Cancer control in small island nations: from local challenges to global action

Abstract

Cancer is a leading cause of death in Small Island Developing States (SIDS), and is forecast to increase substantially over the coming years. Governments, regional agencies, and health services of SIDS face daunting challenges -including small and vulnerable economies, unequal distribution of resources, weak or fragmented health services, small population sizes making sustainable workforce and service development problematic, and specialised cancer services unavailable to many. Deliberate action is required to prevent massive human and economic costs relating to cancer. This paper highlights challenges and opportunities for SIDS, and identifies ways in which the international community can support efforts to improve cancer control in these settings. Our recommendations focus on funding and investment opportunities for cancerrelated health system strengthening, sharing of technical assistance for research, surveillance, workforce and service development, and supporting SIDS with policies changes to reduce consumption of commodities that increase cancer risk. AbstractCancer is a leading cause of death in Small Island Developing States (SIDS), and is forecast to increase substantially over the coming years. Governments, regional agencies, and health services of SIDS face daunting challenges -including small and vulnerable economies, unequal distribution of resources, weak or fragmented health services, small population sizes making sustainable workforce and service development problematic, and specialised cancer services unavailable to many.Deliberate action is required to prevent massive human and economic costs relating to cancer. This paper highlights challenges and opportunities for SIDS, and identifies ways in which the international community can support efforts to improve cancer control in these settings. Our recommendations focus on funding and investment opportunities for cancer-related health system strengthening, sharing of technical assistance for research, surveillance, workforce and service development, and supporting SIDS with policies changes to reduce consumption of commodities that increase cancer risk.

Delays in the Pathway to Cancer Diagnosis in Samoa: A Qualitative Study of Patients’ Experiences

“…Knowledge gaps regarding cancer and its symptoms, particularly misperceptions on pain, need to be addressed in the context of Samoan cultural norms and practices, recognizing the role of family, chiefs, and church leaders in health decision-making 10 and the importance of engaging with traditional healers. 26 Consistent with previous research conducted with vulnerable populations, we also documented financial, practical, and psychological barriers to accessing services for early detection of cancer. 7,19 There was strong evidence of delays due to lack of follow-up and coordination following initial access to health care services.…”

“…Our study provides a hitherto absent evidence base on the experiences of cancer patients in Samoa, and has contributed toward strengthening local research capacity, a critical element in cancer control in small island nations. 26 However, we acknowledge some limitations. The retrospective design may have created recall issues.…”

Difficulties in Accessing Cancer Care in a Small Island State: A Community-Based Pilot Study of Cancer Survivors in Saint Lucia

“…Small island developing states (SIDS) are particularly affected by cancer because of their inherently fragile health care systems secondary to smaller populations, fewer resources, and vulnerability to natural disasters [ 1 , 2 , 3 ]. Further, SIDS experience a higher mortality-to-incidence ratio compared with more developed islands in their region [ 1 , 3 ]; this alludes to system-contingent cancer mortality [ 4 , 5 ].…”

Ageing badly: indicators of old-age structure in Australia and New Zealand

“…Higher cancer death rates in New Zealand are not due simply to higher incidence. 25 The greater differences in deaths than in incidence suggest that patient survival is lower in New Zealand. 26 In addition, Australia showed significant improvements in overall 5-year cancer survival, whereas New Zealand had an only minimal increase in cancer survival.…”