Cancer in the Solomon Islands

Alexandra Martiniuk; Rooney Jagilli; Eileen Natuzzi; John Wesley Ilopitu; Meltus Oipata; Annie-Marie Christie; Jefferey Korini; Cassandra Vujovich-Dunn; William Yu

doi:10.1016/j.canep.2017.04.016

Cancer in the Solomon Islands

Cancer Epidemiol. 2017 Oct;50(Pt B):176-183. doi: 10.1016/j.canep.2017.04.016.

Authors

Alexandra Martiniuk¹, Rooney Jagilli², Eileen Natuzzi³, John Wesley Ilopitu⁴, Meltus Oipata⁴, Annie-Marie Christie⁵, Jefferey Korini⁶, Cassandra Vujovich-Dunn⁷, William Yu⁸

Affiliations

¹ University of Sydney, Australia; University of Toronto, Australia; George Institute for Global Health, Edward Ford Building, 2000, Australia. Electronic address: alexandra.martiniuk@sydney.edu.au.
² General Surgeon and Medical Superintendent National Referral Hospital, Honiara, Solomon Islands. Electronic address: RJagilly@nrh.gov.sb.
³ San Diego State University, School of Public Health, USA. Electronic address: esnmd@mac.com.
⁴ National Referral Hospital, Honiara, Solomon Islands.
⁵ Royal North Shore Hospital, Sydney, Australia. Electronic address: annemariechristie@gmail.com.
⁶ Gizo Hospital, Gizo, Solomon Islands. Electronic address: jkorini@yahoo.com.
⁷ University of New South Wales, Australia. Electronic address: cvujovich-dunn@kirby.unsw.edu.au.
⁸ Hunter New England Health, Newcastle, 2305, Australia. Electronic address: will.xm.yu@gmail.com.

PMID: 29120823
DOI: 10.1016/j.canep.2017.04.016

Abstract

Introduction: The Solomon Islands, with a population of 550,000, has significant challenges in addressing non-communicable diseases, including cancer, in the face of significant economic, cultural, general awareness and health system challenges.

Objectives: To summarise the existing knowledge regarding cancer in the Solomon Islands, to gather new data and make recommendations.

Methods: A literature review was undertaken and cancer data from the National Referral Hospital, Honiara were analysed and are presented. Key stakeholders were interviewed for their perspectives including areas to target for ongoing, incremental improvements. Last, a health services audit for cancer using the WHO SARA tool was undertaken.

Results: Breast and cervical cancer remain the first and second most commonly identified cancers in the Solomon Islands. The Solomons cancer registry is hospital based and suffers from incomplete data collection due to its passive nature, lack of resources for data entry and processing resulting in weak data which is rarely used for decision-making. The health system audit revealed system and individual reasons for delayed diagnosis or lack of cancer treatment or palliation in the Solomon Islands. Reasons included lack of patient knowledge regarding symptoms, late referrals to the National Referral Hospital and inability of health care workers to detect cancers either due to lack of skills to do so, or lack of diagnostic capabilities, and an overall lack of access to any health care, due to geographical barriers and overall national economic fragility.

Conclusion: The Solomon Islands is challenged in preventing, diagnosing, treating and palliating cancer. Stakeholders recommend establishing specialty expertise (in the form of a cancer unit), improved registry processes and increased collaboration between the sole tertiary hospital nationwide and other Solomon health services as important targets for incremental improvement.

Keywords: Cancer; Epidemiology; Health system; Solomon Islands.

MeSH terms

Adolescent
Adult
Female
Humans
Male
Medical Audit
Melanesia / epidemiology
Neoplasms / epidemiology*
Registries
Socioeconomic Factors
Young Adult