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The region of Pacific Island Countries and Territories (PICTs) is highly diverse in terms of geography, economic and social development, population size, culture, language and history but also share certain features. They are characterized by small populations, which are geographically isolated. The weak health care system coupled with fragile economy lack resilience and ability to cope with the increasing effects of climate change. They are facing the triple burdens of high rates of infection-related cancer with rapid transition to cancers relating to reproductive, dietary and hormonal factors in combination with ageing populations. Cancer control in these settings is challenging. Cancer surveillance systems are incomplete, patients tend to present late with advanced cancers, many PICTs are unable to provide cancer care to those affected, with patients either not receiving care, or being treated offshore where resources allow. The latter option poses a huge economic burden on the patient and the families. PICTs often lack screening, pathology, oncology, surgical and palliation services. Addressing these issues is critical to achieve any the goals of the World Cancer Declaration in this region.

He nui ngā rerekētanga i te Moana-nui-a-Kiwa (PICTs), arā mō te hanga o te whenua, mō ngā āhuatanga ōhanga, pāpori hoki, mō te tokomaha o te tāngata, mō ngā ahurea, mō ngā reo me ngā kōrero tuku iho, engari tērā anō hoki ngā hononga. Mō te nuinga, he iti ngā taupori, ā, kei te pūrei hoki. He ngoikore ngā pūnaha hauora, kei te kōpīpī ngā ōhanga, ā, ākuanei ka raruraru i te pānga mai o ngā whakarerekētanga āhuarangi. Kei te pīkau rātau i ngā taimahatanga takitoru, arā he nui ngā tatauranga mate pukupuku e pā ana ki ngā pokenga me te huri tere hei mate pukupuku e pā ana ki ngā āhuatanga whānau tamariki, kai, taiaki, me te kaumātua haere o ngā taupori. He uaua ngā mahi hei āta whakahaere i te mate pukupuku i ēnei horopaki. Kei te taurangi ngā pūnaha tirotiro mate pukupuku, ka tōmuri te tae atu o te tūroro me ngā mate pukupuku kua tino puta, he nui ngā whenua o te Moana-nui-a-Kiwa kāore i te āhei ki te whakawhiwhi i ngā whakarongoā mate pukupuku, ā, kāore ngā tūroro e whakawhiwhia ki te whakarongoā, ka tukuna rānei ki tāwāhi mehemea ka taea te utu. He tino kawenga ā-ōhanga te huarahi o muri nei mō ngā tūroro me ngā whānau. He nui ngā whenua o te Moana-nui-a-Kiwa kāore ā rātau ratonga mō te tirotiro, mō te āhua o ngā mate, mō te mate pukupuku, mō te pokanga, mō te whakamāmā taimaha hoki. He tino mea nui te aro ki ēnei take e tutuki ai ngā whāinga o te Whakapuakanga o te Ao mō te Mate Pukupuku ki tēnei takiwā.

Partner projects

We worked in partnership with Lancet Oncology to develop a series on cancer control in Small Island Developing States. We led this work in collaboration with colleagues from around the Pacific and Caribbean regions, and from the Pacific Community (SPC), the International Agency for Research on Cancer, the World Health Organization and others. The series was published in 2019 here:


  • Sarfati D, Dyer R, Amosa-Lei Sam F, Barton M, Bray F, Buadromo E, Ekeroma A, Foliaki S, Fong J, Herman J, Huggins L, Maoate K, Meredith I, Mola G, Palafox N, Puloka V, Shin H, Skeen J, Snowdon W, Tafuna'I M, Teng A, Watters D, Vivili P. Cancer control in the Pacific: big challenges facing small island states. Lancet Oncology 2019 (see
  • Ekeroma A, Dyer R, Palafox N, Maoate K, Skeen J, Foliaki S, Vallely AJ, Fong J, Hibma M, Mola G, Reichhardt M, Taulung L, Aho G, Fakakovikaetau T, Watters D, Toliman PJ, Buenconsejo-Lum L, Sarfati D. Cancer Management in the Pacific Region - Report on Innovation and Good Practice. Lancet Oncology 2019 (see
  • Spence D, Dyer R, Andall-Brereton G, Barton M, Stanway S, Bray F, Cawich S, Edwards-Bennett S, Fosker C, Gabriel O, Greaves N, Hanchard B, Hospedales J, Luciani S, Martin D, Nimrod M, Ragin C, Simeon D, Tortolero –Luna G, Wharfe G, Sarfati D. Cancer Control in the Caribbean Island Countries and Territories: some progress; the journey continues. Lancet Oncology 2019 (see
  • Sarfati D, Dyer R, Vivili P, Herman J, Spence D, Sullivan R, Weller D, Bray F, Hill S, Bates C, Foliaki S, Palafox N, Luciani S, Ekeroma A, Hospedales J. Cancer control in Small Island Developing States: From local challenges to global action. Lancet Oncology 2019 (see

Linked editorials


Student project

  • Dyer, R. Cancer diagnosis and treatment in the Pacific. A dissertation for Masters in Public Health. 2019 (D Sarfati and R Cunningham, supervisors)

Photos from Cancer Control in SIDS launch at the Pacific Ministers of Health meeting 2019

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