2007 Guam Cancer Plan (file size: 22,974 KB)
	Guam Cancer Resources (file size: 497 KB)

Comprehensive Cancer Control is a collaborative process through which a community pools resources to reduce the burden of cancer that results in risk reduction, early detection, better treatment, and enhanced survivorship.

Not very long ago, cancer was a death sentence. This began to change with passage of the 1971 National Cancer Act, which established the government’s commitment to cancer research. The resulting research, which focused on particular cancer sites such as breast, lung, and prostate, led to a greater understanding of how cancer works, tests for detecting cancer earlier, and better treatments.  While this “site-specific” approach is necessary for success, it is not sufficient to address the nation’s cancer burden; not when many Americans with cancer:

• Are diagnosed with cancers that could have been prevented.
• Are diagnosed with late-stage disease.
• Do not have access to or receive recommended treatment.
• Do not experience optimal quality of life.

In the Pacific Island Jurisdictions, cancer became a focal point in the health care industry when, in mid 1990, physicians from the Pacific Basin Medical Association (PBMA) began to raise concern for the increasing number of patients dying from cancer. At the same time, the Pacific Islands Health Officers Association (PIHOA), the regional health policy body for the United States Associated Pacific Island (USAPIN) jurisdictions, was developing a strategic plan which focused on chronic diseases.

In 1999, the President’s Cancer Council was presented with testimony regarding cancer health disparities in the USAPIN.  Two years later, in February 2001, both PBMA and PIHOA identified cancer as a priority and these issues were discussed numerous times at the Federal level and in 2002, the National Cancer Institute’s Center to Reduce Cancer Health Disparities and the National Institutes of Health’s National Center on Minority Health Disparities provided financial resources in response to Pacific advocates requests. Funding was channeled through Papa Ola Lokahi, a Native Hawaiian Health Organization with experience in providing advocacy and technical assistance to the Pacific. Dr. Neal Palafox, of the University of Hawaii Department of Family Medicine and Community Health serves as the Principal Investigator for this project. These combined NCI and NIH resources were used to form the Pacific Cancer Initiative.

The goal of the Pacific Cancer Initiative was to address the cancer health needs in the USAPIN by:

• Creating a regional cancer leadership team of Pacific Islanders (the Cancer Council of the Pacific Islands (CCPI);
• Assessing and articulating the cancer health needs of the USAPIN; and
• Developing sustainable strategies to address the cancer burden in the USAPIN.

In January 2003, a cancer needs assessment was conducted in Guam by the University of Hawaii Department of Family Medicine and Community Health.  In addition to consulting with the Guam Cancer Registry (GCR), information regarding cancer mortality and morbidity was obtained from a review of death records and off-island referrals for cancer treatment.  As a result of this assessment, cancer was identified as the second leading cause of death in Guam and five priority areas were identified: 1.) Increase the capacity of DPHSS cancer prevention and control staff; 2.) Increase public awareness of cancer risk factors through public education; 3.) Expand the capacity of the Guam Cancer Registry; 4.) Establish a Cancer Prevention and Control Program to coordinate control activities for cancer other than breast and cervical; and 5.) Improve early detection and screening for priority cancers.

In June 2004, the University of Hawaii received a National Comprehensive Cancer Control Planning (NCCCP) grant on behalf of 5 of the 6 USAPIN, including Guam.  These grants were funded by the U.S. Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, which provided funding for the formation of a Comprehensive Cancer Control Coalition to begin developing a comprehensive cancer control plan for the island.

Between 2000 and 2005 there were 1,638 new cases of cancer and between 2001 through 2005, there were 1,387 deaths due to cancer recorded by the Guam Cancer Registry (GCR). Guam’s top three priority areas, based on cancer incidence rates are lung, breast, and colorectal cancer.

Chamorros had the highest overall age-adjusted cancer mortality rate at 247.2 cases per 100,000 population, more than 25% higher than the US rate.  Caucasians were next at 204.6, and Micronesians were lower than the US rate at 172.9.  Both Asians and Filipinos at 94.0 and 93.4 respectively, were more than 50% less that the US rate. The U.S. age-adjusted rate for total cancers for all races was 193.5.

In 2005, Guam became part of this national movement and is committed to helping our community:

• Reduce cancer risk, by encouraging people to
  • Avoid tobacco use.
  • Eat a healthy, balanced diet.
  • Maintain a healthy weight.
  • Exercise regularly.
  • Limit alcohol consumption.
  • Protect themselves from environmental risks (i.e., sun exposure).
• Detect cancers earlier by
• Promoting recommended cancer screening guidelines and tests.
• Educating people about possible cancer signs and symptoms.
• Improve treatment by
• Increasing access to quality cancer care.
• Increasing participation in clinical trials.
• Decrease health disparities by
• Ensuring equal access to, and delivery of, quality cancer care.
• Increasing health care providers' cultural competence.
• Enhance quality of life for cancer survivors by addressing physical, psychosocial, and practical issues.

A united front is more powerful. Comprehensive Cancer Control offers the power of collaboration to what otherwise might be a lonely fight. The result is a powerful network of groups that speaks with one voice about reducing cancer risk, detecting cancers earlier, improving access to quality cancer treatment, and improving quality of life for cancer survivors.

Working together is more efficient. By putting Comprehensive Cancer Control plans into action, coalitions prevent overlap and direct resources to where they matter most in every state, and in many tribes and U.S. territories.

Collective action creates new allies. People from all corners of the cancer community are gaining new allies by participating in Comprehensive Cancer Control. This allows them to pool resources, share expertise, and gain new insights into better ways to get the job done.

Coalitions can tackle cross-cutting issues. A united front against cancer can tackle major issues—like better access to quality care, survivorship, health disparities, and quality of life—that are too broad and cross-cutting for any one organization to confront alone.

Join the Guam Comprehensive Cancer Control Coalition
The Guam Comprehensive Cancer Control Coalition (Cancer Coalition) is a diverse group of public and private sector stakeholders and individuals whose collaborative work identifies methods to reduce the burden of cancer and eliminate gaps in cancer services in Guam.  The success of the Cancer Coalition and the implementation of the Guam Comprehensive Cancer Control Plan depend on the commitment and involvement of a broad spectrum of organizations and partners who are willing to share their expertise, resources and experiences with one another.  As a member of the Cancer Coalition, you will:

• be involved with developing, enhancing, and supporting cancer programs and services;
• be able to advocate for and support cancer survivors and their families; and
• be able to network with others in the community that share a strong interest in cancer and access cancer-related resources and information.

For more information, please contact the Guam Comprehensive Cancer Control Program, Department of Public Health and Social Services at (671) 735-7335 / 7265 or visit www.cdc.gov/cancer/ncccp, http://cancercontrolplanet.cancer.gov, or www.cancerplan.org.