1. Edolem Ikerdeu, CCPI Director, Republic of Palau 57 th PIHOA Executive Board meeting Palau, March 10, 2015

2. Contents: Brief recap of the development of the CCPI and Pacific Cancer Control Programs & Partners Distribution of cancers in the USAPI Highlights of the: Regional CCC Program Regional Cancer Registry REACH Community Health Intervention Project Success stories (2002-2015) CCPI Priorities relevant to PIHOA CCPI Officers and Directors

3. CCPI Regional efforts started in 2002 with funding from the National Cancer Institute. CDC funding since 2004. PIHOA Affiliate since 2008 Two representatives designated by their Senior ranking health official: clinical and public health Should be in a position to positively influence the health systems that impact prevention and control of cancer CCPI oversees all of the Pacific Regional Cancer Programs Administered by the University of Hawaii (Palafox, Buenconsejo-Lum & team) Regional focus: cross-cutting issues that are necessary to improve jurisdiction and regional capacity for cancer and NCD control Human resources for health development (HRH) Surveillance (cancer) and mortality reporting Training in certain areas (public health and clinical), including evaluation Prevention: policies and messages in congruence with other NCD Screening: working to ensure minimum standards Treatment: palliative care / survivorship

4. Cancer Council of the Pacific Islands (Advisory Board) Cancer Council of the Pacific Islands (Advisory Board) Pacific Cancer Coalition University of Hawaii Cancer Center (technical assistance) U54 MI/CCP Partnership with University of Guam Hawaii Tumor Registry Pacific Cancer Research Group International Partners with PIHOA (SPC, WHO) U.S. CCC National Partnership University of Hawaii Dept. of Family Medicine (administrative, technical assistance) RMI Guam CNMI American Samoa Palau Kosrae Chuuk Pohnpei Yap University of Hawaii Office of Public Health Sciences Pacific Islands Health Officers Association (PIHOA) Overarching advisory Micronesian Community Network & Micronesian Health Advisory Council (Hawaii) Micronesian Community Network & Micronesian Health Advisory Council (Hawaii) U.S. Affiliated Pacific Island (USAPI) jurisdictions Regional Comp Cancer Regional Cancer Registry Pacific Center of Excellence in the Elimination of Disparities (Pacific CEED) Community Health Intervention Project (REACH)

5. Distribution of cancers in the USAPI 2007-2011 (CNMI & Chuuk data incomplete) 5 Screening test or PE 45% Tobacco-related 43% Obesity-related 47% HPV-related 7% Only 13% of cancers diagnosed at Stage 1

6. Regional CCC Program Back-funded from jurisdiction prime awards from CDC National Comprehensive Cancer Control program Regional focus: cross-cutting issues that are necessary to improve jurisdiction and regional capacity for cancer and NCD control; leveraging of national and international resources for CCC Partnerships and Communication / website (pacificcancer.org) Training & TA in certain areas (public health and clinical), including evaluation Prevention: policies and messages in congruence with other NCD Screening: working to ensure minimum standards Treatment: palliative care / survivorship Surveillance (cancer) and mortality reporting

7. Pacific Regional Cancer Registry Program Prime awardee from CDC National Program of Cancer Registries Funds cancer registrar in each jurisdiction Except Guam, but PRCCR funds travel / training / additional IT support for the Guam Cancer Registry Cancer data required for CCC and NCD plans (CDC), MDG reporting, WHO 2025 voluntary NCD indicators (cervical cancer, functional cancer registries) Additional focus on improving mortality reporting, documentation in medical records, data flow & reporting Recent report (2007-2011) available on pacificcancer.org

8. Community Health Intervention Project (REACH) Prime awardee from CDC Directly employs assistants in all jurisdictions Supports the comprehensive implementation of effective evidence-based practices to address the excessive and disparate burden of NCDs present throughout USAPI communities. Outcomes of the 3- year program, which targets adults, will focus on Increasing access to smoke-free or tobacco-free environments (public and private worksites including health facilities), Increasing access to environments (worksite, including health facilities) with healthy food or beverage options.

9. CCPI Success stories (2002-2015) Regional and jurisdiction infrastructure for CCC, helped set the stage for NCD collaboration & capacity building Developed cancer registries  cancer surveillance Pacific CEED (2007-2012): breast & cervical cancer focus, NCD risk factors, cervical cancer screening standards in FSM, RMI, American Samoa Partial funding and support of synergistic PIHOA activities: HRH assessment focused on medical records/HIS Technical Working Group on NCD Surveillance PIHOA Quality Improvement efforts NCD Toolkit

10. CCPI Success stories (2002-2015) Caring the Pacific Way Palliative Care Curriculum NCD Toolkit (with PIHOA) REACH CHIP (2014- ): baseline PSE scans related to tobacco and healthy nutrition priorities, rigorous evaluation and communication plan, training Cervical cancer: standards, Expert Panel and ACOG Committee Opinion The panel, comprised of US and Internationally renowned cervical cancer screening experts, was convened by the US Department of Health and Human Services, and the CDC. The meeting resulted in an American Colleges of Obstetricians and Gynecologists (ACOG) Committee Opinion supporting adaptation of the World Health Organization recommendations for diagnosis and treatment in one or two visits in the USAPI. The ACOG opinion could result in improved cervical cancer prevention and more accurate identification of early-stage disease in the USAPI.

11. CCPI priorities relevant to PIHOA Continued emphasis and collaboration to improve NCD surveillance capacity and data systems that inform high quality prevention and care of NCD and cancer Health information systems Mortality reporting Desire for regional, cross-program, sharing of success stories and best practices related to NCD PIHOA website – as part of the NCD Toolkit? Need for more stable supply of medications for palliative care (i.e., narcotics) Regional formulary discussion / pricing considerations

12. CCPI priorities relevant to PIHOA Capacity building/planning for a sustainable technical assistance/training mechanism for evaluation of health programs and policies Consideration of adapting "model" policies for Palliative Care in their jurisdiction CCPI Directors have a listing Continued long-term goal to expand in-region capacity for affordable diagnosis and treatment for cancer

13. CCPI Members President: Dr. John Taitano (Guam) Vice-Present: Dr. Helentina Garstang (RMI) Secretary/Treasurer: Ms. Martina Reichhardt (Yap) RMI: Dr. Cho Cho Thien (Ebeye), Dr. Garstang (Majuro), Ms. Neiar Kabua Kosrae: Mr. Nena Tolenoa, Dr. Livingston Taulung Pohnpei: Ms. Robina Anson, Dr. Kesusa Bermanis, Ms. Pertina Albert Chuuk: Dr. Kino Ruben, Dr. Yoster Ychiro Yap: Dr. Eric Lirow, Mr. John Gilmatam, Ms. Martina Reichhardt FSM National: Dr. Vita Skilling, Mr. Xner Luther Palau: Ms. Edolem Ikerdeu, Dr. Sylvia Osarch, Ms. Irish Tutii American Samoa: Ms. Moira Wright, Dr. Alo Anesi CNMI: Ms. Jocelyn Songsong, Ms. Salome Castro Guam: Ms. Roselie Zabala, Dr. Taitano, Mr. Lawrence Alam

14. For more information, please visit our website at: www.pacificcompcancer.org

15. 15 Si Yu`os Ma`ase Olomwaay Fa`a Fetai Tele Lava Msuulaang Kulo Malulap Komagar Kalangan Kinisou Chapwur Kommol Tata www.pacificcancer.org lbuencon@hawaii.edu