Page 27 - Malaysian Journal of Health Promotion, Vol 4 (Supplementary 1) 2022

Malaysian Journal of Health Promotion, Vol 4 (Supplementary 1) 2022
14 MOH-AMM Scientific Meeting 2022 in conjunction with 23 NIH Scientific Conference Abstract Book
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PLENARY 1: IDENTIFYING GAPS IN CANCER CONTROL TO GUIDE POLICY AND INVESTMENT
IN THE WESTERN PACIFIC REGION

Dr Eleanora Feletto
The Daffodil Centre,
Sydney Australia

This presentation builds on a scoping review of liver cancer in the Western Pacific Region,
commissioned by the World Health Organisation Western Pacific Regional Office, to identify
gaps in liver cancer control which can guide policy and investment in the Western Pacific
Region. Liver cancer is among the leading causes of cancer deaths worldwide and in the
Western Pacific Region and is the 5th most common cancer in males in Malaysia, estimated
by GLOBOCAN 2020. The major risk factors include infections (hepatitis B & C, liver flukes in
endemic areas), behavioural and metabolic factors (alcohol, tobacco, excess body fat), and
aflatoxin. In WPR countries with high chronic hepatitis infections and low testing and
treatment, the liver cancer burden is higher. In developed countries, changes to non-viral risk
factor prevalence are driving changes in disease burden.

While data are not systematically available, we know that approximately 35% of the global
total of people living with viral hepatitis reside in the region. HBV vaccination has served well
as primary prevention but to reduce the future liver cancer burden, testing and treatment of
those infected today is needed. For non-viral risk factors, tobacco and alcohol control and
encouragement of healthy lifestyles also contribute to reducing liver cancer and are already
implemented. When not prevented, screening for advanced liver disease and liver cancer
surveillance in high-risk people can facilitate early detection and curative treatment. Liver
cancer is often diagnosed late when treatment options are limited or palliative care is
required. This can be avoided with emphasis on prevention and expanding access to testing
and treatment for those already infected with viral hepatitis.

Gaps in data limit our understanding of the current burden but existing evidence indicates
that liver cancer is already a considerable burden in the region. Attention on liver cancer
prevention and control should be escalated in priority with a focus on prevention, hepatitis
screening and treatment and early liver cancer detection. Initiatives should be tailored to local
capabilities, and coordination of activities and a cancer related framework could highlight
these important issues and guide policy and investment based on existing regional
understanding, progress, and infrastructure.

PLENARY 2: THE DIAGNOSTIC GAP – THE CRISIS ON THE CASCADE OF CARE

Dr. Kenneth Fleming
Green Templeton College,
University of Oxford

The Lancet Commission on diagnostics has estimated that around 47% of the world’s
population have little or no access to even the simplest diagnostics. In low/low-middle
income countries this rises to 81%. This diagnostic gap is the largest gap in the cascade of
care and is an unrecognised crisis in health care globally. The gap is most acute and severe at

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