title: Reducing cancer health disparities in the US-associated Pacific.
abstract: OBJECTIVE
  To assess cancer prevention and control capacity in the US-associated Pacific Islands (USAPI, including American Samoa, Northern Mariana Islands, Micronesia, Guam, Marshall Islands, and Palau) and to support indigenous leadership in reducing cancer health disparities.
  
  
  METHODS
  Jurisdiction- specific needs assessments were conducted to assess cancer prevention and control capacity and challenges. The Cancer Council of the Pacific Islands (CCPI), an indigenous health leadership team from public health and medicine, was supported to review assessment findings, develop priorities, and build capacity to address recommendations.
  
  
  RESULTS
  Capacity varied across jurisdictions, but generally there is limited ability to measure cancer burden and a lack of programs, equipment, and trained personnel to detect and treat cancer. Most cancers are diagnosed in late stages when survival is compromised and care is most costly. Jurisdictions also are challenged by geographic, social, and political constraints and multiple in-country demands for funding. Based on findings, strategies were developed by the CCPI to guide efforts, including fund seeking, to expand cancer prevention and control capacity in regionally appropriate ways.
  
  
  CONCLUSIONS
  Concerted planning, training, and funding efforts are needed to overcome challenges and upgrade capacity in cancer education, prevention, detection, and treatment in the USAPI. Indigenous leadership and local capacity building are essential to this process.
authors.affiliation: Imi Hale - Native Hawaiian Cancer Network, Honolulu, Hawaii 96813, USA. jtsark@papaolalokahi.org
authors.forename: JoAnn U
authors.initials: JU
authors.lastname: Tsark
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Braun
mesh_terms: D019538:Health Care Surveys; D006297:Health Services Accessibility; D040361:Healthy People Programs; D006801:Humans; D020380:Needs Assessment; D009369:Neoplasms / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D010139:Pacific Islands; D011634:Public Health; D014481:United States