Edolem Ikerdeu, CCPI Director, Republic of Palau

57th PIHOA Executive Board meetingPalau, March 10, 2015

Contents:Brief recap of the development of the CCPI and

Pacific Cancer Control Programs & PartnersDistribution of cancers in the USAPIHighlights of the:

Regional CCC ProgramRegional Cancer RegistryREACH Community Health Intervention Project

Success stories (2002-2015)CCPI Priorities relevant to PIHOACCPI Officers and Directors

CCPI Regional efforts started in 2002 with funding from the National Cancer

Institute. CDC funding since 2004. PIHOA Affiliate since 2008 Two representatives designated by their Senior ranking health official:

clinical and public health Should be in a position to positively influence the health systems that impact

prevention and control of cancer CCPI oversees all of the Pacific Regional Cancer Programs

Administered by the University of Hawaii (Palafox, Buenconsejo-Lum & team) Regional focus: cross-cutting issues that are necessary to improve

jurisdiction and regional capacity for cancer and NCD control Human resources for health development (HRH) Surveillance (cancer) and mortality reporting Training in certain areas (public health and clinical), including evaluation Prevention: policies and messages in congruence with other NCD Screening: working to ensure minimum standards Treatment: palliative care / survivorship

Cancer Council of the Pacific Islands

(Advisory Board)

Pacific Cancer

CoalitionUniversity of

HawaiiCancer Center

(technical assistance)

• U54 MI/CCP Partnership with

University of Guam• Hawaii Tumor

Registry• Pacific Cancer

Research Group

International Partners with PIHOA

(SPC, WHO)

U.S. CCC National

Partnership

Pacific Cancer Control Programs & Partners

University of Hawaii

Dept. of Family Medicine

(administrative, technical assistance)

RMI

Guam

CNMI

American Samoa

Palau

Kosrae

Chuuk

Pohnpei

Yap

FSM

University of Hawaii Office

of Public Health

Sciences

Pacific Islands Health Officers Association

(PIHOA)Overarching advisory

Micronesian Community Network &

Micronesian Health Advisory

Council (Hawaii)

U.S. Affiliated

Pacific Island

(USAPI) jurisdiction

s

Regional Comp Cancer

Regional CancerRegistry

Pacific Center of Excellence in

the Elimination of Disparities (Pacific CEED)

Community Health

Intervention Project (REACH)

Distribution of cancers in the USAPI 2007-2011 (CNMI & Chuuk data incomplete)

5

Screening test or PE45%

Tobacco-related43%

Obesity-related47%

HPV-related7%

Only 13% of cancers diagnosed at Stage 1

14%

14%

11%

9%

6%

6%

5%

5%

4%

3%3%

2%

USAPI Top 12 cancers, 2007-2011

LUNG & BRONCHUS

Breast

PROSTATE

Colorectal

LIVER

CERVIX

Uterus

Leukemia

THYROID

Stomach

Tobacco-related oral cavity & pharynx

Nasopharynx

Regional CCC ProgramBack-funded from jurisdiction prime awards from CDC

National Comprehensive Cancer Control programRegional focus: cross-cutting issues that are necessary to

improve jurisdiction and regional capacity for cancer and NCD control; leveraging of national and international resources for CCCPartnerships and Communication / website (pacificcancer.org)Training & TA in certain areas (public health and clinical),

including evaluationPrevention: policies and messages in congruence with other

NCDScreening: working to ensure minimum standardsTreatment: palliative care / survivorshipSurveillance (cancer) and mortality reporting

Pacific Regional Cancer Registry Program Prime awardee from CDC National Program of Cancer

RegistriesFunds cancer registrar in each jurisdiction

Except Guam, but PRCCR funds travel / training / additional IT support for the Guam Cancer Registry

Cancer data required for CCC and NCD plans (CDC), MDG reporting, WHO 2025 voluntary NCD indicators (cervical cancer, functional cancer registries)

Additional focus on improving mortality reporting, documentation in medical records, data flow & reporting

Recent report (2007-2011) available on pacificcancer.org

Community Health Intervention Project (REACH)Prime awardee from CDC

Directly employs assistants in all jurisdictionsSupports the comprehensive implementation of

effective evidence-based practices to address the excessive and disparate burden of NCDs present throughout USAPI communities. Outcomes of the 3-year program, which targets adults, will focus on Increasing access to smoke-free or tobacco-free

environments (public and private worksites including health facilities),

Increasing access to environments (worksite, including health facilities) with healthy food or beverage options.

CCPI Success stories (2002-2015)Regional and jurisdiction infrastructure for CCC, helped

set the stage for NCD collaboration & capacity buildingDeveloped cancer registries cancer surveillancePacific CEED (2007-2012): breast & cervical cancer

focus, NCD risk factors, cervical cancer screening standards in FSM, RMI, American Samoa

Partial funding and support of synergistic PIHOA activities:HRH assessment focused on medical records/HISTechnical Working Group on NCD SurveillancePIHOA Quality Improvement effortsNCD Toolkit

CCPI Success stories (2002-2015)Caring the Pacific Way Palliative Care CurriculumNCD Toolkit (with PIHOA)REACH CHIP (2014- ): baseline PSE scans related to

tobacco and healthy nutrition priorities, rigorous evaluation and communication plan, training

Cervical cancer: standards, Expert Panel and ACOG Committee OpinionThe panel, comprised of US and Internationally renowned cervical cancer screening experts, was convened by the US Department of Health and Human Services, and the CDC. The meeting resulted in an American Colleges of Obstetricians and Gynecologists (ACOG) Committee Opinion supporting adaptation of the World Health Organization recommendations for diagnosis and treatment in one or two visits in the USAPI. The ACOG opinion could result in improved cervical cancer prevention and more accurate identification of early-stage disease in the USAPI.

CCPI priorities relevant to PIHOAContinued emphasis and collaboration to improve

NCD surveillance capacity and data systems that inform high quality prevention and care of NCD and cancerHealth information systemsMortality reporting

Desire for regional, cross-program, sharing of success stories and best practices related to NCDPIHOA website – as part of the NCD Toolkit?

 Need for more stable supply of medications for palliative care (i.e., narcotics)Regional formulary discussion / pricing considerations

CCPI priorities relevant to PIHOACapacity building/planning for a sustainable

technical assistance/training mechanism for evaluation of health programs and policies

Consideration of adapting "model" policies for Palliative Care in their jurisdictionCCPI Directors have a listing

Continued long-term goal to expand in-region capacity for affordable diagnosis and treatment for cancer

CCPI MembersPresident: Dr. John Taitano (Guam)Vice-Present: Dr. Helentina Garstang (RMI)Secretary/Treasurer: Ms. Martina Reichhardt (Yap)RMI: Dr. Cho Cho Thien (Ebeye), Dr. Garstang (Majuro), Ms. Neiar

KabuaKosrae: Mr. Nena Tolenoa, Dr. Livingston TaulungPohnpei: Ms. Robina Anson, Dr. Kesusa Bermanis, Ms. Pertina AlbertChuuk: Dr. Kino Ruben, Dr. Yoster YchiroYap: Dr. Eric Lirow, Mr. John Gilmatam, Ms. Martina ReichhardtFSM National: Dr. Vita Skilling, Mr. Xner LutherPalau: Ms. Edolem Ikerdeu, Dr. Sylvia Osarch, Ms. Irish TutiiAmerican Samoa: Ms. Moira Wright, Dr. Alo AnesiCNMI: Ms. Jocelyn Songsong, Ms. Salome CastroGuam: Ms. Roselie Zabala, Dr. Taitano, Mr. Lawrence Alam

For more information, please visit our website at:

www.pacificcompcancer.org

15

Si Yu`os Ma`ase

Olomwaay

Fa`a Fetai Tele Lava

Msuulaang

Kulo Malulap

Komagar

Kalangan

Kinisou Chapwur

Kommol Tata

www.pacificcancer.org

lbuencon@hawaii.edu