, including cancer
prioritised cancer promotion and education directorate focused on cancer, has increased
Indonesia’s capacity to address the growing • Implementation and monitoring of national
for the public to reduce stigma and increase
burden of disease. However, the strategy has guidelines for services, comprehensive
uptake rates of screening. Many Indonesians
not yet had a significant impact. To yield better treatment, and multidisciplinary
still believe in traditional medicine, therefore
results, KPKN was recently formed to better management.
education is needed to ensure that appropriate
diagnosis and treatment are sought by coordinate cancer-related efforts within the
people who may otherwise seek the advice of MoH and with other partners. It has established Author’s achievements
traditional healers or unauthorised medical a strategic cancer control plan (2015-2019), The creation of the KPKN1 in Indonesia has
centres. implemented education, planning, registry, been a major step towards improving cancer
regulatory and cancer service programmes, control. KPKN was formally launched on
KPKN has also prioritised training for and is monitoring their effectiveness. NGOs World Cancer Day 2015 and is comprised of
healthcare professionals, initially focusing on have helped achieve these successes and representatives from NGOs, MoH, healthcare
cervical cancer screening by VIA and breast play a key role in health promotion, cancer professionals, and other stakeholders. It is the
cancer screening. The First Lady of Indonesia, prevention and patient support. umbrella organisation tasked with coordinating
together with the Ministry of Health (MoH) and
all cancer control activities for the country. In its
KPKN launched a health screening campaign Key challenges first 18 months, it has successfully developed a
linked to the national strategy on cervical and
Indonesia faces a number of challenges in strategic plan for 2015-2019, prioritised work
breast cancers.
detecting, and recording cancer cases in a on national guidelines for cancer treatment,
Finally, Indonesia introduced universal health country with more than 250 million residents surveillance and registration; public awareness
care in January 2014, which includes coverage spread over 13,000 inhabited islands. Specific and screening; and training. KPKN has a
for cancer screening and treatment. areas that require work include: website that features links to resources, such
as cancer profiles, guidelines, and healthcare
• Developing a population-based cancer facility standards. It will soon have information
registry, as one does not exist, that can about the national cancer registry, mapping of
accurately measure the burden of cancer facilities and resources across Indonesia.
nationally. Work has begun to establish
population-based registration in certain
cities, and this will provide the government
with representative data that could be used
to estimate the burden for the country.
However, this will take additional attention
and resources in the years to come
Footnotes:
1. http://kanker.kemkes.go.id/

Maldives
Contributors: Cancer Society of Maldives
90 60 No No 99% No data

Public
activity
Progress against the World Cancer Key successes Finally, the Maldives needs to introduce a
Declaration targets national HPV vaccination programme with
The Tobacco Control Act (15/2010) was comprehensive coverage for all adolescent
• Policy commitments for improving enacted and is fully aligned with the WHO boys and girls, and strengthen human
comprehensive cancer treatment and FCTC with demand reduction measures such resources for cancer treatment and care, as
care have been made a priority by the as awareness-raising, education, taxation, well as training health professionals to provide
government, who have also started work to advertising and sponsorship bans, as well as information on the signs and symptoms of
establish a cancer registry in the country measures that prescribe smoke-free places, cancer to increase public awareness.
licensing, labelling, display requirements,
• To reduce exposure to risk factors,
banning sales to minors and growing of
tobacco control measures are a priority UICC Member’s achievements
tobacco1. Tax on tobacco products and articles
and the Maldives has ratified the WHO
used in consuming tobacco products are The Cancer Society of Maldives (CSM),
FCTC. A tobacco-free youth campaign ‘I
levied under the Import Export Act 31/37 at formed in 2012, has conducted several cancer
choose life’ was launched, in addition to a
200% of the customs value of the product2. awareness sessions throughout the Maldives
comprehensive ban on tobacco advertising
for the general public as well as specifically for
and an increase in import duty imposed on
tobacco to 200% in 2015 Key challenges school children. CSM marked World Cancer
Day for the first time in the Maldives in 2013;
• To improve healthy dietary habits, the There is a need to implement the policy where CSM conducted awareness campaigns
government introduced a no tax policy commitments made by the government by and activities. Since then, CSM has committed
on imported and locally grown fruit and developing a national cancer control plan. to marking the day each year, and joining the
vegetables This could include improving comprehensive global World Cancer Day campaign.
• Inclusion of the HBV vaccination in cancer treatment and care through
establishing cancer treatment centres in CSM started breast cancer screening ‘camps’
the national Extended Programme of
the country, including chemotherapy and in 2014 in collaboration with FeM Surgery
Immunization (EPI) since 1993, which
integrated palliative care, pain and distress of Mount Elizabeth Hospital, Singapore. Two
administered to all infants and has a
management. screenings are conducted annually extending
coverage rate of 98.7%.
to the outer atolls of the Maldives. So far, three
The Maldives would also benefit from camps have been conducted and have covered
establishing a cancer registry to accurately four out of 20 atolls. Oral cancer and prostate
determine the cancer burden and risk factor cancer screening programmes have also been
profile. This could then be used as the basis for conducted.
more targeted screening programmes across
the atolls. In 2015, CSM embarked on a successful
programme to build human resources by
training two local facilitators from all 20 of
the atolls. This has resulted in a number of
awareness programmes being held in the outer
atolls, which have in the past been unreachable
due largely to the geography of the Maldives.
Footnotes:
1. http://apps.who.int/fctc/implementation/database/parties/maldives
2. www.fctc.org/fca-news/price-and-tax/635-maldives-hikes-tobacco-import-taxes

Myanmar
Contributors: Shwe Yaung Hnin Si Foundation
25,700 23,600 Yes No 72% No data

Not generally available at Not generally available in Not generally available in Not generally available in
public primary healthcare level the public health system the public health system the public health system

Public
activity
Declaration targets Myanmar has made significant steps in The Foundation has been working to improve
Progress across Myanmar includes: reducing tobacco use. The law on the ‘Control prevention and early detection of cancer1. In
of Smoking and Consumption of Tobacco 2014 and 2015, the Foundation conducted 41
• The organisation of a national seminar on
Products’ was passed in 2006, and Myanmar community education sessions that covered
comprehensive oncology services by the
has participated in the Global Tobacco eight townships reaching 8,000 people. In
Ministry of Health
Surveillance System and monitored the addition, 130,000 pamphlets on cancer
• Development of a cancer registry, although prevalence of tobacco use. All government awareness were distributed to members of the
this currently only draws on data from office buildings and compounds are now public, and group discussions were held on a
government hospitals. A population-based smoke-free and the Ministry of Health has holistic approach to cancer2.
death registry system based on data from issued guidance on non-smoking signs and
verbal autopsies is being developed In total, 100 women volunteers have been
smoke-free areas. Notably, WHO presented the
trained on breast health and breast self-
• Myanmar is a signatory to the WHO FCTC World No-Tobacco Award to the Union Minister
examination through workshops. To improve
and warning messages on the health of Health in 2013.
healthcare workers’ knowledge of cancer, 160
hazards of smoking, drinking alcohol,
Researchers in Myanmar have also general practitioners have received training on
nutrition and obesity are now regularly
participated in the three-year ACTION study their role in cancer control in the Yangon and
disseminated through mass media
- a longitudinal cohort study of patients with a Bago regions. To further enhance professional
• The vaccination of children under five first-time diagnosis of cancer, that sought to awareness of cancer control, the First Joint
years of age against HBV since 2002. HPV assess the impact of cancer on the finances Cancer Forum in Myanmar was organised
vaccination is available, but is limited to of patients and their households, patients’ in October 2015 in collaboration with the
private clinics and hospitals survival, costs of treatment and quality of life. Myanmar Oncology Society.
• Cervical cancer screening and breast self-
In addition, the Foundation has screened 2,560
examination programmes are conducted Key challenges people for oral, cervical and breast cancers as
by township health departments to improve
The biggest obstacle to developing future well as Hepatitis B, obesity and diabetes.
early detection, but public screening
programmes are still limited policies in cancer care is the lack of reliable
data. Therefore, the Shwe Yaung Hnin Si
• An sizeable increase in the national health Foundation (the Foundation), would like to see
budget, alongside a concurrent increase the establishment of a cancer registry, using
in the availability of medicines and ICD classification, in all hospitals to obtain a
radiotherapy complete record of cancer and cancer-related
• Establishment of dedicated pain clinics in deaths in hospitals.
all the major hospitals. Private hospices also
now exist in Yangon and Mandalay. It would also be useful for the country to
develop a knowledge transfer network for
cancer amongst caregivers, policy makers,
researchers and public health personnel. In
Footnotes: addition, national guidelines on diagnosis and
1. www.shweyaunghninsi-myanmarcf.org cancer treatment are needed, and it is essential
2. www.facebook.com/ShweYaungHninSi
that cancer is recognised and acknowledged
as a broader societal issue and not just one
confined to health.
Nepal
Contributors: Cancer Society Nepal

Public
activity
Declaration targets Despite facing catastrophic hardship from Over the last ten years, CSN has been working
Despite being a low-income country with recent natural disasters and an unforeseen to improve rates of early detection and to raise
competing health challenges, Nepal has made blockade, both government and civil society cancer awareness, particularly amongst rural
progress against several of the Declaration are giving priority to cancer prevention and communities, including screening individuals
targets including: early detection. Significant progress has been and facilitating their treatment and recovery.
made with multiple stakeholder consultations They have been sustaining a cervical cancer
• The development of tobacco control for the development of a national cancer screening programme and a school-based
policies that mandate pictorial warnings on control plan and cancer registration. Also, cancer education programme. As part of this,
all tobacco products and the introduction of the harnessing of volunteers has helped to CSN has also organised free health camps
smoke-free public places further create a positive environment for both for cancer screening across the country and
• Provision of free cervical screening services cancer patients and those involved in cancer training for volunteers.
• Governmental contributions to help prevention and control. In turn, there have been
More broadly, CSN has advocated for the
patients cover the cost of cancer treatment initial indications that there is an increasing
development and implementation of cancer
up to the value of approximately USD 930. number of cancers that are now being
control strategies and policies at national level.
detected at early stage.
Key challenges
Nepal still has very high cancer mortality, poor
infrastructure and human resources to deliver
cancer services. Those families that can afford
to still seek treatment internationally. Therefore,
a key step in achieving the 2025 targets would
be to create more public trust in the national
services, to extend these services to include
access to palliative and hospice care, and
create more equitable access to those living
outside of the capital city.
There are number of government and NGO-
run cancer hospitals, such as BP Memorial
Cancer Hospital, Bir Hospital, Nepal Cancer
Hospital Pvt, National Hospital and Cancer
Research Centre Pvt, and Bhaktapur Cancer
Hospital. However, the majority of these are
located around the capital city, Kathmandu.
Cancer Society of Nepal (CSN) would therefore
like to see the government coordinate
the efforts of hospital leaders and other
stakeholders to extend services into rural areas
and build national confidence in cancer care.

Sri Lanka
Contributors: National Cancer Control Programme of the Ministry of Health,
Nutrition and Indigenous Medicine of Sri Lanka

Not generally available at public Generally available in the Generally available in the Not generally available in

Public
activity
Progress against the World Cancer Key successes has implemented early detection programmes,
Declaration targets it will be important to improve compliance
In addition to overall progress, Sri Lanka has among the public, and also empower
• Integration of cancer control at primary, also achieved the following: individuals and their families with regard to
secondary and tertiary levels of care • Finalised guidelines for early detection of cancer survivorship and palliative care.
• Further improvement of cancer registration breast, oral and gynaecological cancers
throughout the country, including • Commemoration of World Cancer Day, Author’s achievements
establishing a population-based cancer International Cancer Survivors Day, and The National Policy and Strategic Framework
registry in Colombo district World Palliative Care Day alongside Breast on Prevention and Control of Cancers for
• Launch of a social marketing campaign to Cancer Awareness month through national Sri Lanka was launched in December 2015.
tackle the habit of betel quid chewing advocacy programmes and regional This document highlights seven strategic
• Planned introduction of the HPV vaccine community mobilisation activities objectives for cancer control including primary
into the Expanded Programme of • Launched a Master’s training programme prevention, early detection, diagnosis and
Immunisation from 2017 and other training activities on palliative treatment, survivorship and palliative care,
• Addressing myths related to cancer care cancer registration, human resources, and
through activities on World Cancer Day in • Led two annual forums, one on best cancer research. There are plans for a National
2013 and 2014 practices and the other on cancer research Advisory Committee on the Prevention
and Control of Cancers and cancer control
• Implementation of a screening programme • Establishment of comprehensive diagnostic committees at provincial and district level, to
for cervical and oral cancers, and an early and treatment facilities in all nine provinces plan, implement, monitor and evaluate cancer
diagnosis programme for breast cancers • Gradual introduction of community-based control activities. Currently, the National
• Strengthening of treatment facilities at nine palliative care programmes for cancer Cancer Control Programme is coordinating
cancer treatment centres, including with patients the implementation of the National Policy and
the provision of LINAC therapy Strategic Framework on behalf of the Ministry
• Availability of pain management Key challenges of Health, Nutrition and Indigenous Medicine
medications, including morphine, at district of Sri Lanka.
Sri Lanka is working to ensure the integration
level
of comprehensive cancer care (primary
• Implementation of human resource prevention, early detection, diagnosis and
development programmes. treatment, and palliative care) at all levels of the
healthcare system.
With regards to cancer prevention, scaling-up
behaviour change communication strategies to
reduce unhealthy lifestyles including smoking,
betel chewing, alcohol use, unhealthy diets
and physical inactivity will be critical, as well as
efforts to reduce exposure to occupational and
environmental carcinogens. While Sri Lanka

Thailand
Contributors: National Cancer Institute; Wishing Well Foundation


Public
activity

Declaration targets • Thailand has 18 population-based cancer The authors would also like to see further
Thailand has made good progress in cancer registries covering around 35% of the Thai health awareness and educational activities to
control, including: population, and is working to improve the help reduce the public’s exposure to cancer
quality of data and coverage. A review in risk factors. These activities need to focus
• Universal access to cancer treatment under 2011 highlighted 113,619 new cancer on diet, alcohol and tobacco use, protecting
the National Health Security Office, with diagnoses. against ultraviolet light exposure from the sun,
well-defined guidelines for treatment of as well as environmental exposures to radiation
• In 2004, Thailand set up a national cervical
many types of cancers and carcinogenic chemicals. In addition,
screening programme that targets women
• Harnessing World Cancer Day to raise aged 30 to 60 years to be screened once innovative programs are also needed to fight
awareness of cancer prevention through every five years. The pilot phase ran from the growing obesity epidemic, which has
various activities and campaigns 2004 to 2009, with the second phase from reached 23.8%.
• Active promotion of tobacco control by the 2010 to 2014. 7.9 million women were In terms of radiotherapy, patients still face
Thai Health Promotion Foundation (THPF), screened. Cervical cancer incidence has challenges in receiving timely treatment in
which is funded by a 2% surcharge levied since declined and it is now the second some areas of the country.
on alcohol and tobacco excise tax. Thai most common cancer among females.
smoking rates were approximately 24% in Finally, further efforts are needed to
• In addition, Thailand has been developing
2011. sustainably implement HPV vaccination.
and implementing key cancer control
A pilot HPV vaccination programme has
• 99% coverage of HBV vaccine under the policies. These include laws and taxes on
been implemented in one of 76 provinces
universal vaccination program tobacco products, as well as the 2008
in Thailand, however the plan for rolling-
• Implementation of a population-based Alcoholic Beverages Control Act that details
out national HPV vaccination has not been
screening programme for cervical cancer, the designation of alcohol-free zones and
finalised.
but not yet for breast, or colon cancers. A restrictions on the sale and advertising of
screening program for cholangiocarcinoma alcohol.
has begun for limited areas in Northeast • Palliative care has been included in public
Thailand where it is particularly prevalent health policy since 2014 and will become The National Cancer Institute, in collaboration
• Establishment of systematic training for part of the Health Service Plan in 2016. with other national bodies, developed and
oncologists, radiation oncologists, and Extensive training on cancer pain and promoted the National Cancer Control
oncology nurses. palliative care for physicians and nurses Programme, which was established in 1997.
was introduced in 2015 and morphine is The programme was updated in 2013 and
widely, although not yet universally available consists of seven strategic plans that detail
in Thailand. This has been achieved policies and practices for the prevention,
through the manufacturing of immediate- detection and treatment of cancer and
release oral morphine tablets and morphine supportive care. The Thai Ministry of Health
in liquid form by the Thai Government strongly supports cancer control and its
Pharmaceutical Organization, which has integration into the service plans for healthcare
improved availability and affordability. facilities at all levels.

Investment in treatment services yields important results Probability Of Developing Or Dying From
Quality multidisciplinary
across all cancers. Access to cancer treatment has the
Cancer Before The Age Of 75 In Sub-
potential to save lives, and thereby generate economic
returns from individuals returning to work, as well as Saharan Africa, 2012
improving the quality of life of all cancer patients.
Cervix
By investing in a few core elements, countries can build up 3.8% 2.5%
their treatment capacity and strengthen the whole health
cancer treatment
Breast
system. Tools are on hand to help countries develop and
3.5% 1.8%
prioritise their investments in cancer services.
Prostate
3.4% 1.8%
Liver
0.8% 0.8%
Getting involved:
Equitable access to quality There remains significant inequity in access to essential
medicines and technologies, with significant impacts Programme of Action for Cancer Therapy Colorectum
multidisciplinary treatment on patient outcomes. With prostate cancer for example,
The International Atomic Energy Agency’s Programme
0.7% 0.5%
evidence shows that higher mortality generally reflects low
and care is essential and access to diagnostic and treatment facilities.
of Action for Cancer Therapy (PACT) works closely
0.6%
Esophagus
0.6%
achievable in all resource Following key World Health Assembly resolutions, such as
with global partners to respond to the growing cancer
burden in low- and middle-income countries. PACT Ovary
settings, and will be critical those on palliative care, essential medicines and surgery
and anaesthesia, countries are now challenged with making
supports countries, such as Belarus and those 0.5% 0.4%
to achieving a 25% reduction investments in health systems for sustained implementation.
in Francophone Africa to improve access to safe
radiation medicine technologies, build capacities Kaposi sarcoma
in premature mortality from and mobilise resources to establish quality, effective,
0.5% 0.4%
NCDs by 2025. affordable and sustainable cancer control services.

0.5%
Stomach
0.4%
Nelly Enwerem-Bromson,
Director of PACT, IAEA.
Corpus uteri
“Early presentation, accurate diagnosis,
Target 7 evidenced-based and affordable treatment
0.5% 0.2%
and models of care are essential. Countries Probabilities are for both sexes combined, with the exception
of cervical, breast, and prostate cancers.
that commit to core investments in pathology,
imaging, surgery, radiotherapy and medical
treatments will be the ones that are able to
respond to the growing cancer burden across Resources
all emerging and low-income economies in the
next decade.” WHO Model List of Essential Medicines Expanding global access to radiotherapy
Improve access to services
Richard Sullivan, Director of the Institute The WHO Model List of Essential Medicines is a tool to An estimated 50% of all cancer patients would benefit
across the cancer care help countries develop their own country specific formulary from treatment with radiotherapy, but access is highly
of Cancer Policy, King’s College London
continuum responding to their national disease burden. The document inequitable. Globally, 80% of cancer patients live in low-
can also be used as a tool to revise and update established and middle-income countries, but have access to only
national essential medicines lists, procurement and 5% of the world’s radiotherapy resources3. However
reimbursement policies. investments in radiotherapy are recouped over 10-15
years and have the potential to strengthen the whole
WHO Priority Medical Devices health system.
For many cancer patients in sub-Saharan Africa, the risk of
getting cancer and the risk of dying are comparable because The upcoming ‘WHO Priority Medical Devices for Cancer’ The Lancet Oncology Commission on expanding global
The Global Action Plan for the of late-stage diagnoses and poor or lack of access to quality publication will provide timely advice to governments access to radiotherapy, developed by the Global Task
multimodal treatment. in making the right investments for cancer control Force on Radiotherapy for Cancer Control, explores the
programmes. An expert consultation reviewed the medical investment case for radiotherapy alongside the long-
calls for an 80% availability of the devices required for the management of six cancers: term health and economic benefits of investment in
affordable basic technologies and breast, cervical, colorectal, prostate, lung and leukaemia radiotherapy.
essential medicines, including and a shortlist of interventions and relevant devices is
generics, required to treat major being developed.
NCDs in both public and private

facilities. 15
Atun et al. (2015) Expanding global access to radiotherapy www.thelancet.com/journals/lanonc/article/PIIS1470-2045(15)00222-3/fulltext [Accessed
19.08.16]

Australia
Contributors: Cancer Council Australia

Public
activity
Progress against the World Cancer Key successes • Targeted programmes to reduce disparities,
Declaration targets such as those experienced by indigenous,
Key achievements are listed below, which rural, multicultural, low socio-economic
Since 2013 Australia has made substantial together with overall improvements, have led status communities
progress with: to a 40% increase in cancer survival over three
decades: • Improved quality of, and access to,
• A strong health system with cancer population health data to underpin
outcomes that are amongst the best • Global pioneer in tobacco control accountability and evaluation against the
internationally, however suboptimal measures; such as plain packaging and Declaration targets.
coordination and unwarranted variation tobacco tax increases, of which there have
in cancer treatment leads to inequitable been four since 2008 UICC Member’s achievements
outcomes and lost opportunities for some • The rollout of a bowel cancer screening
population groups Cancer Council Australia (Cancer Council)
programme producing benchmark interim
is the country’s largest non-governmental
• A number of national/state cancer plans, results
research funder, investing more than all NGO
but these are not currently linked to funding. • Further enhancements to an already world- cancer foundations combined1. In 2014-15,
Also, implementation plans lack detail and leading cervical screening programme Cancer Council invested AUD 64 million (USD
there is no overall national cancer plan
• Significant increase in cancer research 47.9 million) into research. They have also had
• National cancer reporting on incidence, investment since 2004. a major impact on biomedical and behavioural
mortality and survival science in Australia.
• Accessible pain relief, although there are Key challenges Cancer Council has led the Australian tobacco
a number of challenges in ensuring care
Priority areas for Australia include: control agenda and also ran the world’s first
equity across an ageing and growing
skin cancer awareness campaigns. In the
population • Greater commitment to tobacco control 1970s, Cancer Council entered the sunscreen
• Education and training of healthcare programmes targeted at socially market (then dominated by tanning lotions)
professionals is strong by international disadvantaged groups and increased with SPF products sold at cost prices,
standards, but there are challenges in general investment in cancer prevention encouraging retailers to follow. Cancer Council
continuous improvement and sustainability. (tobacco, skin cancer, nutrition, physical is the only NGO involved in establishing all
Furthermore, Australia is a world-leader in inactivity and alcohol) three national cancer screening programmes
tobacco control (12.8% smoking prevalence). • Further investment to increase participation and is the leading NGO involved in the
However, aside from tobacco, Australia under- in and effectiveness of three national development of cancer clinical guidelines.
performs in cancer risk factor prevention. screening programmes
The organisation’s main activities involve
There are very high skin cancer rates (due to a • Improved management of liver cancer and policy advice, advocacy, patient support,
fair-skinned population and high UV exposure); at-risk communities and community and professional education.
and while management is improving, • Significant increase in priority-driven Cancer Council is the only Australian NGO that
investment in prevention is low. Nationally, cancer research, in order to shape is active in all facets of cancer control, across
there are high rates of obesity and alcohol apolitical, evidence-based and equity- all neoplasms.
use. Australia is performing well in the areas of driven improvements to health system
cancer screening, HBV and HPV vaccination. sustainability and reach
Footnotes:
1. www.cancer.org.au.

Cambodia
Contributors: Sihanouk Hospital Center of HOPE
5,100 5,500 Yes No 92% No


Public
activity
Declaration targets The Cambodian government has recognised The SHCH2 was established in 1996 to provide
The Government of Cambodia has the importance of strengthening health service clinical education and training to health
developed national strategies and policies delivery to support the treatment and control of professionals, while also delivering free care to
for NCDs, including cancer. In collaboration NCDs, including cancer. Key examples include: the poor in Cambodia. Cancer services were
with key development partners and NGO introduced at the hospital in 2008, including
• The Minimum Package of Activities for
stakeholders, the government is also diagnosis and treatment. In 2016, the hospital
Public Sector Health Centres (2008-15),
identifying opportunities for further progress opened a dedicated women’s health clinic,
which includes measures to detect the
in the areas of cancer registration, prevention, which specifically focuses on the diagnosis
early signs and symptoms of breast and
and improving access to quality diagnosis, and treatment of cervical and breast cancers
cervical cancers, education on breast self-
treatment and care. - the two most prevalent cancers among
examination and risk factors, and the need
women in Cambodia. 671 women have already
NGOs, such as the Sihaouk Hospital Center of for cancer screening1
attended the Women’s Health Clinic. Prior to
HOPE (SHCH), are supporting cancer control • The Health Information System Strategic establishing the Women’s Health Clinic, SHCH
activities. Examples include, additional training Plan (2008-2015) details a process for the has offered breast cancer services since 2008,
for healthcare professionals and providing establishment of surveillance and reporting reaching 30,244 women with peer education
diagnosis and treatment facilities. A network systems for NCDs. and providing 651 women with breast cancer
of community-based peer educators has also diagnoses. Furthermore, SHCH is currently
been used to improve public awareness of Key challenges establishing a partnership with Douleurs Sans
cancer warning signs and symptoms. Frontieres to provide referrals for palliative care
As national policies and strategies are updated
services to patients who require it.
post-2015, it will be necessary to continue
discussing and representing NCDs, including The hospital has also trained more than 670
cancer, in these documents and advocating for medical professionals on women’s cancers in
sustained implementation efforts. Budgets and order to improve detection and treatment.
resources continue to be limited, and require
Finally, SHCH plans to publish two articles
advocacy and government commitment to
on challenges in the management of breast
ensure sufficient funding is allocated for cancer
cancer in a low-resource setting in South
control.
East Asia, and screening for the prevention
Community education will be important to of cervical cancer in HIV-positive and HIV-
increase cancer awareness and improve negative Cambodian women using VIA.
practices, including preventative measures.
There are continuing challenges around health
seeking behaviours, whereby many patients
choose traditional medicines and/or private
practitioners in the first instance, which or who
may not effectively treat the disease. Patients
often present too late to health facilities for
trained providers to treat the disease.
Footnotes:
1. www.wpro.who.int/asia_pacific_observatory/hits/series/cambodia_health_systems_review.pdf
2. www.sihosp.org

China
Contributors: Chinese Anti-Cancer Association; Hong Kong Anti-Cancer Society
1,425,700 779,500 Yes Population-based 99% No data
Generally available at public Generally available at public Not generally available in Not generally available in Generally available in the
primary healthcare level primary healthcare level the public health system the public health system public health system

Public
activity
Declaration targets In 2012, the Ministry of Public Health of China Since 2012, CACA has been successfully
China’s National Office for Cancer Prevention worked with 15 government departments running the Poor Area Cancer Relief Pilot
and Control Research was established in 1969 to conduct the Chinese Chronic Disease Project sponsored by the Ministry of Civil
and cancer prevention plans have been in Prevention and Control Planning Programme Affairs. The project engages well-known local
place since 1986. Building on this, the more (2012-2015), which carried out early diagnosis experts to provide breast and cervical cancer
recent 2004-2010 plan identified objectives and treatment in the top 30% highest risk screening services for women from poor
including the identification of eight national regions. The project screened for stomach, areas in the provinces of Jiangxi and Guizhou.
priority cancers. The identified objectives lung, colon-rectum1, breast, cervix, and The aim is to promote standard treatment
included: pancreatic cancers depending on the guidelines, and to train professional oncology
regional risk profile. For example, oesophagus medical teams in these regions.
• Improving the cancer registry system screening took place in Lin County, Henan
CACA has also been collaborating with UICC
• Promoting health education Province, while stomach screening was
and other national civil society organisations
• Strengthening cancer prevention and implemented in Linqu, Shandong Province.
to run World Cancer Day events since 2008
implementing early diagnosis and Simultaneously, the project implemented
to raise public awareness and have included
treatment policies concerning tobacco control,
a marathon and public seminars on patient
vaccination, healthy diet and exercise to reduce
• Strengthening the Chinese National care and scientific updates. These events have
the population’s exposure to key risk factors.
Comprehensive Cancer Network (NCCN). helped millions of people to access cancer
prevention materials.
Alongside this, there has been strong Key challenges
engagement from supporting non- Around 60,000 cancer control professionals
A recent review by the Chinese Anti-Cancer
governmental organisations, such as the Hong have benefitted from more than 100 continued
Association (CACA) on efforts in cancer control
Kong Anti-Cancer Society, in the delivery and medical education training courses that have
nationally found that civil society has played
support of key services, such as palliative been held over the last five years, and since
a critical role in strengthening government
care. As a whole, Chinese organisations have 2013, CACA has been collaborating with UICC
leadership on cancer prevention and control;
engaged actively nationally and regionally in to run an international medical education
developing and optimising professional
research and conferences on cancer. programme. This fellowship programme aims
training; and reducing cancer incidence and
to develop future leaders in cancer research
mortality.
and clinical practice, and selected fellows are
The review also highlighted some important given the opportunity to train at international
national challenges including the need for: centres of excellence around the world.
• Further multisectoral work nationally to fully

implement and evaluate current policies
• Promotion of the Chinese NCCN
guidelines and a series of cancer treatment
guidebooks to standardise cancer
treatment by health professionals
• Further public awareness-raising and
Footnotes: education on prevention, early detection
1. www.colonscreen.gov.hk/en/index.html and treatment.

Fiji
Contributors: Fiji Islands Ministry of Health and Medical Services;
Fiji Cancer Society
200 400 Yes Hospital-based 99% Yes

Generally available at public Not generally available in Generally available in the Generally available in the
primary healthcare level the public health system public health system public health system
(VIA only)

Public
activity
Progress against the World Cancer • One other major success has been the UICC Member’s achievements
Declaration targets establishment of a dedicated oncology
ward at the main hospital in 2012. There are In 2015, with the support of the Fiji Health
Fiji is making significant and rapid progress four beds in this ward with two specialist Sector Support Programme, Fiji endorsed a
against the Declaration targets including: nurses that treat approximately nine Cervical Cancer Screening Policy that laid out
patients per week with chemotherapy. the strategic direction for a Cervical Cancer
• The Ministry of Health and Medical Screening Programme. This is now under the
Services (MoHMS) is working to develop control of the MoHMS and has one dedicated
a national cancer registry given the vital Key challenges
staff member. As part of this programme,
importance of collecting information to Fiji would make the greatest advances by the MoHMS has ensured that when nurses
measure progress. This activity is in the improving access to services across the cancer receive training on cervical cancer screening,
early stages so definitive results are yet to care continuum. they are also taught breast self-examination,
be seen and subsequently are required to instruct all
Key measures would include:
• Coverage of HBV vaccinations is at 90.9% patients on breast self-examination. Breast
• Improving awareness through close and cervical cancers are the most prevalent
and the HPV vaccination rate is 72% after
partnerships with the Fiji Cancer Society in Fiji and so this strategy aims to target both
only a few years of operation.
and the NGO, WOWS Kids Fiji, to provide simultaneously. The cervical cancer screening
a structured and effective awareness project works in close partnership with
Key successes programme including cervical screening other stakeholders in cancer screening, aid
There are a number of key achievements to and breast self-examination for women in programmes and NGOs, and clinical parctice,
note: rural and maritime areas and selected fellows are given the opportunity
• Continuing work with IAEA on a project to to train at international centres of excellence
• In 2010, the MoHMS cancer registry began
establish radiotherapy, which is expected around the world.
collating information from multiple sources
to be up and running by 2021. This is
to create a more accurate account of the
a substantial project, which involves
national cancer burden. In one year, twice
introducing a new medical discipline
the number of cancer cases were detected,
which, while initially shocking, is likely due • Improvements in chemotherapy with the
to the fact that the system generates more return of two Fijian medical oncologists
accurate data. As a result, there is now a later in 2016, following their training
clearer idea of the challenge and resources overseas
needed • Ensuring the development of palliative
• In 2010, parliament passed the Tobacco care as a new discipline through planned
Decree and a dedicated Tobacco Unit was consultations and the inclusion of palliative
established in a National Wellness Centre care within the 2016 National Cancer
by 2012. The Tobacco Unit enforces new Control Plan.
laws around smoking, and smoking rates
have noticeably decreased as a result

Korea, the Republic of
Contributors: National Cancer Center; Korean Association for Clinical Oncology

Public
activity

Declaration targets The five year relative survival rate for all cancers To address some of the key national
Korea has made the following progress: has increased from 65.1% (2001-2005) to challenges, the following programmes are set
69.4% (2009-2013) in Korea, while the age to be introduced as part of the 2016-2020
• The national population-based cancer standardised mortality rate has decreased by National Cancer Control Plan:
registry covers nearly 100% of cancer 2.7% annually from 2002 to 2013. • A national programme for lung cancer
cases1
The main contributors to this include; a screening with low dose CT for high risk
• Ten codes of practice for cancer prevention target groups, following a series of pilot
functioning screening and early detection
have been publicised, and Korea is studies and an infrastructure assessment
programme with enhanced quality control,
preparing to revise them based on latest
a robust health system with quality medical • Implementation of a new survivorship
evidence
services, sustained national efforts to programme by regional cancer centres
• Since 2002, a national cancer screening reduce the financial burden on patients, • Extension of hospice care to include
progamme for five cancers has been in and importantly the government’s steady consultative and home services
place. Together with private sector cancer investment into cancer prevention
screening services, around 70% of the • In collaboration with national and
programmes2.
target population now participate in cancer international organisations, cancer research
screening and early detection Since 2015, an increase in cigarette prices, across the cancer continuum, including
WON 2,500 to WON 4,500 (USD 2.26 to USD clinical oncology, will be encouraged. Also,
• HBV vaccination has been part of the
4.06) has increased the budget for the Health efforts will be made to foster public interest
National Immunisation Programme (NIP)
Promotion Fund, which can be used for cancer oriented clinical trials.
for several years. Coupled with vertical
prevention activities, especially smoking
transmission prevention services, it is
cessation programmes. UICC Member’s achievements
having a significant impact
• From 2016, HPV vaccination for 12 year-old The National Cancer Center (NCC) has
girls has been included in the NIP supported implementation of the second
• National insurance covers 95% of total 10-year National Cancer Control Plan
medical cost for cancer treatment (2006-2015). NCC leads cancer research,
coordinates the national cancer registration
• Korea organised a cancer leadership programme, provides technical support to
course (CanLEAD) and will open an online regional cancer centres, and manages a
course with WHO. financial aid programme for cancer patients.
NCC also evaluates and ensures the quality
of nationwide hospice services, and operates
the National Cancer Information Center and
Tobacco Quitline Service3.
Footnotes:
1. http://ncc.re.kr/main.ncc?uri=english/sub04_Statistics
2. www.ncc.re.kr/sub07_Publications.ncc?isgubun=A&searchKey=title&searchValue=&pageNum=1
3. www.ncc-gcsp.ac.kr
4. www.ncc.re.kr/main.ncc?uri=english/sub04_ControlPrograms

Malaysia
Contributors: National Cancer Society of Malaysia

(Pap smear only)

Public
activity
Progress against the World Cancer Key successes Greater efforts are needed to ensure
Declaration targets equity and access to cancer care through
In 2013, the National Cancer Institute was multidisciplinary management, structured
• More surgeons have been trained in established as the country’s reference patient navigation and affordable treatments.
breast cancer management, ensuring the and research centre on cancer, providing
availability of surgery in eight major public state-of-the-art cancer treatment. It has
hospitals. Two additional academic centres greatly reduced the waiting time for radical
have also been dedicated to breast cancer radiotherapy (from 120 days in 2013 to 28 days The National Cancer Society of Malaysia
care. MYR 50 million (USD 12.55 million) in 2014). (NCSM) through its three pillars of education,
and one mobile clinic bus were allocated to care and support augments national efforts in
Malaysia has also strengthened its smoking
mammogram subsidy programmes, and cancer prevention, early detection and patient
regulations to fulfil its WHO FCTC obligations,
MYR 9 million (USD 2.25 million) to provide support. In collaboration with government
including banning smoking in air-conditioned
breast prostheses ministries, NCSM provides community
public places and sheltered walkways, and
outreach programmes, cervical and breast
• ‘MQuit’ was launched in 2015 to encourage raising the tobacco tax by more than 40% from
screening to underserved populations.
smoking cessation, as well as a ‘Hebat 2014 to 2015. A National Tobacco Bill will be
Annually over 7,000 free and subsidised
programme’ in schools, which was effective enacted in 2016.
mammograms, HPV vaccinations and Pap
in encouraging healthy eating, exercising
In 2010, a national HPV vaccination tests are provided to targeted populations. In
and reducing obesity among children
programme for girls was introduced to 2015 alone, NCSM held over 150 grassroots
• HBV immunisation began in 1989, decrease cervical cancer risk. education events.
achieving 88% coverage in 2003. HPV
vaccinations are also now provided in The provision of palliative care has been NCSM drives tobacco control through
national schools as well as a catch up incorporated into cancer management, with advocacy, cancer awareness and ‘quit smoking’
programme for young women who missed most state hospitals now offering some form of programmes for teenagers in schools, and has
it, with a current coverage of 70% and a the service. established a smoking cessation clinic.
98% acceptance rate
A free cancer information service, which
• Traditional and complementary medicine Key challenges includes a toll-free helpline, provides resources
has been incorporated in the Strategic The implementation of a cohesive national and support to individuals, health professionals
Plan for Cancer Control to help relieve pain cancer control plan incorporating all and cancer networks nationally.
and distress using techniques which have stakeholders is integral to the country’s
undergone clinical trials. commitment to fight cancer. The National
Cancer Registry also needs to be strengthened
to provide key cancer surveillance data. With
a projected rise in cancer incidence, a focus
on prevention and earlier detection of cancer
is imperative. Malaysia’s elevated exposure
to cancer risk factors such as the rapid
increase in youth and adult obesity incidence,
high tobacco prevalence and sedentary
lifestyle requires more stringent policies and
collaborative measures within the cancer and
NCD framework.

Mongolia
Contributors: National Cancer Center of Mongolia
1,800 1,400 Yes Hospital-based/National 98% No data

Generally available at
public primary healthcare
level (Pap smear only)

Public
activity
Progress against the World Cancer • Pain management guidelines have been UICC Member’s achievements
Declaration targets developed and there are regulations for the
provision and use of opioids The NCCM provides cancer care and services
• Cancer care and services in Mongolia are nationwide, receiving patients referred from
• Every province and district has an oncology all districts of the capital city and all provinces,
provided free of charge and fully funded by
physician and nurse, a palliative care as well as providing telemedicine support
the state budget
physician and nurse. for specialists in the field. NCCM is also
• A population-based cancer registry was
responsible for overseeing cancer registration,
established in 2012, but further efforts Key successes research, and training of cancer specialists.
are needed to improve quality. In 2013,
with support from WHO, the International • The ‘Action Plan on Cancer Prevention and NCCM has implemented the ‘National anti-
Classification of Diseases for Oncology Control’ (2011-2021) has been endorsed cancer campaign’ since 2011, in cooperation
(ICD-O-3) was translated into Mongolian by the Ministry of Health and outlines with the private Khaan Bank and the Mongolian
and a workshop was held to train national strategies on cancer prevention, National Broadcaster. Campaign activities
pathologists and statisticians diagnostics, treatment, and palliative care. include: screening and early detection with
This plan informs the development of the high-risk populations for the most common
• The second ‘National Programme on
‘Sub-programme on Cancer Prevention cancers, raising public awareness on cancer,
Prevention and Control of Diseases caused
and Control’ (2015–2020) and the national training of district and province level health
by Harmful Lifestyle Factors’ was approved
NCD programme. The third national service providers on prevention and early
in 2014, and addresses prevention of
‘Sub-programme on Cancer Prevention detection, and building a network of health
common risk factors for NCDs, including
and Control’ was approved in 2014, and is volunteers specialised in cancer prevention.
through laws for tobacco, alcohol and food
currently being implemented
safety NCCM is a key technical institution that
• Development of the ‘Strategic Plan for
• A national strategy against viral hepatitis oversees the development and implementation
Development of Radiotherapy’ (2011-2021)
has been implemented of the second and third National Sub-
aims to upgrade the quality of radiotherapy
• Following a successful HPV pilot project programmes on Cancer Prevention and
in Mongolia to international standards and
in two provinces and two districts of the Control, and has also established the
make it accessible for all patients
capital city, plans are in place for national molecular genetics laboratory at the National
• The Tobacco Control Law was revised and Cancer Centre.
rollout
updated in 2014.
• Cervical and breast cancer screening NCCM is also involved in updating clinical
has been implemented since 2012. guidelines on early detection, diagnosis and
Key challenges
Gynaecologists, cytologists and feldshers treatment of cancer.
(medical assistants) have been trained in Key challenges include:
cervical cancer screening
• High prevalence of cancer risk factors
• A liver cancer screening strategy was
• Limited funding and weak multisectoral
endorsed in 2014
cooperation for cancer control
• A new extension building for the National
• Lack of cancer research capacity
Cancer Centre of Mongolia (NCCM) is
under construction, which will allow for • The need to improve diagnostic and
expansion of cancer services, including liver treatment equipment.
surgery and transplantation, radiotherapy
and chemotherapy

New Zealand
Contributors: Cancer Society of New Zealand

(mammogram only) (Pap smear only)

Public
activity
Progress against the World Cancer Key challenges Finally, it is notable that some cancers are
Declaration targets given more attention than others; for example
The Cancer Society would welcome measures breast cancer receives more focus and funding
The Government of New Zealand has to develop specific cancer-related strategies, than bowel cancer, despite the fact that bowel
developed several strategies and documents with clearer strategic goals and objectives in cancer has higher mortality rates nationally
that include cancer. The Cancer Society of order to address: with a death rate per annum of around 1,2831.
New Zealand (the Cancer Society) has worked • Health inequalities – there are sections of Bowel cancer screening and care delivery
with the government to establish and promote the population, including the Māori and should therefore be fast tracked.
measures such as smoke-free cars, sunbed Pasifika, who lack easy access to care with
legislation, access to immunotherapies and implications for treatment outcomes of UICC Member’s achievements
work and income support for cancer patients. at-risk groups
The Cancer Society is working hard – on
Since the introduction of the Cancer Registry • Determinants of health – the Health
both local and national levels - to reduce
Act in 1993 and the Cancer Control Strategy Strategy 2016 identifies the need for action
the incidence and impact of cancer through
in 2003, New Zealand has made significant on a number of cancer risk factors including
advocacy and the provision of health
progress against the first three Declaration poor diets, physical inactivity, and obesity,
promotion, support services, information and
targets. particularly during childhood
research2.
• Workforce needs
Key successes • The Cancer Society funds a large range of
• Sustainable funding – this is required to
cancer research in New Zealand each year,
The Plain Packaging Bill is on its third reading deliver on the aspirational strategies set out
as well as PhD scholarships
through Parliament. The Cancer Society has in the Health Strategy 2016 and to ensure
that current cancer strategies can be • To reduce cancer risk factors, the Cancer
been advocating strongly for this Bill to be
properly implemented Society has representation on the National
passed.
Smokefree Working Group, and the
• NGO representation and involvement
PHARMAC, the government agency Smokefree Cars, Smokefree National
responsible for providing funded access • Cross-government policy – to ensure Action Plan and Tobacco Tax sub-
to pharmaceuticals for New Zealanders that New Zealand has a coordinated and committees. The Cancer Society was also
has recently announced the funding of effective national cancer response, which involved in the development of the Skin
immunotherapies. includes prevention and research Cancer Control Strategy 2014-2017 and
• Early intervention – which is important for continues promoting SunSmart Schools
improving long-term health outcomes and across the country.
efforts should be combined with improving • To ensure that New Zealand has a strong
access to primary care services and health system, the Cancer Society develops
screening. and presents submissions on government
activities.
• To improve the well-being of all those
in New Zealand affected by cancer, the
Cancer Society provides an impressive
range of supportive care and information
Footnotes:
1. Ministry of Health, Cancer Registry 2012 services to patients and their families.
2. https://cancernz.org.nz/

Philippines, the
Contributors: Philippine Cancer Society

Not generally available at Generally available in the Generally available in the Not generally available in
public primary healthcare level public health system public health system the public health system

Public
activity
Declaration targets • Quality data on the national cancer PCS is undertaking pioneering activities in
• A population-based cancer registry is in burden is now available as a result of the the fields of cancer registration, tobacco
place establishment of cancer registries by the control, hospice and palliative care, and patient
Philippine Cancer Society (PCS) and the navigation. It also works in close collaboration
• A National Programme for Healthy
Department of Health with the government and supports several
Lifestyles has been introduced focusing
• Tobacco control efforts have resulted cancer prevention and control activities in an
on tobacco control, healthy diet, increased
in a significant reduction in tobacco advisory capacity.
physical activity and moderate intake of
alcohol. National legislation on tobacco consumption, as indicated in the latest In particular, PCS:
control has been enacted National Nutrition Survey • Advocated for tobacco control laws on
• National Cancer Consciousness Week is • National legislation requiring a mandatory tobacco regulation (2003), sin taxes for
observed in the third week of January every HBV vaccination birth dose for all infants tobacco and alcohol (2013), graphic health
year and cancer awareness activities are has resulted in more than 90% compliance. warning signs on tobacco packaging
held every month (2015), and founded the Framework
Convention on Tobacco Control Alliance in
• Training has been introduced to build Key challenges the Philippines
national capacity for cervical cancer
screening To achieve the Declaration targets by 2025, • Established the first cancer screening
further work is needed to: and early detection clinic, and operates a
• There are several initiatives to address
cancer screening bus with facilities for VIA,
hospice and palliative care, including • Update the National Cancer Control
cryotherapy and clinical breast examination
national legislation and policies Programme
• Advocated for HBV vaccination and has
• The Philippine National Health Insurance • Raise awareness of cancer prevention
organised several national summits on this
Programme has expanded its coverage to and the need for early detection with local
issue
include benefits for certain cancers. government
• Founded the National Hospice and
• Educate and train more cancer care
Palliative Care Council of the Philippines
specialists
and the Philippine Society of Hospice
• Increase the availability, accessibility and and Palliative Care Nurses, and organises
affordability of pain medicines, especially national summits on cancer and palliative
opioids care.
• Provide hospice and palliative care to the • Leads activities for the American Cancer
terminally ill at all levels of care. Society’s Relay for Life campaign in the
Philippines and organises several cancer
support groups.

Samoa
Contributors: Samoa Cancer Society Inc.
No data No data Yes Hospital-based 95% No data
Generally available at public Not generally available at Not generally available in Generally available in the Generally available in the
primary healthcare level public primary healthcare level the public health system public health system public health system

Public
activity
No data No data No data No data No data No data No data
Declaration targets Samoa has made a key policy commitment SCS is a non-profit NGO and is the only
At the moment, Samoa is not able to fully track with the implementation of the National national organisation focused on reducing the
the incidence of cancer and mortality rates, Tobacco Control Policy and Strategy 2010- national cancer burden, as well as ensuring
and therefore is unable to effectively allocate 2015 with a comprehensive approach towards the best possible outcomes for those affected
and justify the resources required for effective tobacco control. In May 2015, the Government by it. Founded in 1998 and governed by a
cancer prevention and management. Whilst of Samoa introduced an excise tax on tobacco voluntary board, SCS is committed to reducing
progress against the Declaration targets may products. premature death and suffering from cancer.
have been limited, Samoa has made good It is the only organisation in Samoa providing
The Pacific mCessation project, which is
progress with regard to reducing exposure to support to cancer patients and their carers,
a partnership between the University of
risk factors for cancer. The National Non- and that raises awareness of cancer to try to
Auckland and the Samoa Ministry of Health,
Communicable Disease Policy (2010-2015) improve treatment-seeking behaviour. SCS’s
supports tobacco cessation in Samoa. The
outlines the need to address smoking, poor key achievements include:
pilot project will launch a new anti-smoking
nutrition, physical inactivity and alcohol mass media campaign early this year and the • Educating over 8,000 people per year
consumption through health promotion Samoa Cancer Society (SCS) will assist with on the warning signs of cancer and the
programmes, health reform and legislation to the pre and post-test evaluation and feedback importance of seeking treatment early
support lifestyle changes by individuals and studies.
families. Civil society groups have played an • Providing over 80 people per year with
important role in supporting the promotion support in managing cancer diagnosis,
Key challenges treatment and palliative care
and reinforcement of these health messages,
and in the implementation of reforms and SCS would like to see further work on health • Developing and maintaining a database of
legislation that reduce unhealthy behaviour. promotion and cancer awareness in villages cancer patients to better inform planning
and community groups to encourage and policy making.
individuals to seek early diagnosis and
treatment. Working with the government and
health providers, SCS can help to ensure that
effective early detection programmes are
considered and implemented where they are
deemed feasible and appropriate.
Development of palliative care services across
the islands will be an important step in order
to provide patients with adequate support
and relief from symptoms. SCS will continue
to work with the government and health
providers to strengthen palliative care planning
for cancer patients and to continue to provide
support for pain management as well as
medical, social and psychological needs.

Taiwan, Province of China
Contributors: Formosa Cancer Foundation

Public
activity
Progress against the World Cancer Key successes To control national obesity levels, multi-
Declaration targets sectoral approaches will be critical, particularly
• The number of people utilising cancer for ensuring sustainable purchasing and
Since 2005, Taiwan has implemented three screening services increased from 3.01 to production, and advocating for food industries
phases of its National Cancer Control Plan, and 5.06 million, from 2009 to 2015 to reduce sugar content and promote the
has now adopted all of the WHO’s NCD targets • Of the five million people who received Nutrition Act.
for 2025. screening in 2015, about 12,000 were
diagnosed with cancer, and 48,000 UICC Members’ achievements
• The Health Promotion Administration
precancerous lesions were found
(HPA) has subsidised more than 230 The Formosa Cancer Foundation (FCF) has
hospital practices to incorporate preventive • The screening rates for breast, colorectal,
been involved in several nationwide prevention
healthcare services for tobacco and betel oral and cervical cancers in 2015
campaigns including launching the ‘five-a-
quid cessation, weight loss, and cancer were 39.5%, 42.0%, 56.1% and 74.5%
day’ healthy eating campaign in 1999, and
screening. HPA provides cervical, breast, respectively
specifically in elementary schools in 2003. In
colorectal and oral cancer screening free of • The standardised mortality rate fell from 2006, the ‘five-a-day’ recommendation was
charge to age-specific population groups 132.5 per 100,000 population in 1998, to adopted as part of healthy diet guidelines by
• The Tobacco Hazards Prevention Act was 130.2 in 2014 Health Bureaus across the country.
adopted in 1997 • The five-year survival rate increased
FCF has been working with anti-tobacco
• HBV vaccination for infants was launched from 48.3% during 2003-2007 to 54.3%
NGOs since 2007 to urge the government to
in 1984. Free HPV vaccination has been between 2008-2013
make tobacco control a priority. In 2010, the
offered to girls in aboriginal regions and • The smoking rate among adults has ‘5 Easy Ways to Keep Cancer Away’ campaign
from low- and middle-income households decreased from 21.9 to 17.1%, from 2008 was launched, underlining that cancer is
since 2011 to 2015. Betel quid chewing rate has preventable through smoking cessation,
• In 2008, the Cancer Care Quality decreased from 17.2 to 8.8% between healthy diet, weight control, exercise and
Accreditation was launched to ensure 2007 and 2015, and the national target for screening.
the provision of cancer care by multi- weight-loss has been achieved - 1,142,729
kgs in 2014. FCF operates cervical cancer screening
disciplinary teams.
mobile clinics in remote regions and has been
Key challenges promoting HPV vaccination for cervical cancer
prevention since 2007.
A national goal has been set to achieve a
20% reduction in cancer mortality by 2020. In 2009, FCF launched the ‘Capture the Polyp’
This will require additional funding from the campaign to raise awareness of colorectal
government, closer collaboration with NGOs, cancer.
and the development of human resources, Finally, since 2007, FCF has established
particularly to increase screening rates. In ‘Survivors Care Centers’ in northern and
addition, efforts need to be made in ensuring southern Taiwan that provide cancer survivors
that newly diagnosed patients receive regular with services to facilitate optimal recovery.
treatment within three months of receiving
their diagnosis.

Tonga
Contributors: Ministry of Health of Tonga
No data No data Yes Hospital-based 99% No data

Public
activity
Progress against the World Cancer Key successes • Improve access to treatment and palliative
Declaration targets care for cancer patients. Treatment
Tonga has seen a number of key successes: plans with international hospitals are
The National Health Strategic Plan (2015- • The cancer registry was re-established being streamlined, however only 1% of
2020) has driven progress towards the in 2014, using the CanReg5 database to patients are sent overseas due to budget
Declaration targets, incorporating various input data, and is continually developing. constraints. As such, the MoH needs
cancer control strategies to help strengthen Data from the pathology laboratory is being to develop rigorous patient selection
the health system. These include a policy added to the database, increasing the processes and sustain relationships with
outlining an essential package of preventative, quality of the data collected these institutions
curative and palliative health services to
• Strengthening of national tobacco control • Establish a dedicated oncology unit, led by
strengthen early detection and management
measures, such as the Tobacco Control Act a trained oncologist.
of NCDs, including cancer. In addition,
Tonga commissioned its first mammography (2000) and the development of legislation
machine in 2014, and CT scans were made banning smoking in public places Author’s achievements
available in 2013. Ultrasound guided biopsy is • Chemotherapy for children with leukaemia The MoH of Tonga has undertaken
also available and in 2009, chemotherapy for is available in Tonga since 2009, with four comprehensive work to improve cancer control
paediatric patients was developed, with five out nurses trained on the administration of nationally, this includes:
of eight patients surviving. chemotherapy in 2012.
• Establishing a cancer registry to identify
Tonga has also ratified the WHO FCTC and the current cancer burden and improve
Key challenges
in line with this, the government passed surveillance to inform future cancer control
a Tobacco Control Act in 2000, including Key development priorities for the Ministry of plans
legislation for a ban on smoking in public Health (MoH) are to: • Adopting the Package for Essential NCD
places.
• Develop a national cancer control strategic Interventions in 2012, and the inclusion
plan and conduct further research into of cancer control strategies in the National
cost-effective services for the population Health Strategic Plan 2015-2020
• Establish a population-based registry from • Strengthening tobacco control legislation
the current infrastructure on smoke-free environments, advertising,
manufacture and imports under the
• Improve screening methods, such as
Tobacco Control Act. Alongside this, in May
developing immunohistochemistry,
2016, the MoH launched mass media anti-
to identify tumour markers alongside
tobacco campaigns and tobacco cessation
improved cervical screening methods
services
• Develop and expand rigorous public
• Availability of paediatric chemotherapy
awareness campaigns to improve
services for leukaemia since 2009
awareness of cancer risk factors, signs and
symptoms in order to improve rates of early • Engaging in regional meetings including
diagnosis and treatment the Pacific Cancer Control Leadership
Forum in 2014, a Cancer Registry training
• Introduce the HPV vaccination
course led by WHO WPRO and IARC in
Footnotes: South Korea in 2014, and building close
1. http://www.who.int/nmh/publications/essential_ncd_interventions_lr_settings.pdf working relationships with physicians in
New Zealand and Australia.
Untreated Deaths In Pain, 2011
Palliative Care and 1,000 or less 1,001—4,334 4,335—7,667 7,668—11,000 11,001 or more No Data Top ten countries
Pain Relief Opioid analgesics are considered essential medicines and

are present on almost every national essential medicines list.
A small number of medications, none of which are limited
by patent, can control pain for almost 90% of people with
cancer pain16, including children17.
Morphine, the most effective pain control medicine, is safe,
effective, inexpensive, easy to use and available in plentiful
supply globally. However, legal and regulatory restrictions,
With a small investment, cultural misperceptions about pain combined with
all countries can deliver inadequate training and poorly-functioning markets forces
5.5 million cancer patients on average to die in pain each
the limited number of year18.
inexpensive medicines There are considerable inequities in terms of global access
to pain relief and palliative care. Patients in low- and middle-
required to provide effective income countries often have the most limited access. It is
pain relief to cancer patients. estimated that 92% of the world’s medical morphine is
consumed by just 17% of the global population19, located
predominantly in high-income countries. By comparison,
approximately 75% of the world’s population has no or
limited access to pain relief.
Target 8 The WHO assessment of National Capacity for the

Resources
Prevention and Control of NCDs found that approximately
41% of countries could provide palliative care services
through primary healthcare facilities, but only 36% could Global Opioid Policy Initiative HAU worked with the Government of Uganda to change
offer community or home-based care20. legislation to enable prescriptions for liquid oral morphine
The European Society for Medical Oncology-led by specialist trained nurses and clinical officers. Since
The regulatory requirements established by international Global Opioid Policy Initiative explored barriers to 2003, morphine has been available for free to patients with
drug control treaties are designed to prevent the diversion opioid access across the globe and provides a set of 10 a prescription.
and abuse of controlled drugs. However, many countries recommendations on how countries can reduce those
barriers. The project includes data and a number of Training and oversight have been central to HAU’s aims
have adopted measures that exceed those required by
Universal availability of advocacy resources that make the case for palliative care and this is provided through the Institute of Hospice and
the UN Single Convention on Narcotic Drugs. Numerous
pain control and distress international agreements now call for improved balance in action in every region. Palliative Care in Africa. The institute offers training courses
and support, alongside a distance learning programme up
management drug policies to improve access to pain medicines including:
Hospice Africa Uganda to degree level through an e-learning platform.
the 2015 report from the International Narcotics Control
Board entitled the Availability of Internationally Controlled Hospice Africa Uganda (HAU) was established to provide HAU’s success has stemmed from the delivery of tailored
Drugs, World Health Assembly Resolution on Palliative modern methods of pain and symptom control to patients and effective education to healthcare professionals and
Care, and the Global Action Plan for the Prevention and with cancer and HIV/AIDS. HAU treats over 3,000 cancer measures to ensure access to opioids as part of safe pain
Control of NCDs. patients per year with an emphasis on holistic care and management services.
support for patients and families.
The four core elements of an effective palliative care
The Global Action Plan for the response are policies, education, availability, and
Prevention and Control of NCDs regulation.
calls for improved access to
palliative care. “Ensuring access to controlled substances for medical purposes requires a focus on education of both
Zech et al. (1995) Validation of World Health Organization Guidelines for cancer pain relief: a 10-year
clinicians and the public; ready availability of the medicines and improving the laws and regulations that
16
prospective study www.ncbi.nlm.nih.gov/pubmed/8577492 [Accessed 19.08.16]

17
Zernikow et al. (2006) Paediatric cancer pain management using the WHO analgesic ladder-results of a in many countries act as a clear barrier to pain relief. Each on its own is ineffective, but when taking place
prospective analysis from 2265 treatment days during a quality improvement study www.ncbi.nlm.nih.
gov/pubmed/16243549 [Accessed 19.08.16] together can result in balanced access to opioids.”
18
WHO, Ensuring balance in national policies on controlled substances www.who.int/medicines/areas/
quality_safety/guide_nocp_sanend/en/ [Accessed 19.08.16]
Jim Cleary, Director Pain and Policy Studies Group, UW Carbone Cancer
19
INCB, Report 2014 www.incb.org/documents/Publications/AnnualReports/AR2014/English/AR_2014.
pdf [Accessed 19.08.16]
WHO, Assessing National Capacity for the Prevention and Control of Noncommunicable Diseases
20
(2015) http://apps.who.int/iris/bitstream/10665/246223/1/9789241565363-eng.pdf?ua=1 [Accessed

19.08.16]

Conclusion
Sanchia Aranda We believe that it is critical to respond to this need by uniting

as a cancer community to call for a comprehensive and robust
President Elect, Union for International World Health Assembly cancer resolution in 2017 that would
Cancer Control articulate a clear framework for a health systems response
As I take up the UICC presidency from November 2016 for cancer, establishing the core disciplines and services for a
through to 2018, I am both encouraged and inspired by the holistic, impactful and scalable response, adapted to the local
stories of progress featured in this Report. In particular by burden and aligned with national capacities. The resolution
the diverse contributions made by UICC members to advance would also:
the World Cancer Declaration targets through awareness • Reinforce WHO’s mandate to respond to Member States’
raising, training and education, service delivery and working requests for assistance
in national and regional cancer control partnerships and NCD
• Provide a framework for international engagement
Alliances. I am particularly impressed with the number of
member organisations that recognise the critical importance • Support and encourage alignment and integration with the
of cancer surveillance and data as a foundation for focused WHO strategies on child, adolescent and maternal health,
action. As highlighted in the Report, the Global Initiative for and life course and aging
Cancer Registry Development (GICR) is providing vital know-
• Bring together the components of recently adopted World
how and support for every country to understand their own
Health Assembly Resolutions including on palliative
burden and I urge you to engage with GICR if you do not have a
care, access to surgery and anaesthesia, and essential
population-based cancer registry in your country.
medicines.
Whilst several UICC members are leading or contributing to If a cancer resolution is going to make a difference by 2025,
the development of national cancer control plans or cancer UICC must also to play its part, and show leadership in the
chapters in NCD plans – the Report highlights that many translation of global commitments into action. I am therefore
of these plans are not in the public domain or are not being honoured to announce that in January 2017, UICC will
implemented due to underfunding, lack of expertise for launching an innovative multi-stakeholder initiative focusing
scale up, or both. Particularly in developing countries where on the smallest unit of a cancer health system response – a
the burden is set to increase most rapidly, governments are reference cancer centre. We will be calling on city leaders to
urgently seeking best-practice guidance for implementation take up the challenge of establishing a cancer solution in all
and scale up of phased, feasible and quality national cancer cities of 1 million population or more, and we welcome our
control programmes. A health systems response for timely members and partners to join us in this bold challenge.
cancer diagnosis and early and potentially curative treatment,
which we know is cost-effective, is where help is most urgently
needed.

Current Distribution of
NCD Alliances Regional And National
NCD Alliances 45 CD Alliances
N
Worldwide
UICC members have a crucial

“Together, as an alliance, we
role to play in delivering advocated for the inclusion
national action on NCDs of a target in the Sustainable
Development Goals to reduce
through national and regional premature mortality due to NCDs
alliances. by one third by 2030. I encourage
all cancer advocates to get
Many of the solutions to more effective cancer involved in NCD advocacy and
prevention and control are shared across NCDs, connect with, or start, local NCD
such as diabetes, cardiovascular disease and networks to amplify your voice
chronic respiratory disease. UICC is a founding and call for increased government
federation of the NCD Alliance, a unique civil action on cancer and NCDs.”
society network, uniting 2,000 organisations
Katie Dain, Executive Director,
in more than 170 countries, dedicated to
NCD Alliance
improving NCD prevention and control
worldwide.
“The challenge of NCDs is so
As well as promoting global advocacy, NCD huge that one single stakeholder
Alliance supports national and regional NCD can’t tackle it alone. By standing Maldives
civil society organisations and coordinates a together with our alliance Zanzibar
growing network of 45 national and regional partners, we as cancer advocates
NCD alliances, strengthening these vital gain a broader perspective, are
platforms for collaboration and unified advocacy. more easily heard by decision-
makers and have more impact.
For the better of all of us.”
Anne Lise Ryel, Secretary
General, Norwegian Cancer
Society
“The NCD movement offers

Forging powerful partnerships Shaping national policy Leveraging networks in Norway
enormous opportunity to expand with risk factor organisations in in Ethiopia
our tobacco control advocacy The Norwegian NCD Alliance was
Brazil
networks and increase our The Consortium of Ethiopian NCD formed in 2010 by four members:
ACT+Br, was originally ACT Br, a Associations (CENCDA) was formed in Norwegian Health Association, Norwe-
chances of policy impact. As
tobacco control organisation. After July 2012, with the Mathiwos Wondu- gian Cancer Society, Norwegian Heart
tobacco advocates we also
2014, it broadened its mission to YeEthiopia Cancer Society acting as its and Lung Foundation and Norwegian
have unique advocacy skills that include NCDs and in 2015, it advocated secretariat. The consortium advocated Diabetes Association. It has successfully
can benefit the rest of the NCD tirelessly with the Brazilian government for a Strategic NCD Framework, a key collaborated with the Norwegian gov-
community.” for the inclusion of tobacco and NCDs policy and strategic document, which ernment on a physical activity campaign
Paula Johns, Executive in the SDGs, in which it was successful. was integrated into the Fourth Health targeting over 50s who are not physically
Implementing the FCTC is one of the key Sector Development Program for the active to help them reduce their own
Director, ACT+
means of implementation for the health first time. risk of developing cancer, heart or lung
goal. disease.

UICC members:
1,000 and counting
In September 2016, UICC reached the milestone of 1,000 member organisations
Afghanistan Australian Catholic University, Exercise Darwin Prostate Support Awareness Group
Afghan Society Against Cancer Lifestyle Clinic - Prosper
Bairnsdale Prostate & Partners Support Denmark PCSG
Algeria Group Devonport PCSG
Ballarat Prostate Cancer Support Group Diamond Valley PCSG
Association d’Aide aux Enfants Cancéreux
Barossa Prostate Cancer Support Group Dubbo PCSG
Association d’Aide aux Enfants Cancéreux -
Béchar Bass Coast Prostate Cancer Support Group Dural PCSG
Association des Médecins Libéraux d’Annaba Bathurst Prostate Cancer Support Group Eastern Shore PCSG
Chu Annaba - Clinique Médicale Infantile Bayside Kingston PCSG Essendon PCSG & Diamond Valley PCSG
Sainte Bendigo & Districts Prostate Cancer Support Far North Queensland (Cairns) PCSG
El Adwa Group Far North Queensland PCSG
EL BADR Biloela PCSG Frankston & District PCSG
El-AMEL Association Blackwood Districts PCSG Fremantle PCSG
ENNOUR for Helping Cancer Patients - Sétif Box Hill PCSG Garvan Research Foundation
Errahma Breast Cancer Network Australia Gawler PCSG
Nassima Brisbane Prostate Cancer Support Network Gay Melbourne Prostate Cancer Group
Nour Doha Broken Hill Prostate Cancer Support Group Gay Prostate Support Adelaide
Waha Bunbury District Prostate Cancer Support Gay/Bisexual Prostate Cancer Support QLD
Group Geelong Prostate Support Group
Anguilla Bundaberg & District Prostate Cancer Geraldton PCSG
Support Group Gladstone & District Prostate Cancer Support
Anguilla Family Planning Association Busselton PCA&SG Group
Cancer Australia Glass House Country PCSG
Antigua and Barbuda
Cancer Council ACT Glen Innes PCSG
Antigua Planned Parenthood Association
Cancer Council Australia Gold Coast North Prostate Cancer Support &
Caribbean Family Planning Affiliation, Ltd.
Cancer Council Northern Territory Awareness Group
Cancer Council NSW Gold Coast Prostate Cancer Partners
Argentina
Cancer Council Queensland Support Group
Asociación Leucemia Mieloide de Argentina Goulburn & District Prostate Cancer Support
Cancer Council South Australia
Fundación para la Salud del Adolescente Group
Cancer Council Tasmania
Fundación SALES Granite Belt PCSG
Cancer Council Victoria
Liga Argentina de Lucha Contra el Cáncer Great Lakes Prostate Cancer Support Group
Cancer Council Western Australia
Linfomas Argentina Griffith PCSG
Cancer Nurses Society of Australia
Sociedad Latinoamericana y del Caribe de Griffith University Menzies Health Institute
Capricorn Coast Prostate Support &
Oncología Médica Queensland
Awareness Group
Central Australia Support Group Leaders Gympie & District PCSG
Aruba Teleconference Group Hastings Prostate Cancer Support Network
Foundation for Promotion of Responsible Central Coast Carers Group Hervey Bay Prostate Cancer Support Group
Parenthood Central Coast PCSG Illawarra Prostate Cancer Support Group
Central Coast Pre Op Support Group Innisfail Prostate Support Group
Australia Inverell PCSG
Central Gold Coast PCSG
Adelaide Hills PCSG Cessnock Prostate Cancer Support Group Ipswich Prostate Cancer Support Group
Adelaide Mitcham PCSG Chinese Cancer Society of Victoria Cancer Kalamunda PCSG
Albany PCSG Support Group Kingborough PCSG
Albury Wodonga PCSG Citiplace Advanced PCSG Kingston & Robe PCSG
Alice Springs PCSG Clarence Valley Prostate Cancer Support Kyabram & District Prostate Support Group
Anastasia Greek Cancer Support Group Group Latrobe Valley Prostate Support Group
Ararat & District Prostate Cancer Support Clayton Greek Cancer Support Group Leederville Prostate Exercise Group
Group Coffs Harbour PCSG Leukaemia Foundation of Australia
Armidale PCSG Collie PCSG Limestone Coast PCSG
Concord PCSG Lockyer Valley PCSG
Cootamundra PCSG Lower Eyre Prostate Cancer Support Network
Cure Brain Cancer Foundation Lower North PCSG

Ludwig Institute for Cancer Research Redcliffe PCSG Bangladesh
Lymphoma Australia Ringwood PCSG Bangladesh Cancer Society
Mackay & District Prostate Cancer Support Riverland PCSG Eminence
Group Rockhampton PCS&A Group Obayedullah-Ferdousi Foundation Cancer
Mandurah PCSG Royal Australian and New Zealand College of Hospital and Research Institute
Maryborough Prostate Cancer Support Radiologists (RANZCR)
Group Royal Prince Alfred Hospital PCSG (Day Barbados
Melmarsh Prostate Cancer Support Group Group) Barbados Family Planning Association
Mens Engagement Network Royal Prince Alfred Hospital PCSG (Evening The Myeloma, Lymphoma and Leukaemia
Monaro Prostate Cancer Support Group Group) Foundation of Barbados
Monash University Prostate Cancer Research Saddleworth PCSG
Group Shepparton & District PCSG Belarus
Mornington Peninsula Prostate Support Shine A Light Group for Gay/Bisexual Men Belarusian Society of Oncologists
Group Shoalhaven PCSG
Movember Foundation South Perth PCSG Belgium
Mudgee Prostate Cancer Support Group Southern Highlands PCSG
Belgian Foundation against Cancer
Murray Bridge PCSG St Arnaud PCSG
European CanCer Organisation
Naracoorte Mens Cancer Support Group St Vincents PCSG
European Cancer Patient Coalition
National Breast Cancer Foundation St Vincent’s PCSG for Women
European Organisation for Research and
Nepean/Blue Mountains PCSG Inc. Stay Strong Prostate Cancer Exercise Group Treatment of Cancer
Newcastle/Hunter Mater Prostate Cancer Sunraysia Prostate Support Group European Society for Radiotherapy and
Support Group Sunshine Coast PCSG Oncology
North Burnett PCSG Swan Hill Prostate Support Group Patient Organisation Hodgkin and Non-
North Shore PCSG Sydney Adventist Hospital Educational Hodgkin Diseases
North West QLD Prostate Cancer Support Presentations (Night) The Anticancer Fund
Group Sydney Adventist Hospital Facilitated Group
Northern Beaches Prostate Cancer Support Discussion (Day) Belize
Group Tamworth Prostate Cancer Support Group Belize Family Life Association
Northern Rivers Day PCSG Taree PCSG
Northern Rivers Evening PCSG Tatiara Prostate Cancer Support Group Benin
Northern Tablelands PCSG Tomaree PCSG Association Franco Béninoise de Lutte Contre
Northern Territory Rainbow PCSG Toowoomba Prostate Cancer Support Group le Cancer
Ocean Reef PCSG Townsville PCSG Association pour la Lutte Contre le Cancer au
Orange PCSG University of Southern Queensland Bénin
Orbost PCSG Victoria and Tasmania Support Group Initiative des Jeunes pour le Développement
Parkes Prostate Awareness and Support Leaders Teleconference Group Pathology Laboratory of Faculty of Health
Group Victorian Comprehensive Cancer Centre Sciences / Cancer Registry of Cotonou
PCS - City of Onkaparinga Group Wagga Wagga PCSG SOS Cancer
PCSG Bellarine Peninsula Walter & Eliza Hall Institute of Medical
Perth Gay/Bisexual PCSG Research Bermuda
Perth Partners Group Warialda Community Support Group Bermuda Cancer and Health Centre
Perth PCSG Western Australia Support Group Leaders Teen Services
Perth Southsiders Prostate Cancer Support Teleconference Group
Group Westgate Region Prostate Cancer Support Bolivia, Plurinational State of
Perth Western Suburbs Group Group
Asociación de Lucha Contra la Leucemia
Peter MacCallum Cancer Institute Westmead PCSG
Paolo Belli - Instituto de Oncohematología
Port Pirie PCSG Westside Prostate Cancer Support Group
Centro de Investigación, Educación y
Prostamates Support Group Whyalla PCSG Servicios
Prostate (Cancer) Support Awareness Wyong PCSG Fundación Boliviana Contra el Cáncer
Adelaide Group Yorke Peninsula PCSG
Prostate Awareness Twin Town & Tweed Younger Men Central Coast PCSG Botswana
Coast Younger Men PCSG - Leederville
Prostate Cancer Action Group (S.A.) Inc. Cancer Association of Botswana
Younger Men’s Prostate Cancer
Prostate Cancer Foundation of Australia Nurses Association of Botswana
Teleconference Group
Prostate Cancer Partners SG Bentleigh
Bayside Brazil
Azerbaijan
Prostate Cancer Support Group ACT Region National Oncology Centre of Azerbaijan ABRALE Brazilian Lymphoma and Leukaemia
Prostate Cancer Support Group of Younger Republic Association
Men Amigos na Luta Contra o Câncer
Prostate Heidelberg Bahamas Associação Amor a Vida
Prostate Melbourne Support Group Bahamas Family Planning Association Associação Brasileira de Apoio aos Pacientes
Prostate Support Group Warrnambool de Câncer
QIMR Berghofer Medical Research Institute Bahrain Associação Brasileira de Portadores de
QLD Advanced PCSG (Telephone Group) Câncer AMUCC
Bahrain Cancer Society
Queensland and Northern NSW Support Associação Brasiliense de Apoio ao Paciente
Group Leaders Teleconference Group com Câncer - ABAC-Luz
Reach to Recovery International Associação Capanemense de Apoio e

Prevenção ao Câncer da Mulher - APCM Liga Norteriograndense Contra o Câncer - Canada
Associação Cascavel Rosa Grupo Despertar Alberta Cancer Foundation
Associação Cearense das Mastectomizadas - Núcleo Assistencial para Pessoas com Alberta Health Services - Cancer Care
Toque de Vida Câncer
British Columbia Cancer Agency
Associação das Amigas da Mama Rede Feminina de Combate ao Câncer de
Canadian Association of Gastroenterology
Associação das Mulheres Iguatuenses Blumenau
Canadian Association of Nurses in Oncology
Associação de Apoio a Mulher Portadora de Rede Feminina de Combate ao Câncer de
Canadian Association of Radiation Oncology
Neoplasia Brasília
Canadian Cancer Action Network
Associação de Apoio de pessoas com Câncer Rede Feminina de Combate ao Câncer de
Brusque Canadian Cancer Society
Associação de Combate ao Câncer da
Rede Feminina de Combate ao Câncer de Canadian Federation for Sexual Health
Grande Dourados
Gaspar Canadian Institutes of Health Research
Associação de Combate ao Câncer do Brasil
Rede Feminina de Combate ao Câncer de Canadian Organization of Medical Physicists
Central
Itajaí Canadian Partnership Against Cancer
Associação de Mulheres Atuantes de Paraíso
do Tocantins Rede Feminina de Combate ao Câncer de Cancer Care Ontario
Jaraguá do Sul Centre for Chronic Disease Prevention
Associação de Mulheres Mastectomizadas
de Brasília Rede Feminina de Combate ao Câncer de Department of Oncology, Faculty of Medicine,
Maravilha McGill University
Associação do Câncer Amor Próprio - Uma
Luta pela Vida Rede Feminina de Combate ao Câncer de Direction québécoise du cancer, Ministère de
Ponta Porã la Santé et des Services Sociaux
Associação dos Amigos da Mama de Niterói
Rede Feminina de Combate ao Câncer de São Fondation Québécoise du Cancer
Associação dos Amigos da Oncologia
Bento do Sul International Psycho-Oncology Society
Associação dos Amigos de Prevenção do
Rede Feminina de Combate ao Câncer de International Society of Nurses in Cancer
Câncer- GAMA
União da Vitória Care (ISNCC)
Associação dos Amigos do CRIO
Rede Feminina de Combate ao Câncer de Lymphoma Coalition
Associação em Educação e Saúde da Mama
Xaxim
Jesuína Estrela (AMAJES) Lymphoma Foundation Canada
Rede Feminina de Combate ao Câncer do
Associação Feminina de Educação e Princess Margaret Cancer Centre
Amazonas
Combate ao Câncer The Cedars Cancer Institute at the McGill
Rede Feminina de Combate ao Câncer em
Associação Laço Rosa - pela cura do câncer University Health Centre
Alagoas
de mama - Fundação Laço Rosa
Rede Feminina Regional de Combate ao
Associaçao Limeirense de Combate ao Cayman Islands, the
Câncer de Xanxerê - Santa Catarina
Câncer Cayman Islands Cancer Society
Santa Casa de Misericórdia da Bahia
Associação Mário Penna
União e Apoio no Combate ao Câncer de
Associação Petropolitana de Pacientes Chad
Mama – UNACCAM
Oncológicos Association DONAMA
Associação Rosa Viva - ROSAVIVA Association Tchadienne Contre le Cancer
Bulgaria
Bem-Estar Familiar no Brasil Association Tchadienne des Femmes Vivants
Bulgarian Lymphoma Patients’ Association
Brazilian Oncology Nursing Society avec le Cancer
Bulgarian National Association of Oncology
Centro de Integração Amigas da Mama
Bulgarian Oncology Nursing Society
Elas Por Elas Vozes e Ações das Mulheres Chile
Federação Brasileira de Instituições Asociación Chilena de Protección de la
Burkina Faso
Filantrópicas de Apoio à Saúde da Mama - Familia
FEMAMA Action Contre le Cancer Infantile au Burkina
Faso Corporación Nacional Maxi-Vida
Federación Latinoamericana de Mastología
Espoir Cancer Féminin Fundación Chilena para el Desarrollo de la
Fundação Antonio Prudente - A.C. Camargo Oncología - Fundación Cáncer Chile
Cancer Center Kimi
Fundação do Câncer, Brazil Solidarité contre le cancer
China
Fundação Maria Carvalho Santos
Burundi Beijing New Guideline Medical Technology
Grupo Beltronense de Prevenção ao Câncer Development co., ltd
Grupo de Mama Renascer Alliance Burundaise Contre le Cancer
Beijing New Sunshine Charity Foundation
Grupo para Motivação e Auto-Ajuda Cancer Foundation of China
Renovadora - Grupo AMAR Cambodia
Chinese Anti-Cancer Association
Grupo Rosa e Amor Sihanouk Hospital Center of HOPE
Chinese Medical Association
Hospital de Caridade de Ijui
Hangzhou Cancer Hospital
INCA Instituto Nacional de Câncer Cameroon
Jiangxi Cancer Hospital
Instituto Avon Association des Volontaires pour la Santé Oncology Nursing Committee of Chinese
Instituto Brasileiro de Contrôle do Câncer Familiale Nursing Associations
Instituto da Mama do Rio Grande do Sul - Cameroon Laboratory and Medicine Peking University Cancer Hospital and
IMAMA Foundation Health Centre Institute
Instituto de Desenvolvimento e Valorização Michael and Mauritia Patcha Foundation Shanghai Roots & Shoots
Humana Solidarité Chimiothérapie - SOCHIMIO Sun Yat-sen University Cancer Center
Instituto do Câncer do Ceará Synergies Africaines Contre le Sida et les The Fourth Hospital of Hebei Medical
Instituto Humanista de Desenvolvimento Souffrances University Cancer Institute
Social - HUMSOL Yaounde Gynaeco-Obstetric and Pediatric Tianjin Medical University Cancer Institute
Instituto Oncoguia Hospital and Hospital
Liga Mossoroense de Estudos e Combate ao Xinhua Translational Institute for Cancer Pain,
Câncer - Grupo Toque de Mama Shanghai

Colombia Cyprus Finland
Asociación Pro-Bienestar de la Familia Cyprus Anti-Cancer Society Cancer Society of Finland
Colombiana Cyprus Association of Cancer Patients and
Colombian Leukemia and Lymphoma Friends France
Foundation AFROCANCER
Funcancer Czech Republic Alliance des Ligues Francophones Africaines
Fundación Esperanza Viva League Against Cancer Prague et Méditerranéennes contre le cancer
Instituto de Cancerología S.A. Lymfom Help Alliance Mondiale Contre le Cancer
Instituto Nacional de Cancerología - Association Française des Infirmiers de
Colombia Denmark cancérologie
La Asociacion de Enfermeria Oncologica Danish Cancer Society Association Laurette Fugain
Colombiana Cancérologues Sans Frontières
Multinational Association of Supportive Care
Liga Colombiana Contra el Cáncer in Cancer Cent Pour Sang La Vie
Registro Poblacional de Cáncer de Cali de la Patientforeningen for Lymfekræft & Leukæmi Centre Antoine Lacassagne
Universidad del Valle
Centre Eugène Marquis
Union Comorienne Contre le Cancer
Djibouti Centre Georges-François Leclerc
Association pour le Développement du Centre Henri Becquerel
Congo, the
Millénaire Centre Léon Bérard
Accompagnez la vie
Centre Oscar Lambret
Association des Infirmiers du Congo Dominica Centre Paul Strauss
Bénévoles pour le Bien être Familial
Dominica Cancer Society Centre Régional François Baclesse
Fondation Calissa Ikama
Dominica Planned Parenthood Association Centre Régional Jean Perrin
Union Congolaise contre le Cancer
Fondation ARC pour la Recherche sur le
Dominican Republic, the Cancer
Congo, the Democratic Republic of the
Asociación Dominicana Pro-Bienestar de la Fondation JDB-prévention cancer
Agir Ensemble France Lymphome Espoir
Familia
Clinique de Pointe à Pitre / Kinshasa French League Against Cancer
Liga Dominicana Contra el Cáncer
Ligue Congolaise Contre le Cancer Groupe Franco-Africain d’Oncologie
Patronato Cibaeño Contra el Cáncer
Un Paso Max Pédiatrique
Costa Rica Gustave Roussy
Asociación Demográfica Costarricense Ecuador Gynécologie Sans Frontières
Asociacion Profesional del Enfermeras Institut Bergonié
Asociación Ecuatoriana de Ayuda a Pacientes
Oncohematologicas Institut Curie
con cáncer “Esperanza y Vida”
Fundación Dra. Anna Gabriela Ross Institut de Cancérologie de Lorraine
Centro Ecuatoriano para la Promoción y
Acción de la Mujer Institut de Cancérologie de l’Ouest
Côte d’Ivoire Fundación Jóvenes contra el Cáncer Institut du Cancer de Montpellier
Aidons les Personnes Atteintes ou Affectées Sociedad de Lucha contra el Cáncer Institut Jean Godinot
par le Cancer
Institut National du Cancer
Association de Soins Palliatifs de Côte Egypt Institut Paoli Calmettes
d’Ivoire
Arab Medical Association Against Cancer Institut pour la Prévention de Cancer du Sein
Association Imagine le Monde
Association d’aide aux Malades du Cancer Institut Universitaire du Cancer Toulouse
Association Ivoirienne de Lutte Contre le
dans l’Oasis de Dakhla Oncopole
Cancer
Association Médicale Franco-Egyptienne NESSMA
Association Ivoirienne des Soins Palliatifs
Can Survive Egypt OncoMali
CHU de Treichville - Service de Pédiatrie
Egyptian Society for Promotion of Women’s Pathologie Cythologie et Développement
Hope Life
Health Physicien Médical Sans Frontières
Ligue Ivoirienne Contre le Cancer
Fakkous Center for Cancer and Allied Raid Evasion Run
Société Ivoirienne de Pathologie Diseases Sécurité Solaire / Sun Safety
SOS Cancers National Cancer Institute - Cairo SOS Don de Moelle Osseuse Moyen Orient
UNICANCER
Croatia El Salvador
Association of Patients with Leukemia and Asociación Demográfica Salvadoreña Gabon
Lymphoma
Asociación Salvadoreña para la Prevención Fondation Sylvia Bongo Ondimba
Croatian League Against Cancer del Cáncer Ligue Gabonaise Contre le Cancer
Cuba Estonia Georgia
Sección Independiente de Control del Cáncer Estonian Cancer Society Georgian Nursing Association
Sociedad Científica Cubana para el Desarrollo
de la Familia National Cancer Center of Georgia
Ethiopia
Sociedad Cubana de Oncología, Radioterapia National (Cancer) Screening Center
Mathiwos Wondu Ye-Ethiopia Cancer Society
y Medicina Nuclear
Germany
Fiji
Curaçao Deutsche Krebsgesellschaft e.v.
Fiji Cancer Society Deutsche Krebshilfe
Foundation for the Promotion of Responsible
Parenthood Fiji Islands Ministry of Health and Medical Deutsche Leukaemie & Lymphom-Hilfe eV
Services

Deutsches Krebsforschungszentrum Cancer Foundation of India Associazione Vittorio Tison Cultura e
Krebsallianz GmbH Cancer Patients Aid Association Solidarietà
Myeloma Euronet A.I.S.B.L. Delhi State Cancer Institute Centro di Riferimento Oncologico
Dharamshila Cancer Hospital and Research Centro di Riferimento per l’Epidemiologia e la
Ghana Centre Prevenzione Oncologica in Piemonte
African Cancer Organisation Dr. Bhubaneswar Borooah Cancer Institute European School of Oncology
Breast Care International Enhance head neck rehabilitation & enhance Fondazione “Edo Ed Elvo Tempia Valenta”
social initiative Onlus
Ghana Health Service, Non Communicable
Disease Control Program Friends of Max Fondazione IRCCS “Istituto Nazionale dei
Global Marwari Charitable Foundation Tumori”
Greece Gujarat Cancer & Research Institute Istituto Nazionale Tumori Regina Elena
HealthCare Global Entreprises Lega Italiana per la Lotta Contro i Tumori -
Hellenic Cancer Society
Roma
Hellenic Society of Medical Oncology Indian Cancer Society - National HQ
Patologi oltre Frontiera
International Institute of Anticancer Research Institute Rotary Cancer Hospital
Soleterre-Strategie di Pace Onlus
Kidwai Memorial Institute of Oncology
UPMC San Pietro
Grenada Meherbai Tata Memorial Hospital
Grenada Planned Parenthood Association North East Cancer Hospital and Research
Institute Jamaica
Priyamvada Birla Cancer Research Institute Jamaica Family Planning Association
Guadeloupe
Satna
Association Guadeloupeenne pour le Japan
Rajiv Gandhi Cancer Institute & Research
Planning Familial
Centre Aichi Cancer Center
Ruby Hall Clinic Asia Cancer Forum
Guatemala
Saroj Gupta Cancer Centre & Research Cancer Solution K.K.
Asociación de Pacientes con LMC Institute Chiba Cancer Center
Asociación Pro-Bienestar de la Familia de Tata Memorial Hospital Foundation for Promotion of Cancer Research
Guatemala
The Oncology Nurses Association of India Fukuoka Foundation for Sound Health
Instancia por la salud y el desarrollo de las
V Care Foundation Group Nexus Japan
Mujeres
Liga Nacional Contra el Cáncer Guatemala Higashi Sapporo Hospital
Indonesia Hokkaido Cancer Society
One Voice Against Cancer
Indonesian Cancer Foundation Japan Cancer Society
Indonesian Center for Expertise in Japan Lung Cancer Society
Guinea
Retinoblastoma Japan Society of Clinical Oncology
Génération Sans Tabac
Indonesian Oncology Nurses Association Japan Society of Gynecologic Oncology
Yayasan Sentuhan Kasih Anak Indonesia Japanese Breast Cancer Society
Guyana
Japanese Cancer Association
Guyana Responsible Parenthood Association Iran, Islamic Republic of
Japanese Foundation for Cancer Research
Cancer Institute, Imam Khomeini Medical Japanese Foundation for Multidisciplinary
Haiti
Center Cancer Treatment
Association pour la Promotion de la Famille MAHAK “Society to Support Children Jikei University School of Medicine
Haitienne Suffering from Cancer”
Kanagawa Cancer Center
Reza Radiation Oncology Center
Honduras Mie University Hospital
Miyagi Cancer Center
Asociación Hondureña de Planificación de Iraq
Familia National Cancer Research Center - Japan
Zhianawa Cancer Center Niigata Cancer Center
Asociación Hondureña de Lucha contra el
Cáncer Osaka Medical Center for Cancer and
Ireland Cardiovascular Disease
Fundación Hondureña para el Niño con
Irish Cancer Society Princess Takamatsu Cancer Research Fund
Cáncer
Lymphoma Support Ireland Saga-ken Medical Centre Koseikan
Liga Contra el Cáncer - Honduras
National Cancer Control Programme Saitama Cancer Center
Hong Kong UPMC Whitfield Cancer Centre Sapporo Cancer Seminar Foundation
Asian Fund for Cancer Research Sasaki Foundation
Israel Shizuoka Cancer Center
Hong Kong Blood Cancer Foundation
Flute of Light Tochigi Cancer Center
The Hong Kong Anti-Cancer Society
Hadassah Tokyo Metropolitan Komagome Hospital
World Cancer Research Fund Hong Kong
Israel Cancer Association
Hungary Jordan
Italy King Hussein Cancer Center
Hungarian League Against Cancer
Associazione Italiana contro le Leucemie- King Hussein Cancer Foundation
linfomi e mieloma – Pazienti
Iceland
Associazione Italiana di Oncologia Medica Kazakhstan
Icelandic Cancer SocietyIndia
Associazione Italiana Malati di Cancro Parenti Almaty Oncology Centre
Apollo Cancer Institute, Apollo Hospitals -
e Amici
Hyderabad Kazakh Research Institute of Oncology/
Associazione Italiana per la Ricerca sul Radiology
Cancer Aid & Research Foundation
Cancro
Kenya

Aga Khan University Hospital Max Family Society Malaysia Hôpital Cheikh Khalifa Ibn Zaid
Childhood Cancer Initiative Malaysian Oncological Society Lalla Salma Foundation - Cancer Prevention
Faraja Cancer Support Trust National Cancer Council and Treatment
Henzo Kenya National Cancer Society of Malaysia Université Mohammed VI des sciences de la
Hope Beyond Cancer Trust Pink Ribbon Wellness (L) Foundation santé
Kenya Cancer Association
Kenya Hospices and Palliative Care Maldives Mozambique
Association Cancer society of the Maldives Beira Cancer Registry
Kenya Medical Research Institute
National Cancer Institute of Kenya Mali Myanmar
National Nurses Association of Kenya Association de Lutte Contre les Maladies Myanmar Oncology Society
PECA-Kenya Cancéreuses Shwe Yaung Hnin Si Cancer Foundation
Women 4 Cancer Early Detection & Treatment Association de Lutte contre le Tabac, l’Alcool
Youth Against Cancer in Kenya et les Stupéfiants Namibia
Simasoh-Nani International Cancer Association of Namibia
Korea, the Republic of
Asian Society of Gynecologic Oncology Malta Nepal
Korean Association for Clinical Oncology Action for Breast Cancer Foundation B.P. Koirala Memorial Cancer Hospital
Korean Cancer Association Cancer Society Nepal
Korean Society for Radiation Oncology Martinique Children’s Cancer Foundation
National Cancer Center - Korea Association Martiniquaise pour l’information Nepal Cancer Relief Society
Yonsei Cancer Center et l’orientation Tulasi Maya Memorial Cancer Relief
Foundation
Kosovo Mauritania
Kosova Task Force for Cancer Control Association Mauritanienne de lutte contre le Netherlands, the
cancer Childhood Cancer International
Kuwait Association pour la Santé Préventive de la Dutch Cancer Society
Femme Erasmus MC Cancer Institute
Kuwait Society for Preventing Smoking and
Cancer Association pour Mieux Vivre avec le Cancer European Waldenström Macroglobulinemia
Gynécologique Network
Kyrgyzstan Ligue Mauritanienne de Lutte Contre le IDA Foundation
Cancer
Public Foundation “Ergene” IKNL Integraal Kankercentrum Nederland
Ministère de la Santé - Programme national
LymfklierkankerVereniging Nederland
de lutte contre le Tabagisme de Mauritanie
Latvia Wereld Kanker Onderzoek Fonds
August Kirchenstein Institute of Microbiology Mauritius
and Virology New Zealand
Leukaemia Foundation
Limfomas Pacientu Atbalsta Cancer Society of New Zealand Inc.
Link to Life
Leukaemia & Blood Cancer New Zealand
Lebanon
Mexico
Lebanese Cancer Society Nicaragua
Asociación Gerardo Alfaro A.C.
Naef K. Basile Cancer Institute Asociación Pro-Bienestar de la Familia
Asociación Mexicana contra el Cancer de
Nicaraguense
Mama AC “Fundación Cimab”
Lithuania Fundación Alas de Vida
Asociación Mexicana De Leucemia y Gist A.C.
Kraujas Asociación Mexicana de Lucha Contra el
National Cancer Institute – Lithuania Niger
Cáncer A.C.
Centro de Investigacion de Cancer en Sonora Association Against Leukemia in Niger
Luxembourg Fundación Mexicana para la Planeación Centre National de Lutte contre le Cancer
Een Häerz fir Kriibskrank Kanner Familiar, A.C. Ministry of public health of the Republic of
Fundacion Nacional de Pacientes con Niger
The Fondatioun Kriibskrank Kanner
Linfoma no Hodgkin (FunaLinH) Société Nigérienne de Cancérologie
Macedonia, the former Yugoslav Republic Fundación Rebecca De Alba, A.C. SOS Cancer Niger
Instituto Nacional de Cancerología - México SOS Tabagisme
of
Sociedad Mexicana de Oncología, AC TATALLI
Borka – For Each New Day
Tous Unis Contre le Cancer
Madagascar Mongolia
Mongolian Oncology Nursing Society Nigeria
Fondation Akbaraly
National Cancer Council of Mongolia Act of Random Kindness Foundation
Union Malagasy Contre le Cancer
International
Morocco Breast Cancer Association of Nigeria
Malawi
Breast Without Spot Initiative
Malawi Cancer Registry Association de Soutien des Cancéreux de
l’Oriental CancerAware Nigeria
Association des malades atteints de Care Organisation Public Enlightenment
Malaysia
leucémies Ego Bekee Cancer Foundation
Breast Cancer Welfare Association Leah Cancer Centre
Association SOS Face Marrakech
Cancer Research Malaysia

Lifetouch Africa (reg. as Life Touch For African Oncosalud S.A.C. Saudi Arabia
Women Health Initiative) Sociedad Peruana De Enferenonas Encologas Ministry of Health - Saudi Arabia
Nigerian Cancer Society Saudi Cancer Society
Nursing and Midwifery Council of Nigeria Philippines Sheikh Mohammed Hussien Al-Amoudi
Partnership for Eradication of Cancer in Africa Benavides Cancer Institute, University of St Center of Excellence in Breast Cancer
- PECA Nigeria Tomas Hospital Zahra Breast Cancer Association
Project PINK BLUE - Health & Psychological Cancer Warriors Foundation, Inc
Trust Centre I Can Serve Foundation Senegal
Sebeccly Cancer Care and Support Centre Philippine Alliance of Patients’ Organisations Association Cancer du Sein du Sénégal
Society of Oncology and Cancer Research of Philippine Cancer Society Hôpital Aristide Le Dantec, CHU Dakar
Nigeria
Philippine Children’s Medical Center Institut pour la Formation et la Recherche en
The Bricon Foundation
Philippine Oncology Nurses Association Inc. Urologie et en Santé de la Famille
Tobacco Control Foundation of Nigeria.
St. Luke’s Medical Center - Quezon City Ligue Sénégalaise Contre le Cancer
(Nigeria Tobacco Control Alliance)
The Cancer Institute Foundation, Inc. Ministry of National Education Senegal -
University of Abuja Nigeria
Touched By Max Division du Controle Medical Scolaire
West African College of Surgeons
Norway Sierra Leone
Poland
Norwegian Cancer Society
International Hereditary Cancer Center Crusaders Club Ministry Sierra Leone
Polish Lymphoma Association MEPS Trust Well Woman Clinic
Oman
National Oncology Centre, the Royal Hospital, Singapore
Portugal
Muscat
AEOP - Portuguese Association Oncology Leukemia and Lymphoma Foundation
Pakistan Nurse National Cancer Center - Singapore
Associacao Portuguesa Contra a Leucemia Singapore Cancer Society
Cancer Patients’ Welfare Society NIMRA
Assoçiacão Portuguesa de Leucemias e The Skin Cancer Institute
Children Cancer Foundation Pakistan Trust
Linfomas
Green Hills Science College Muzaffarabad,
Instituto Português de Oncologia de Coimbra Slovakia
Kashmir Pakistan
Francisco Gentil, EPE Lymfoma Slovakia
Pakistan Atomic Energy Commission
Liga Portuguesa Contra o Cancro Slovak League Against Cancer
Shaukat Khanum Memorial Cancer Hospital
& Research
Puerto Rico Slovenia
Shaukat Khanum Memorial Cancer Hospital
& Research Centre Asociación Puertorriqueña Pro-Bienestar de Association of Slovenian Cancer Societies
la Familia
The Children’s Hospital Lahore Pakistan & Društvo Bolnikov z Limfomom
Paediatric Palliative Care Group Ljubljana Institute of Oncology
Romania
Slovenian Coalition for Public Health,
Palestine, State of Association P.A.V.E.L. Environment and Tobacco Control
Alhayat Association for Cancer Control Romanian Nursing Association Slovensko Združenje Bolnikov z Limfomom in
Augusta Victoria Hospital Levkemijo
Russian Federation
Palestinian Oncology Society
Patient’s Friend’s Society-Jerusalem Equal Right to Life South Africa
N.N. Blokhin Russian Cancer Research Center African Organisation for Research and
Panama Petrov Research Institute of Oncology Training in Cancer
Asociación Nacional Contra el Cáncer Society for Assistance to People with Campaigning for Cancer
Oncohematologic Disease Cancer Association of South Africa
Asociación Panameña para el Planeamiento
de la Familia The National Society of Pediatric Cape Peninsula University of Technology,
Hematologists and Oncologists Faculty of Health and Wellness Sciences
Hospital del Niño de Panamá
Panamanian Oncology Nursing Society National Oncology Nursing Society of South
Rwanda Africa
Paraguay Butaro Hospital People Living with Cancer
Inshuti Mu Buzima (Partners In Health - PinkDrive
Centro Paraguayo de Estudios de Población
Rwanda) Women in Action
Fundacion Unidos Contra El Cancer –
Rwanda Children’s Cancer Relief
Paraguay
Spain
Haematooncology Pediatric Department,
Saint Kitts and Nevis AEAL, Asociación Española de Afectados por
Faculty of Medical Sciences, National
University of Asunción Nevis Family Planning Association Linfoma, Mieloma y Leucemia
St. Kitts Family Life Services Association Ltd. Asociación Española Contra el Cáncer
Peru Institut Catala d’Oncologia
ALIADA Saint Lucia Société Internationale de Sénologie - SIS
FUNDACIÓN PERUANA DE CÁNCER St. Lucia Planned Parenthood Association Vall Hebron Institut of Oncology
Instituto de Oncología & Radioterapia de la
Clínica Ricardo Palma Saint Vincent and the Grenadines Sudan
Instituto Nacional de Enfermedades St. Vincent Planned Parenthood Association The Radiation & Isotopes Centre Khartoum
Neoplásicas
Instituto Peruano de Paternidad Responsable Samoa Suriname
Liga Peruana de Lucha contra el cáncer Samoa Cancer Society Inc. Stichting Lobi
Luz de Esperanza

Sweden Turkey Chicago Blood and Cancer Foundation
Blodcancerförbundet Fondation des Enfants Atteints de la College of American Pathologists
Cancer Society in Stockholm Leucémie Cutaneous Lymphoma Foundation
European Society for Medical Oncology Help Those With Cancer Association Dana Farber Cancer Institute
Fondation ISREC Istanbul University Oncology Institute Direct Relief
Gavi, the Vaccine Alliance KÖKDER Fred Hutchinson Cancer Research Center
Ho/Noho - Schweizerische Ministry of Health - Turkey Harvard Global Equity Initiative
Patientenorganisation für Lymphombetroffene Turkish Association for Cancer Research and Indiana University Simon Cancer Center
und Angehörige Control International Cancer Expert Corps
Hopitaux Universitaires de Genève Turkish Oncology Nursing Society International Myeloma Foundation
International Extranodal Lymphoma Study Turkish Society for Radiation Oncology International Planned Parenthood Federation
Group Turkish Society of Lung Cancer Western Hemisphere Region
International Society for Geriatric Oncology Turkish Society of Medical Oncology International Waldenstrom’s
SIOP International Society of Pediatric Urooncology Society in Turkey Macroglobulinemia Foundation
Oncology Jhpiego Corporation
Swedish Cancer Society - Cancerfonden Uganda John Wayne Cancer Foundation
Swiss Cancer League African Palliative Care Association Leukemia & Lymphoma Society
Bless a Child Foundation LIVESTRONG Foundation
Syrian Arab Republic Uganda Cancer Institute Love Hope Strength Foundation
Association Médicale Franco-Syrienne Uganda Cancer Society Lymphoma Research Foundation
Uganda Women’s Cancer Support Massey Cancer Center
Taiwan, Province of China Organization Melanoma Research Foundation
Formosa Cancer Foundation Memorial Sloan Kettering Cancer Center
Hope Foundation for Cancer Care Ukraine Missouri Cancer Registry & Research Center,
Ukrainian Public Association for Patients with University of Missouri School of Medicine
Chronic Lymphoproliferative Diseases Dept. of Health Management & Informatics
Tanzania, United Republic of
National Cancer Coalition, Inc.
Medical Women Association of Tanzania
United Arab Emirates National Cancer Institute - USA
Ministry of Health Community Development,
Friends of Cancer Patients National Comprehensive Cancer Network
Gender, Elderly and Children of Tanzania
Mediclinic City Hospital FZ-LLC National Foundation for Cancer Research
Ocean Road Cancer Institute
Positive Cancer Foundation North American Association of Central
T-MARC Tanzania
Cancer Registries
Tumaini La Maisha Tanzania
United Kingdom Oncology Nursing Society
Partners HealthCare
Thailand Breast Cancer Now
PATH
Department of Pediatrics, Faculty of Cancer Research UK
Patients Against Lymphoma
Medicine, Prince of Songkhla University Cancer Research UK Manchester Institute
Pink Ribbon Red Ribbon
MaxSmiles Cancer52
Prevent Cancer Foundation
National Cancer Institute - Thailand ecancer
RTI International
Thai International Chemotherapy Society European Oncology Nursing Society
Society of Gynecologic Oncology
Thai Pediatric Oncology Group Leukaemia CARE
Society of Surgical Oncology
The Wishing Well Foundation Lymphoma Association
St. Baldrick’s Foundation
Udon CML Patient Supporting Group Macmillan Cancer Support
St. Jude Children’s Research Hospital
World Cancer Research Fund
Togo Susan G. Komen for the Cure
World Cancer Research Fund International
T-Cell Leukemia Lymphoma Foundation
Association pour la Promotion de la Santé et World Child Cancer
du Bien-Etre Social The George Washington University Cancer
Institute
Ligue Togolaise Contre le Cancer United States of America
The Max Foundation
Abramson Cancer Center, University of
The University of Texas MD Anderson Cancer
Trinidad and Tobago Pennsylvania
Center
Family Planning Association of Trinidad and American Association for Cancer Education
UCSF Helen Diller Family Comprehensive
Tobago American Association for Cancer Research Cancer Center
American Cancer Society University of Colorado Cancer Center
Tunisia American Childhood Cancer Organization University of Hawaii Cancer Center
Association des Malades du Cancer American College of Surgeons University of Miami - Sylvester
Association SELIMA American Institute for Cancer Research Comprehensive Cancer Center
Association Tunisienne Contre le Cancer American Society for Clinical Pathology University of Pennsylvania Radiation
Association Tunisienne d’Assistance aux American Society for Radiation Oncology Oncology
Malades du Cancer du Sein American Society of Clinical Oncology UPMC
Association Tunisienne de Soins Palliatifs - Basic Health International, Inc UW Carbone Cancer Center
Gabès Campaign for Tobacco-Free Kids Young Professionals Chronic Disease
Association Tunisienne des Sages-Femmes Cancer Africa Network
Association Tunisienne des Soins Palliatifs CancerCare
C-Change
Centers for Disease Control and Prevention

Uruguay
Asociación Uruguaya de Planificación
Familiar
Comisión Honoraria de Lucha contra el
Cáncer
Comisión Pro Fomento Vecinal Plaza
Cuauhtémoc
Fundación Porsaleu
Grupo Linfoma Uruguay
Hospital de Clínicas “Dr. Manuel Quintela”
Venezuela, Bolivarian Republic of

Asociación Civil de Planificación Familiar
Asociación de Ayuda a Pacientes Hemato-
Oncologicos
Asociación Venezolana de Amigos con
Linfoma
Fundación Hemato-Oncológica Guyana
Sociedad Anticancerosa de Venezuela
Viet Nam
Breast Cancer Society of Hue
Bright Future Fund Vietnam
Can Tho Oncology Hospital
Ho Chi Minh City Oncological Hospital
Vietnam Cancer Society
Virgin Islands, British

BVI Family Life Association
Virgin Islands, US
Virgin Islands Family Planning Association
Yemen
National Cancer Control Foundation
Zambia
Breakthrough Cancer Trust
Cancer Diseases Hospital
Tobacco - Free Association of Zambia
Zambian Cancer Society
Zimbabwe
Cancer Association of Zimbabwe - Harare
Branch
Hospice & Palliative Care Association of
Zimbabwe
Zimbabwe National Cancer Registry

The Cancer Atlas,
Second Edition
in Arabic, Chinese, French, Hindi,
Portuguese, Russian, Spanish, and Turkish
The Cancer Atlas, Second Edition, a collaborative effort between the
American Cancer Society, the International Agency for Research on Cancer,
and the Union for International Cancer Control (UICC), provides a vital
tool for the cancer community. This compelling volume aims to increase
knowledge, provide a reliable basis for evidence-based decision making,
and inspire united action and partnerships against the cancer epidemic.
The Atlas has been translated into Arabic, Chinese, French, Hindi, Portuguese,
Russian, Spanish, and Turkish, and disseminated at a series of regional
launch events. Support for these translations is provided by these UICC
member organizations:
Alliance des Ligues francophones africaines et méditerranéennes contre le cancer

Blokhin Russian Cancer Research Society
Friends of Cancer Patients
Hong Kong Anti-Cancer Society
Hospital de Câncer de Barretos
La Ligue Contre Le Cancer
Turkish Association for Cancer Research and Control
Visit cancer.org/canceratlas for more information.

Visit canceratlas.cancer.org/more-languages for free PDF downloads
of The Cancer Atlas, Second Edition in other languages.
“ » “
‫أطلس‬ 癌症 L’ATLAS “ АТЛАС “ EL ATLAS“ KANSER
... это жизненно важное издание станет необходимым и доступным
्कैं सर
ресурсом для всех сторон, вовлеченных в борьбу против
...cette publication critique sera une ressource essentielle et accessible онкологических заболеваний – от правозащитников и государственных
pour toutes les personnes engagées dans la lutte contre le cancer — … esta crucial publicación será un recurso esencial y accesible para todos los
учреждений до политиков и пациентов, а также для каждого, кто так или
‫يُع ُّد هذا المؤلَّف المنشور مصدرً ا أس‬... ……这本重要的出版物对参与抗癌战斗的每个人都将是必不可少而且容易访问 partisans, organismes, décideurs politiques, patients ou autres. …यह महतविपूण्व प्र्काशन ्कैं सर ्के ्विरूद्ध संघष्व में शालमल प्रतये्क वयशकत — अधधविकताओं involucrados en la lucha contra el cáncer, desde los encargados de la abogacía, …bu ciddi yayın, taraflar ve kuruluşlardan politika üreticilerine ve hastalara
иначе вовлечен в эти сферы деятельности. Этот своевременный, научно
ve bunların arasında kalan herkese kadar, kanserle savaşıma katılan
ПО
的资源——从倡议者及机构，到政策制定者及患者，以及其他所有人。 Cette publication fondée sur des preuves en temps opportun offre une los organismos creadores de políticas públicas hasta los pacientes, incluyendo
और एजेंलसयञों से ले्कर नीनत-ननमा्वताओं और रोधगयञों और इन्के बीच हर वयशकत ्के
DU DEL ATLASI
‫بدءًا من المناصرين والوكاالت ووصو‬
‫السرطان‬ 图谱
обоснованный документ представляет множество убедительных данных
herkes için temel ve erişilebilir bir kaynak olacaktır.
एटलस
这本及时的循证出版物提供了大量令人信服的数据来帮助全球各地的社区和国 multitude de données convaincantes pour aider à combattre le cancer ललए ए्क आवि्य्क और सुलभ संसाधन है l यह समयानु्कूल, साक्य आधाररत प्र्काशन a toda la comunidad intermedia. Esta oportuna publicación, basada en la
АТЛАС ПО ОНКОЛОГИИ
،‫هذا المؤلَّف المنشور القائم على األدلة‬

EL ATLAS DEL CÁNCER
для содействия борьбе против онкологических заболеваний

‫للمساعدة في مكافحة‬ 家对抗癌症。 dans les communautés et les pays du monde entier. दुननया भर में दे शञों और समुदायञों में ्कैं सर ्का मु्काबला ्करने ्के ललए ननणा्वय्क आं्कडञों ्का evidencia, ofrece gran cantidad de datos de peso para ayudar a combatir Bu güncel ve kanıta dayalı yayın, dünya çapındaki topluluklara ve milletlere
в различных сообществах и странах всего мира.
—John Seffrin，美国癌症协会首席执行官 िजाना प्रसतुत ्करता है । el cáncer en las comunidades y las naciones de todo el mundo. kanserle savaşmak için ilgi uyandırıcı veri zenginliği sunmaktadır.
L'ATLAS DU CANCER
‫— جون‬ —Dr John Seffrin, Président directeur général, American Cancer Society
- Джон Сеффрин, исполнительный директор Американского онкологического общества —John Seffrin, Director Ejecutivo, Sociedad Americana del Cáncer —John Seffrin, Genel Müdür, Amerikan Kanser Derneği
—जॉन सेफररन, चीफ एक्जयु्केटटवि ऑकफसर, अमेरर्कन ्कैं सर सोसायटी
ОНКОЛОГИИ
KANSER ATLASI
CANCER CÁNCER
‫أطلس السرطان‬
कैं सर एटलस
癌症图谱
‫ الذي يُع ُّد ثمرة جهد مشترك لخ‬،‫ بطبعته الثانية هذه‬،‫نقدِّم لكم أطلس السرطان‬ 第二版《癌症图谱》将世界各地的癌症控制专家聚集在一起，介绍主题包括
‫الطبعة الثانية‬ 第二版
L'Atlas du cancer, 2e édition a réuni des experts de la lutte Les sujets comprennent
Deuxième Édition द्वितीय संस्करण 2-е издание Атласа по онкологии объединило Основные темы:
Второе издание
La segunda edición de El Atlas del Cáncer incluye temas Temas incluidos
Segunda edición
Kanser Atlasının 2. baskısı kansere karşı savaşta yardımcı Başlıklar
İkinci Baskı
‫ فورمان‬،‫ توري‬،‫ براي‬،‫ فينيس‬،‫الطبعة الثانية جيمال‬
्कैं सर एटलस, द्वितीय संस्करण ने ्कैं सर ्के खिलाफ लडाई में सहायता ्के
Segunda edición Jemal, Vineis, Bray, Torre, Forman
ववषयों में शालमल हैं

第二版
Deuxième Édition Jemal, Vineis, Bray, Torre, Forman
द्वितीय संस्करण
Второе издание Джемал, Винеис, Брей, Торре, Форман
İkinci Baskı
‫من جميع أنحاء العالم لتقديم معلومات مفيدة وسهلة الفهم للمساعدة في مكافح‬ 实用且易于理解的信息来帮助对抗癌症。这本全新版本描绘了有关 contre le cancer issus du monde entier pour présenter специалистов по борьбе с раком со всего мира, чтобы reunidos por expertos en el control del cáncer de todo el olmak amacıyla yararlı ve anlaşılır bilgiler sunmak için tüm
ललए उपयोगी और सुबोध जान्कारी पेश ्करने ्के ललए दुननया भर से ्कैं सर
‫هذه الطبعة الجديدة بالكامل نظرة شاملة عالمية للمعلومات حول عبء السرط‬ 癌症负担、相关危险因素、预防方法和控制措施信息的综合整体概烟草使用的风险
‫أحمدين جيمال‬ des informations utiles et compréhensibles afin d'aider Risques du tabagisme तंबा्कू ्के जोखिम представить полезную и ясную информацию для Риски, обусловленные употреблением табака mundo presentando una información útil y comprensible para Riesgos del consumo de tabaco dünyadan uzman görüşlerini bir araya getirmiştir. Tümüyle Tütün Riskleri
‫ ويقدِّم أيضًا معلومات أساسية‬.‫ وتدابير المراقبة‬،‫ وطرق الوقاية‬،‫المرتبطة به‬ Ahmedin Jemal ननयंत्रण Ahmedin Jemal
्विशेषज्ञों ्को ए्क साथ ए्कत्र क्कया है । यह बबल्कुल नया संस्करण
अहमदीन जेमल Ахмедин Джемал Ahmedin Jemal Ahmedin Jemal
述，以方便使用且容易访问的形式为癌症控制倡议者、政府和公共饮食、身体活动以及超重和肥胖为癌症 à faire avancer le combat contre la maladie. Cette toute L'alimentation, l'activité physique, le surpoids ्कैं सर ्के बोझ, संबंधधत जोखिम ्कार्कञों, रो्कथाम ्के तरी्कञों और ननयंत्रण поддержки мероприятий, направленных на борьбу против Питание, физическая активность, избыточный вес ayudar en la lucha contra el cáncer. Esta edición, totalmente Dieta, actividad física, sobrepeso yeni olan bu baskı, kanser yükü, ilgili risk faktörleri, önleme Kanserde risk faktörleri olarak diyet, fiziksel
‫باولو فينيس‬ ्कैं सर ्के जोखिम ्कार्कञों ्के रूप में आहार,
‫للسرطان بإسلوب شيق وسهل المنال لمناصري مكافحة السرطان والحكومات‬ 卫生机构、政策制定者，以及患者、幸存者和普通公众提供了有关危险因素 Paolo
nouvelle Vineis
édition représente une vue d'ensemble globale et l'obésité comme facteurs de risque de cancer Paolo Vineis
्के उपायञों ्के बारे में जान्कारी पर ए्क वयाप्क विैश्वि्क अविलो्कन ननरू्पत पौलो वीननस рака. Это принципиально новое издание представляет и ожирение как факторы риска онкологических заболеваний Паоло Винеис
novedosa, presenta información exhaustiva y de ámbito y obesidad como factores de riesgo Paolo Vineis
yöntemleri ve kontrol önlemleri ile ilgili kapsamlı ve evrensel aktivite ile aşırı kilo ve obezite Paolo Vineis
‫ والجمهو‬،‫ وواضعي السياسات وكذلك المرضى والناجين من المرض‬،‫العامة‬ शारीरर्क गनत्विधध, और अधध्क विजन
全球癌症负担的基础信息。它将成为促进全球癌症预防和控制的宝 ‫فريدي براي‬ des informations sur le fardeau du cancer, les facteurs de
Freddie Bray ्करता है Freddie Bray
। यह ्कैं सर ्क े विैश््क भार ्के बारे में ्कैं सर ननयंत्रण अधधविकताओं, तथा मोटापा
всеобъемлющий обзор всемирной информации о социальном mundial sobre la carga del cáncer, los factores de riesgo
Фредди Брей de cáncer bilgiler
Freddie sunmaktadır.
Bray Kanser Atlası, kanser kontrolünü Freddie Bray
‫أداة ال تقدَّر بثمن لتعزيز الوقاية من السرطان ومكافحته في جميع أنحاء العال‬ 贵工具。
感染相关的癌症
risque associés, les méthodes de prévention et les mesures
Cancers liés aux infections फ्ेडी ब्े значении онкологических заболеваний, связанных с ними
Онкологические заболевания, связанные с инфекциями
asociados, los métodos de prevención y las medidas de destekleyenler, hükümet ve kamu sağlığı kurumları ve karar
Enfeksiyonla ilişkili kanserler
‫ليندسي تور‬ सर्कार और सावि्वजनन्क सविास्थय एजेंलसयञों, तथा नीनत ननमा्वताओं ्के साथ-
Jemal, Vineis, Bray, Torre, Forman
जेमल, वीननस, ब्े, टोरी, फॉरमैन
Cánceres relacionados con las

Jemal, Vineis, Bray, Torre, Forman
儿童期癌症 Lindsey
de contrôle. ElleTorre
fournit des informations de base sur le Cancers pédiatriques Lindsey Torre
साथ रोधगयञों, इससे बचे लोगञों और आम जनमानस ्के ललए ए्क उपयोग्कता्व
संक्रमण से संबंधधत ्कैं सर
ललंडसे टोरी факторах риска, методах профилактики и мерах контроля. Онкологические заболевания у детей Линдси
control. Toрре información básica sobre la carga global
Proporciona Lindsey
alıcıların yanıTorre
sıra hastalar, eski kanser hastaları ve genel halk Çocukluk çağı kanserleri Lindsey Torre
infecciones
‫ديفيد فورمان‬ fardeau mondial du cancer sous une forme facile à utiliser बालयाविसथा ्कैं सर Основополагающая информация о глобальном значении del cáncer de una forma clara y accesible para los defensores için küresel kanser yükü konusunda kolay kullanılabilir ve
按人类发展指数划分的癌症负担 David Forman Fardeau du cancer basé sur l'Indice de अनु्कूल David
और सुलForman
भ रूप में बुननयादी जान्कारी प्रदान ्करता है । यह दुननया
डेववड फॉरमैन
Социальное значение онкологических заболеваний Дэвид Форман David Forman İnsani Gelişme Endeksine göre kanser yükü David Forman
et accessible pour les partisans de la lutte contre le cancer, онкологических заболеваний изложена в удобной и доступной del control del cáncer, los gobiernos, las agencias de salud Cáncer infantil erişilebilir temel bilgiler sunmaktadır. Dünya çapında kanserin
按世界各地区划分癌症负担的特殊章节 Développement Humain भर में ्कैं सर ्की रो्कथाम और ननयंत्रण ्को बढाविा दे ने ्के ए्क बहु मूलय मानवि ्वि्कास सूच्कां्क ्के अनुसार в зависимости от индекса развития человеческого
Dünya bölgelerine göre özel kanser yükü
les organismes de santé publics et gouvernementaux, les उप्करण ्के रूप में ्काय्व ्करे गा। форме для сторонников борьбы с раком, для государственных потенциала pública y los responsables políticos, así como los pacientes, La carga del cáncer por el Índice de önlenmesi ve kontrolünü geliştirmek için çok değerli bir araç
Sections spéciales concernant le fardeau ्कैं सर ्का बोझ bölümleri
乳腺癌 décideurs politiques, ainsi que les patients, les survivants et и общественных органов здравоохранения, для политиков, sobrevivientes, y el público en general. Será una valiosa Desarrollo Humano olarak işlev gösterecektir.
le grand public. Elle sera un outil précieux pour promouvoir la du cancer par région du monde ्वि्वि ्के क्ेत्र अनुसार ्कैं सर ्का बोझ для больных и пациентов излечившихся от рака, а также Специальные разделы, посвященные распространенности herramienta para promover la prevención y control del cáncer
肺癌 Meme kanseri
prévention et la lutte contre le cancer dans le monde. Cancer du sein पर ्विशेष िण्ड для широкой общественности. Атлас послужит бесценным онкологических заболеваний по регионам мира en todo el mundo. Secciones especiales sobre la carga
疫苗 del cáncer por regiones del mundo Akciğer kanseri
सतन ्कैं सर инструментом для содействия профилактике онкологических Рак молочной железы
Cancer du poumon
早期检测 заболеваний, а также борьбы с ними по всему миру. Cáncer de mama Aşılama
फेफडे ्का ्कैं सर Рак легкого
Vaccination
管理与治疗 Cáncer de pulmón Erken tanı
Dépistage précoce टी्का्करण Вакцины
CANCER.ORG/BOOKSTORE
CANCER.ORG/BOOKSTORE 疼痛控制 CANCER.ORG/BOOKSTORE CANCER.ORG/BOOKSTORE CANCER.ORG/BOOKSTORE CANCER.ORG/BOOKSTORE Vacunación Yönetim ve tedavi
ACS PRODUCT CODE 9670.02
शुरूआत में पता लगना Ранняя диагностика CANCER.ORG/BOOKSTORE
ACS 产品代码9670.02 ACS PRODUCT CODE 9670.02 Prise en charge et traitement ACS PRODUCT CODE 9670.02 ACS PRODUCT CODE 9670.02 ACS PRODUCT CODE 9670.02
$29.95 (CAN $32.95)
Detección temprana ACS ÜRÜN KODU 9670.02 Ağrı kontrolü
$29.95 (CAN $32.95) $29.95 (CAN $32.95) $29.95 (CAN $32.95) प्रबंधन और उपचार $29.95 (CAN $32.95) Наблюдение и лечение $29.95 (CAN $32.95) $29.95 (CAN $32.95)
ISBN-13: 978-1-60443-228-2 Contrôle de la douleur
ISBN-13:978-1-60443-228-2 ISBN-13: 978-1-60443-228-2 ISBN-13: 978-1-60443-228-2 ISBN-13: 978-1-60443-228-2
Обезболивание
ISBN-13: 978-1-60443-228-2 Tratamiento del cancer ISBN-13: 978-1-60443-228-2
52995 पीडा ननयंत्रण
52995 52995 52995 52995 52995 Control del dolor 52995
9 781604 432282 >
9 781604 432282 > 9 781604 432282 > 9 781604 432282 > 9 781604 432282 > 9 781604 432282 > 9 781604 432282 >
©2013, American Cancer Society, Inc. No. 012721 - Rev. 10/16
156
UNION FOR INTERNATIONAL CANCER CONTROL
62 route de Frontenex, 1207 Geneva, Switzerland
Tel +41 (0)22 809 1811 Fax +41 (0)22 809 1810
info@uicc.org | www.uicc.org

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World Cancer

The World Cancer Declaration 03

Image credits Acknowledgements Editors

We would also like to recognise the

Strengthen health systems for Universal access to screening

Measure cancer burden and impact Improve access to services across

Reduce exposure to cancer risk Universal availability of pain

Universal coverage of HPV Improve education and training

Reduce stigma and dispel

Stigma associated with cancer will be reduced, and damaging

World Cancer Declaration Progress Report 2016 3

World Cancer Declaration Progress Report 2016 4

World Cancer Declaration Progress Report 2016 5

Tezer Kutluk increase access to paediatric oncology services including

World Cancer Declaration Progress Report 2016 6

3  emaining challenges in order for

World Cancer Declaration Progress Report 2016 7

Data sources and keys Abbreviations

World Cancer Declaration Progress Report 2016 8

cost effective interventions. They make a public

The Global Action Plan for the

GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf [Accessed 19.08.16]

am/10665/246223/1/9789241565363-eng.pdf?ua=1 [Accessed 19.08.16]

World Cancer Declaration Progress Report 2016 10

Measure cancer burden and

am/10665/246223/1/9789241565363-eng.pdf?ua=1 [Accessed 19.08.16]

am/10665/246223/1/9789241565363-eng.pdf?ua=1 [Accessed 19.08.16]

World Cancer Declaration Progress Report 2016 12

WHO cancer country profile 2014 Link to profile

10,900 11,000 Yes Population-based 95% No data

Breast screening Cervical screening Radiotherapy Chemotherapy Oral morphine

WHO NCD progress monitor 2015 Link to monitor

World Cancer Declaration Progress Report 2016 13

WHO cancer country profile 2014 Link to profile

1,700 2,000 No No 78% No data

Breast screening Cervical screening Radiotherapy Chemotherapy Oral morphine

WHO NCD progress monitor 2015 Link to monitor

World Cancer Declaration Progress Report 2016 14

WHO cancer country profile 2014 Link to profile

2,300 3,100 No No 96% Yes

Breast screening Cervical screening Radiotherapy Chemotherapy Oral morphine

WHO NCD progress monitor 2015 Link to monitor

World Cancer Declaration Progress Report 2016 15

WHO cancer country profile 2014 Link to profile

3,800 4,400 Yes Population-based 89% Yes

Breast screening Cervical screening Radiotherapy Chemotherapy Oral morphine

WHO NCD progress monitor 2015 Link to monitor

World Cancer Declaration Progress Report 2016 16

WHO cancer country profile 2014 Link to profile

2,000 2,500 No data No data 48% No data

Breast screening Cervical screening Radiotherapy Chemotherapy Oral morphine

No data No data No data No data No data

WHO NCD progress monitor 2015 Link to monitor

World Cancer Declaration Progress Report 2016 17

WHO cancer country profile 2014 Link to profile

200 200 No No 83% No data

Breast screening Cervical screening Radiotherapy Chemotherapy Oral morphine

WHO NCD progress monitor 2015 Link to monitor

World Cancer Declaration Progress Report 2016 18

WHO cancer country profile 2014 Link to profile

800 700 Yes Hospital-based 69% No data

Breast screening Cervical screening Radiotherapy Chemotherapy Oral morphine

WHO NCD progress monitor 2015 Link to monitor

3 emaining challenges in order for