Skip to main content

Comprehensive cancer control planning in the Pacific: the Cancer Council of the Pacific Islands a multi-national regional coalition



In the early 1990s, a comprehensive cancer control (CCC) approach was developed in the United States (US). In 2003, the US-Affiliated Pacific Islands (USAPI) adopted the CCC approach through a regional coalition, the Cancer Council of the Pacific Islands (CCPI). Using the CCC approach, the CCPI developed jurisdiction-specific cancer coalitions and initiated their respective cancer plans.


The evolution of the CCC approach and the history of the CCPI regional coalition are reviewed. The outcomes of the regional approach for cancer control in the USAPI are described to illustrate the possibilities, value-added and innovation of using a CCC strategy in a multi-national coalition based in a resource-limited environment.


The CCC approach enabled the CCPI to (1) harmonize cancer control efforts between the six USAPI jurisdictions, (2) represent the USAPI cancer needs as a single voice, and (3) develop a regional cancer control strategy. Outcomes include (1) a regional cancer registry, (2) three sequential regional CCC plans, (3) leveraged resources for the USAPI, (4) enhanced on-site technical assistance and training, (5) improved standards for cancer screening, (6) evidence-based cancer control interventions adapted for the USAPI.


The regional CCPI coupled with the CCC approach is an effective engine of change. The CCC strategies enabled navigation of the political, geographic, cultural, and epidemiologic Pacific environment. The regional partners have been able to harmonize cancer control efforts in resource-limited settings. Regional cancer coalitions may be effective in the global arena for cancer control between communities, states, or countries.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3


  1. Given LS, Black B, Lowry G, Huang P, Kerner JF (2005) Collaborating to conquer cancer: a comprehensive approach to cancer control. Cancer Causes Control 16(1):3–14

    Article  Google Scholar 

  2. The Union for International Cancer Control (UICC) ECLE (2012) Supporting national cancer control planning: a toolkit for Civil Society Organisations (CSOs). Geneva

  3. Given LS, Hohman K, Graaf L, Rochester P, Belle-Isle L (2010) From planning to implementation to outcomes: comprehensive cancer control implementation building blocks. Cancer Causes Control 21(12):1987–1994

    Article  Google Scholar 

  4. Centers for Disease Control and Prevention (2016) National Comprehensive Cancer Control Program Logic Model. Centers for Disease Control and Prevention, Online

  5. Comprehensive Cancer Control National Partnership (2018) Comprehensive cancer control national partnership website. Accessed 11 Aug 2018

  6. Hohman K, Rochester P, Kean T, Belle-Isle L (2010) The CCC National Partnership: an example of organizations collaborating on comprehensive cancer control. Cancer Causes Control 21(12):1979–1985

    Article  Google Scholar 

  7. Isle LB, Plescia M, La Porta M, Shepherd W (2010) In conclusion: looking to the future of comprehensive cancer control. Cancer Causes Control 21(12):2049–2057

    Article  Google Scholar 

  8. National Cancer Institute (2018) Cancer control leadership forums. Accessed 11 Aug 2018

  9. International Cancer Control Partnership (2018) Developing a NCCP. Accessed 11 Aug 2018

  10. Romero Y, Trapani D, Johnson S, Tittenbrun Z, Given L, Hohman K, Stevens L, Torode JS, Boniol M, Ilbawi AM (2018) National cancer control plans: a global analysis. Lancet Oncol 19(10):e546–e555.

    Article  PubMed  Google Scholar 

  11. International Cancer Control Partnership (2018) Achieving mesurable progress towards the NCD targets: the importance of National Cancer Control Plans (NCCPs). UICC, online

  12. Pacific Regional Central Cancer Registry (2018) Cancer in the US Affiliated Pacific Islands 2007–2012. University of Hawai’i, online

  13. Palafox NA, Yamada S, Ou AC, Minami JS, Johnson DB, Katz AR (2004) Cancer in Micronesia. Pac Health Dialog 11(2):78–83

    PubMed  Google Scholar 

  14. Katz AR, Palafox NA, Johnson DB, Yamada S, Ou AC, Minami JS (2004) Cancer epidemiology in the freely associated U.S. Pacific Island jurisdictions: challenges and methodologic issues. Pac Health Dialog 11(2):84–87

    PubMed  Google Scholar 

  15. Ou AC, Waidubu G, Etheredge GD, Palafox NA (2004) Epidemiology of cancer in the Republic of Nauru. Pac Health Dialog 11(2):101–106

    PubMed  Google Scholar 

  16. Ou AC, Kienene T, Tenaua K, Etheredge GD, Palafox NA (2004) Epidemiology of cancer in the Republic of Kiribati. Pac Health Dialog 11(2):88–93

    PubMed  Google Scholar 

  17. Palafox NA, Tsark JU (2004) Cancer in the US Associated Pacific Islands (USAPI): history and participatory development. Pac Health Dialog 11(2):8–13

    PubMed  Google Scholar 

  18. Gunawardane K, Demei Y (2004) Cancer Council of the Pacific Islands: speaking with one voice. Pac Health Dialog 11(2):14–16

    PubMed  Google Scholar 

  19. Palafox NA, Gunawardane K, Demei Y (2006) Pacific island partnership: the Pacific cancer initiative. J Cancer Educ 21(1 Suppl):S87–S90.

    Article  PubMed  Google Scholar 

  20. Cancer Council of the Pacific Islands (2015) USAPI Pacific Regional Comprehensive Cancer Control Plan 2012–2017. Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawai’i-Manoa

  21. Cancer Council of the Pacific Islands (2018) Cancer Council of the Pacific Islands. Accessed 11 Aug 2018

  22. Nitta M, Tanner C, Narvarte K, Luces P, Silverio A, Zabala R, Navasca D, Sy A, Palafox NA (2015) Policy, system, and environment strategies to promote physical activity and healthy food sources to address Guam’s disparate non-communicable disease burden. J Health Care Poor Underserved 26(2 Suppl):96–103.

    Article  PubMed  Google Scholar 

  23. Nitta M, Navasca D, Tareg A, Palafox NA (2017) Cancer risk reduction in the US Affiliated Pacific Islands: utilizing a novel policy, systems, and environmental (PSE) approach. Cancer Epidemiol 50:278–282

    Article  Google Scholar 

  24. American College of Obstetrics and Gynecology (2015) Committee Opinion No. 624: cervical cancer screening in low-resource settings. Obstet Gynecol 125(2):526–528.

    Article  Google Scholar 

Download references


The authors would like to acknowledge the individuals who were instrumental in founding the CCPI in 2003. They are Dr. Harold Freeman (NCI), Dr. Johnny Hedson (Pohnpei, FSM), Dr. Victor Tofaeono (AS), Dr. Victor Ngaden (deceased—Yap, FSM), Wincener David (Pohnpei, FSM), Dr. Kamal Gunawardane (RMI), Dr. Richter Yow (Yap, FSM), Dr. Livinson Taulung (Kosrae, FSM), Dr. Robin Shearer (CNMI), Dr. Sheldon Riklon (RMI), Jocelyn Songsong (CNMI), Margaret Sesepasara (AS), Dr. Vita Skilling (Kosrae, FSM), Yorah Demei (ROP), Dr. Francisca Soaladaob (ROP), Dr. Kino Ruben (Chuuk, FSM), and Rosalie Zabala (deceased—Guam).


This publication was supported by Centers for Disease Control and Prevention Cooperative Agreement Numbers 17NU58DP006312 (Pacific Regional Central Cancer Registry 2017–2022), NU58DP006335 (American Samoa CCC 2017–2022), NU58DP006348 (CNMI CCC 2017–2022), NU58DP006269 (Guam CCC 2017–2022), NU58DP006303 (FSM CCC 2017–2022), NU58DP006336 (RMI CCC 2017–2022), NU58DP006289 (Palau CCC 2017–2022), NU58DP005810 (REACH 2014–2018), DP003906 (PRCCR 2012–2017), DP000976 (PRCCR 2007–2012), DP000777 (American Samoa CCC 2012–2017), DP00847 (CNMI CCC 2012–2017), DP000781 (Guam CCC 2012–2017), DP000779 (FSM CCC 2012–2017), DP000826 (RMI CCC 2012–2017), and DP003939 (Palau CCC 2012–2017), along with the National Cancer Institute 2U54CA143727. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention, the National Cancer Institute, or the Department of Health and Human Services.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Neal A. Palafox.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Palafox, N.A., Given, L., Hohman, K. et al. Comprehensive cancer control planning in the Pacific: the Cancer Council of the Pacific Islands a multi-national regional coalition. Cancer Causes Control 29, 1287–1295 (2018).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: