Cancer continues to pose a global public health challenge. Multiple factors – aging populations, unhealthy behaviours, infections, and environmental exposure, among others – are contributing to the growing burden of cancer. Individuals, families, and health systems are increasingly feeling the detrimental emotional, and psychosocial impact and financial strain due to cancers. Most of the countries are challenged by uneven access to cancer prevention, diagnosis, treatment, and care tools and systems, invariably affecting more the poorer segments and population groups.
An estimated 20 million new cases and 9.7 million cancer related deaths were reported globally in 2022, with nearly 70% deaths occurring in Low- and Middle-Income countries (LMICs). The South-East Asia region estimated to have 2.37 million cases and nearly 1.53 million deaths due to cancers during the same period. Estimates suggest that cancers are responsible for 20% of premature deaths due to noncommunicable diseases (NCDs). Projections predict an 87.5% increase in new cancer cases by 2050. Oral, lung, prostate, and digestive tract are the most common types of cancers among males globally, whereas breast, cervix and uterine cancers are commonest among females globally.
Reducing the burden of cancers requires a mix of public health and health system interventions. Between 30% and 50% of cancer deaths could be prevented by modifying environmental and behavioral risk factors and infections. Cancer is more likely to respond to effective treatment when identified early. Improving screening, early diagnosis and ensuring prompt treatment would result in greater probability of survival. Also, psychosocial support and palliative care focusing on improving the quality of life of patients and their families is an essential component of cancer care.
Cancer is one of the four main noncommunicable diseases included in WHO NCD global Action Plan 2013-2020, extended to 2030, aligned with the 2030 Agenda for Sustainable Development (SDGs). The global target aims to reduce the premature mortality from NCDs by a third by 2030. WHO has developed specific strategies that guide the control of avoidable risk factors, as well as to scale up services for cancer control. With UN agencies and global partners, WHO has launched initiatives and international cooperation for high burden cancers, especially for LMICs that are disproportionately affected. These include Global Initiative for Cancer Registry Development in 2011, Global Initiative for Childhood Cancer (GICC) in 2018, Global Strategy to Accelerate the Elimination of Cervical Cancer in 2020, and Global Breast Cancer Initiative in 2021. Rays of Hope initiative was launched in 2022 by the International Atomic Energy Agency (IAEA) to boost radiation medicine services. To support the Member States of the South-East Asia Region, an implementation Roadmap for the Prevention and Control of NCDs in South-East Asia (2022–2030) has been adopted to improve resource mobilization and capacity-building, and scale-up early detection and coverage, through prioritizing cost-effective and high-impact interventions.
Cancer significantly contributes to morbidity and mortality in Sri Lanka. In 2022, 33 243 new cases and 19 145 deaths were reported, showing age-standardized incidence rate of 106.9 per 100 000 individuals and age-standardized mortality rate of 59.0 per 100 000. The highest 5-year age specific incidence rates have been in the age group 70-74 years. Males tend to have high prevalence of oral, lung and digestive tract cancers, while breast, cervix and thyroid cancers were commonest in females. Sri Lanka has a National Cancer Control Policy since 2015, and the country has been improving infrastructure, cancer diagnosis and treatment capacity and services under the National Cancer Control Programme (NCCP). However, there has been an almost a 30% increase in registered cases compared to 2018, with projections suggesting a further 39% increase in new cases by 2045. Matching up with increasing demand of cancer treatment continues to pose a challenge. The country has also gone through dual crises over the last few years, due to COVID-19, followed by economic crises. These crises led to challenges of availability of medicines and provision of services.
WHO country office support to address the cancer burden in Sri Lanka is aimed at improving prevention, early detection, treatment, and palliative care services. WHO supports NCCP through international collaborations and initiatives for strengthening the national capacities of cancer health workforce, cancer registry, and services including provision of medicines. Sri Lanka is being supported through global collaborations for childhood cancer under the GICC, and trainings are being provided to improve screening, early diagnosis and treatment of breast and cervical cancers with the support of WHO Collaborating Centre for cancer control in India. Comprehensive reviews of national cancer services have been conducted in 2008 and 2019 in collaboration International Atomic Energy Agency (IAEA) and International Agency for Research on Cancer (IARC). The technical assistance from WHO country office has followed to support the MoH to implement the recommendations from these reviews. During 2024, major areas of technical assistance included documenting cancer incidence data from 25 national cancer treatment centres, and expanding breast and cervical cancer screening and management services in Sri Lanka. Under the GICC project, in collaboration with St. Jude Children’s Research Hospital and IARC, projects have been supported to improve treatment guidelines, nutritional guidelines, and expand population-based cancer registry across all districts of Colombo to monitor childhood cancer trends and services for children with cancers.
In 2025, WHO country office is supporting the National Cancer Control Programme to review the National Strategic Plan on Cancer Control 2020-24 to assess the progress so far and identify actions to address the challenges of rising burden of cancers during the next five years. A third Integrated mission of Programme of Action for Cancer Therapy (imPACT review) is being organized with the Ministry of Health Sri Lanka during the first quarter of 2025, to have a comprehensive assessment of national cancer control capacities, from primary prevention to management as well as palliative care. This joint assessment will be conducted in collaboration with IAEA and IARC. The assessment aims to systematically identify the priority needs across the spectrum of cancer prevention and care, including the aspects of cancer control financing and supplies. It would also inform improving cancer prevention and screening through primary health care and strengthening cancer management through PHC and community level care to reduce the burden on upstream health services, especially in the new context of changing epidemiology and demographics of the country.
WHO is also supporting Sri Lanka’s inclusion into Global Platform for Access to Childhood Cancers Medicines (GPACCM) to support the ongoing needs of availability of quality-assured childhood cancer medicines in the country through this global forum.