PNG Cancer Perspective
Planning health services requires knowledge about the burden of disease. For example, if we want to introduce a new treatment for cancer we need to have an idea of the magnitude of the disease. This knowledge then determines how much money and resources are injected into the planning, introduction and sustaining that service.
With the new cancer treatment facility being built in Port Moresby, I thought it would be good to have a breakdown of the burden of disease caused by all forms of cancer in PNG. This information presented here is from the World Health Organization PNG Profile. This data can be accessed via the WHO website.
As of 2014 according to WHO PNG cancer profile, PNG’s estimated population was 7,167,000 (7.1 million). And by income generation the World Back classifies PNG as lower middle. If we use Fiji for comparison Fiji’s income category is upper middle, one step above PNG. Solomon Islands is categorized as a lower middle income country as well. A boy born in PNG has a life expectancy of 62 years and a girl born in PNG has a life expectancy 65 years. By comparison a boy born in Fiji has a life expectancy of 69 years and a girl born in Fiji has a life expectancy of 73 years. A boy born in the Solomon Islands has a life expectancy of 67 years and girl born in Solomon Islands has a life expectancy of 70 years.
In 2014, 5200 people in PNG died from all forms of cancer – 2300 men and 2900 women. If we compare deaths caused by malaria in PNG in the same year, there were 200 deaths from malaria and 28,000 cases of TB were diagnosed. In the same year (2014), 600 people in Fiji died from all forms of cancer while in the Solomon Islands there were 300 deaths. This simple comparative analysis can give some idea of the burden of disease caused by cancer in PNG with respective to malaria, another common illness in PNG. We can also see how Fiji and Solomon Islands are doing compared to PNG. More importantly, in 2014 malaria and TB combined affected more people in PNG then cancer! I don’t think much have changed since 2014. If we look at the numbers in 2020, infectious diseases will still remain as the biggest killers in PNG. However, the burden of diseases caused by life-style diseases, cancer included, accounts for nearly 50% of hospital admissions in PNG. This is most obvious in the major urban hospitals.
What Cancers are common in PNG?
The next thing we need to know is what are the common types of cancers in PNG?
Common types of Cancers in Men
The numbers from 2014 show that 16% of all deaths from cancer in men were caused by cancers of the mouth, tongue and throat – that means 368 men died from cancers of the head and neck region. Liver cancer caused 14% of the deaths, prostate cancer 8%, lungs and trachea 7.6% and cancers of the lymphatic system (lymphoma, myeloma) 7.3%. Cancers from other parts of the body such as intestines, skin, bone, eye, brain and muscles together caused 46% of all cancer deaths in men.
Common types of Cancers in Women
Using the figures from 2014 – almost 19% of all deaths from cancer in women was caused by cancers of the cervix and uterus. That translates to 545 women dying from cancers of the cervix and uterus in 2014. Breast cancer caused about 15% of the deaths, mouth, tongue and throat cancer 11%, liver cancer 7%, and ovarian cancer deaths 5%. Cancers from other parts of the body such as intestines, skin, bone, eye, brain and muscles together caused 44% of all cancer deaths in women.
The Big Picture
Although infectious diseases continue to be the major killers in PNG, cancer and other life-style diseases are as equally important. The emergence and burden of diseases caused by life-style diseases is almost 50% of the disease burden in PNG. The other 50% of the disease burden are caused by infectious diseases. This pattern is now referred to as the double-burden of diseases and is most evident in countries such as PNG where drastic changes are occurring in life-styles from modernisation without improvement to health services in rural parts of the country.
Dr Rodney Itaki, MBBS, BMedSci
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Good analysis. Resources not yet allocated to prevention and management of non communicable diseases in PNG.
Most important of all resources is manpower training. By that I mean training overseas in established curriculum until SMHS at UPNG is ready to nationalize such trainings.
Meanwhile political direction is contrary to administrative thinking. The missing link is obviously on administration advice here but as in PNG politics gets better of all. Therefore the missing link could be either. Until then building of infrastructure does not equate to better care
Dr.Leslie Bahn Kawa MSc, MRCP UK, MRCP Edin, FRCP