The occurrence of cancer cases in Lao People's Democratic Republic (PDR) has doubled in the past 20 years. This trend is expected to continue increasing, and the International Agency for Research on Cancer (IARC) projects that 11 800 people could die from cancer in Lao PDR by 2040 - a 90 per cent increase from the 6 210 deaths in 2020. Cancer is regarded as a public health priority in Lao PDR, and in light of those projections, the IAEA at the country's request, with the support of the World Health Organization (WHO) and IARC, recently carried out a technical assessment of national health capacities through an imPACT review.
"Cancer is an emerging health issue in Lao PDR and the Ministry of Health is committed to making cancer control a priority in the country," said Phetsamone Arounlangsy, Lao PDR Ministry of Health National Coordinator for the imPACT review. "For this reason, the conduct of the imPACT review is very opportune, and we look forward to using the recommendations to inform our national cancer programme planning."
Lao PDR received its first imPACT Review in 2014, to help move the non-communicable disease (NCD) and national cancer control agenda forward. The country's request for a further imPACT review this year provided an opportunity for the IAEA and national stakeholders to take stock of progress and to determine outstanding actions. The review's recommendations emphasized the importance of health promotion and the prevention of cancer, specifically at the level of primary health care with personal physicians, and highlighted the need for investment in tertiary care, which is typically very specialized in nature.
"One of the priorities set forward is to use technical expertise from the IAEA, WHO and IARC to help us in planning for a national comprehensive cancer centre, as a means to improve cancer care accessibility and services for the people of Lao PDR," said Arounlangsy.
National experts are currently planning a new national comprehensive cancer centre in Vientiane which has benefited from guidance provided through the 2014 imPACT review and by the recently published WHO-IAEA Framework on setting up a cancer centre.
Ying-Ru Lo, World Health Organization (WHO) Country Representative to Lao PDR and member of the imPACT review team, emphasized the importance of tailoring NCD and cancer control interventions to the context. "WHO has supported the Ministry of Health in developing the Lao Package of Essential Noncommunicable Disease Intervention (Lao PEN), which are locally adapted and fit to the needs of the communities, followed by support for implementation at the primary health care level," Lo said.
To address the burden of non-communicable diseases, including cancer, in an effective and sustainable manner, it is essential to strengthen health promotion by addressing NCD risk factors, together with prevention, early detection and timely referral, Lo added. She stressed that primary health care is a core foundation for the implementation of these priority actions.
The findings of the 2022 imPACT Review will be used to inform ongoing and planned IAEA support to Lao PDR. The IAEA has been assisting in enhancing the country's capabilities in cancer management, particularly in diagnostic radiology, nuclear medicine and radiotherapy services through support to Mittaphab Hospital - Lao PDR's only operating radiotherapy centre. "The conduct of the follow-up imPACT review is very timely, as its findings and outcomes will inform the country on how to strategize the technical cooperation projects in the next cycle and beyond, as part of the overall country cancer management plan," said Mio Kato, an IAEA Programme Management Officer for Lao PDR.
An important component of strengthening cancer control in Lao PDR is South-South cooperation. Experts participating in the imPACT Review team came from eight countries, including India, Thailand and the Philippines. The findings of the Review highlighted technical assistance delivered by the National Cancer Institute of Thailand and Khon Kaen University, also in Thailand.
"The imPACT Review process bolsters these partnerships and provides a platform for further capacity building that will have long-term impact on cancer control in Lao PDR and throughout the region," said Lisa Stevens, Director of the IAEA Programme of Action for Cancer Therapy (PACT).
Additionally, through its Rays of Hope initiative, the IAEA provides support to countries without radiotherapy or with inequitable access, focusing on a limited number of high-impact, cost-effective and sustainable interventions in line with national needs and commitment. This initiative is open to funding and partnerships including from governments, international financing institutions and the private sector to ensure maximum reach, impact and sustainability
Cancer is an emerging health issue in Lao PDR and the Ministry of Health is committed to making cancer control a priority in the country. For this reason, the conduct of the imPACT review is very opportune, and we look forward to using the recommendations to inform our national cancer programme planning.
WHO, IARC and IAEA experts visiting a community health care facility to observe the integration of NCDs/cancer interventions at the primary health care level. (Photo: I. Velkjkovikj/IAEA)
