A Consensus Plan for Action to Improve Access to Cancer Care in the Association of Southeast Asian Nations (ASEAN) Region

  • Woodward, Mark (The George Institute for Global Health, University of Oxford)
  • Published : 2014.10.23


In many countries of the Association of Southeast Asian Nations (ASEAN), cancer is an increasing problem due to ageing and a transition to Western lifestyles. Governments have been slow to react to the health consequences of these socioeconomic changes, leading to the risk of a cancer epidemic overwhelming the region. A major limitation to motivating change is the paucity of high-quality data on cancer, and its socioeconomic repercussions, in ASEAN. Two initiatives have been launched to address these issues. First, a study of over 9000 new cancer patients in ASEAN - the ACTION study - which records information on financial difficulties, as well as clinical outcomes, subsequent to the diagnosis. Second, a series of roundtable meetings of key stakeholders and experts, with the broad aim of producing advice for governments in ASEAN to take appropriate account of issues relating to cancer, as well as to generate knowledge and interest through engagement with the media. An important product of these roundtables has been the Jakarta Call to Action on Cancer Control. The growth and ageing of populations is a global challenge for cancer services. In the less developed parts of Asia, and elsewhere, these problems are compounded by the epidemiological transition to Western lifestyles and lack of awareness of cancer at the government level. For many years, health services in less developed countries have concentrated on infectious diseases and mother-and-child health; despite a recent wake-up call (United Nations, 2010), these health services have so far failed to allow for the huge increase in cancer cases to come. It has been estimated that, in Asia, the number of new cancer cases per year will grow from 6.1 million in 2008 to 10.6 million in 2030 (Sankaranarayanan et al., 2014). In the countries of the Association of Southeast Asian Nations (ASEAN), corresponding figures are 770 thousand in 2012 (Figure 1), rising to 1.3 million in 2030 (Ferlay et al., 2012). ASEAN consists of Brunei Darussalam, Cambodia, Indonesia, Lao, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam. It, thus, includes low- and middle-income countries where the double whammy of infectious and chronic diseases will pose an enormous challenge in allocating limited resources to competing health issues. Cancer statistics, even at the sub-national level, only tell part of the story. Many individuals who contract cancer in poor countries have no medical insurance and no, or limited, expectation of public assistance. Whilst any person who has a family member with cancer can expect to bear some consequential burden of care or expense, in a poor family in a poor environment the burden will surely be greater. This additional burden from cancer is rarely considered, and even more rarely quantified, even in developed nations.


Cancer incidence;cancer mortality;ASEAN


  1. Kimman M, Jan S, Kingston D, et al (2012b). Socioeconomic impact of cancer in member countries of the Association of Southeast Asian Nations (ASEAN): the ACTION study protocol. Asian Pac J Cancer Prev, 13, 421-5.
  2. Boyle P, Sullivan R, Zielinski C, Brawley OW (Eds.) (2013). The State of Oncology. International Prevention Institute, Glasgow.
  3. Ferlay J, Soerjomataram I, Ervik M, et al (2012). GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide. IARC CancerBase No. 11 [Internet]. International Agency for Research on Cancer, Lyon.
  4. Kimman M, Norman R, Jan S, et al (2012a). The burden of cancer in member countries of the Association of Southeast Asian Nations (ASEAN). Asian Pac J Cancer Prev, 13, 411-20.
  5. Moore MA (2013). What and where for publications by cancer registries in the Asian Pacific? - roles for the APJCP in the future. Asian Pac J Cancer Prev, 14, 4939-42.
  6. Moore MA, Attasara P, Khuhaprema T, et al (2010a). Cancer epidemiology in mainland South-East Asia - past, present and future. Asian Pac J Cancer Prev, 11, 67-80.
  7. Moore MA, Manan AA, Chow KY, et al (2010b). Cancer epidemiology and control in peninsular and island South-East Asia - past, present and future. Asian Pac J Cancer Prev, 11, 81-98.
  8. Moore MA, Sangrajrang S, Bray F (2014). Asian Cancer Registry Forum 2014 - regional cooperation for cancer registration: priorities and challenges. Asian Pac J Cancer Prev, 15, 1891-4.
  9. Sankaranarayanan R, Ramadas K, Qiao YL (2014). Managing the changing burden of cancer in Asia. BMC Medicine, 12, 3.
  10. United Nations (2010). Towards a Global MDG Breakthrough Plan. United Nations Non-Governmental Liaison Service, Geneva.

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