Health Surveillance and Disease Prevention and Control / Chronic Diseases / Cancer
PAHO Plan of Action for Cancer Prevention and Control: Cancer Stakeholders Meeting
(Washington, DC, 11–12 June 2008)
Cancer is the second leading cause of death in the Americas. In 2005, approximately 1.15 million people died of cancer in this Region, and 480,000 of the cases were from countries in Latin America and the Caribbean (LAC). The highest cancer mortality rates are observed in Uruguay, Barbados, Peru, Argentina and Chile. Currently, there is a trend of increasing mortality in most countries. By 2030, it is projected that over 1.6 million people will die from cancer, an increase attributed to demographic changes and increased exposure to risk factors.
Purpose: To discuss an action plan for cancer prevention and control for LAC, with representatives from governments, cancer institutions, nongovernmental organizations (NGOs), professional associations, and PAHO/WHO.
Cancer control leaders, researchers, health professionals and program managers from 19 countries and 10 partner organizations gathered together in Washington, DC on 11-12 June 2008 to discuss a Regional Action Plan for Cancer Prevention and Control. This is part of PAHO's Regional Strategy on Chronic Diseases, in which PAHO is scaling up its efforts in cancer prevention and control.
The purpose of the action plan is to align existing work being undertaken by PAHO and the various actors in the cancer control community into a common framework, and build synergies across all partner organizations. The cancer stakeholders meeting, convened by PAHO, was an opportunity to unite representatives from non governmental organizations, professional organizations and PAHO Member States to discuss the relevance and content of the cancer action plan.
The participants of the meeting were all aware of the magnitude of the problem. In 2005, approximately 1.15 million people in the Americas died of cancer, and 480,000 of these deaths were in Latin America and the Caribbean (LAC). Expected demographic changes, along with increased exposure to cancer risk factors, will result in increases in the burden of cancer in LAC in the near future. Inequalities in access to cancer care and to preventive health services further exacerbate the problem.
Cancer prevention and control requires a complete spectrum of activities from prevention, early detection, treatment and palliative care. Current PAHO activities are focusing on technical cooperation with Member States in national cancer control planning, cancer prevention strategies such as tobacco control, promotion of healthy diet and physical activity, HBV immunization, environmental and occupation health strategies, as well as assistance in radiological health and monitoring cancer burden and risks. PAHO is currently scaling up and aligning these activities under the organization-wide Plan of Action for Cancer Prevention and Control.
The overall goal of the Plan of Action is to prevent what is preventable, to cure what is curable, to provide palliative care for all cancer patients in need and to manage and monitor for measurable results. The plan is complementary to the Regional Strategy and Plan of Action for Chronic Diseases and follows the four lines of action: policy and advocacy; monitoring and surveillance; health promotion and cancer prevention; and cancer management. The plan includes specific objectives, indicators and activities for each of the four lines of action.
The participants of the meeting had an opportunity to review and discuss the contents of the Plan of Action, during working groups and in plenary sessions. The current initiatives in cancer control in the Region from partner organizations and potential areas for synergy were also discussed. Concrete suggestions were provided to further develop the plan of action and to tailor it to the concrete country needs and develop an inclusive regional plan. There was general consensus that the plan is relevant and timely for moving forward the agenda for cancer control. Many countries in LAC still do not have a national cancer plan because of gaps in political commitment to this major public health problem. For this reason, it was suggested that the plan of action include a communication strategy. A crucial part of this plan is to support scaling up the health system at all levels of care, in order to improve access to treatment and palliative care for cancer patients. In order to make this happen, the plan should catalyse collaboration among countries and partners.
The participants also discussed the way forward and next steps. It was agreed that the declaration of Rio de Janeiro, made during the 2nd International Cancer Control Congress in Brazil and endorsed by several country representatives and stakeholders was a basis from which to move forward. Notably, the Latin American and Caribbean Alliance for Cancer Control, initiated during the 2nd ICCC is a key forum for the implementation of the cancer plan of action.
The meeting concluded that the proposed plan of action presented will be further developed, taking into account the suggestions resulting from this meeting's discussions. Several participants suggested that the cancer plan of action be included on the agenda of the PAHO Directing Council in order to help raise the prominence and political support for the issue of cancer control in the Region. It was agreed that PAHO/WHO Member States and partner organizations would collaborate within the Latin American and Caribbean Alliance for Cancer Control. Subsequent meetings, such as during the occasion of the UICC World Cancer Congress 2008, will be held with cancer stakeholders from LAC in order to further refine the cancer plan and concretize the operations of the Alliance. The establishment of a joint secretariat for the Alliance is needed to manage joint projects and to monitor the implementation of the plan of action.
In terms of immediate next steps, a proposal will be put forth to the PAHO Executive Committee by several PAHO Member States, to have the cancer action plan and an accompanying resolution on the agenda of the 2009 PAHO Directing Council. In the meantime, the action plan would be further elaborated with additional input from countries and partner organizations; a set of concrete joint projects would be established for the next 2 years; a secretariat for the Latin American Alliance for Cancer Control would be established to facilitate communication and networking within the Alliance and facilitate the implementation of the joint projects.