Fiji has one of the highest death rates from breast and cervical cancer in the world, according to the International Agency for Research on Cancer (IARC) GLOBOCAN 2012 data. In response to the high rate and the growing number of cancer cases, Fiji's Minister of Health, Dr. Neil Sharma, requested that the IAEA, through its Programme of Action for Cancer Therapy (PACT), conduct a cancer control capacity and needs assessment.
The comprehensive capacity and needs assessment, conducted during the week of 24-28 March 2014, addressed the full range of cancer control areas - from cancer information and registration systems, to palliative care and civil society activities within a national health care system.
Based on the IAEA assessment, Fiji will need to implement cancer control programmes that incorporate prevention, early detection, and treatment linked with follow-up care.
The implementation of preventive measures (in the form of tobacco control to reduce the risk of tobacco related cancers; promotion of healthy diets and physical activity to reduce breast, colorectal and prostate cancers; HPV vaccination to prevent cervical cancer; and hepatitis B vaccination to prevent liver cancers), are especially important in the short term.
The Situation
Currently cancer control services are provided at the primary (health centres, nursing stations), secondary (sub-divisional hospitals) and at the tertiary care (divisional hospitals) levels. Basic cancer services such as counselling, Pap smear collection and processing, referrals for suspected cancer patients are provided at the primary and secondary care levels whereas cancer diagnosis and treatment (basic surgery, limited chemotherapy and hormone therapy) are provided at the tertiary care level.
Unfortunately, Fiji has no radiotherapy services and the Ministry of Health sends approximately 15-24 radiotherapy patients (on a cost share basis) every year to India, New Zealand or Australia.
According to Dr. Sharma, "Fiji intends to establish a radiotherapy facility beginning with a basic radiotherapy facility followed by a gradual expansion to meet the growing demand for cancer treatment. The future centre will serve to consolidate the cancer care and management services for better care of patients and their families."
Background
The IAEA imPACT mission to Fiji was implemented under the TC project RAS/6/069 Supporting Comprehensive Cancer Control in the Asia and the Pacific Region with financial support from the Government of Australia.
imPACT Reviews help countries to swiftly and efficiently respond to the cancer crisis by providing an evaluation of a country's readiness to implement cancer control programmes, completing an assessment of the national cancer burden and providing recommendations on developing the cancer control capacity.