The Federated States of Micronesia (FSM) is a low-middle income country made up of 4 States – Kosrae, Pohnpei, Chuuk and Yap - with 102,624 people residing on hundreds of scattered atolls in over one million miles of the Pacific Ocean. The FSM has a Compact of Free Association Treaty with the U.S. This Compact allows the U.S. to provide economic assistance (including eligibility for federal funding), defense of the FSM and other benefits in exchange for U.S. military and other operating rights. In FSM, there are 3 levels of government - national, State, and local, modeled on the U.S. system. The National Government has monitoring and oversight function of the federation, including fiscal appropriations, while service delivery function is with the State governments.
The FSM National Comprehensive Cancer Control (CCC) Program is applying for this grant on behalf of the 4 established FSM State CCC programs. Each State will have its State-specific plans directly aligned with the FSM National CCC Plan but implemented within the context of each State’s reality, towards the same end goal of reducing cancer burden on our vulnerable populations. One National plan will be implemented in the 4 States in a coordinated manner with emphasis on a multi-sectoral collaborative approach to ensure there is health equity
and that any identified disparate populations are addressed in a just and inclusive way. This approach will also reduce duplication of efforts at the State level while increasing collaborations and sharing limited resources on cross-cutting issues. This collaboration will also allow improved monitoring, tracking and evaluation of FSM cancer priorities and performance measures. FSM will continue to work in concert with the Pacific Regional CCC effort helping to inform the regional efforts along with all the other Pacific Island jurisdictions through the Cancer Council of the Pacific Islands network. We are not only working locally but regionally to see how we can come together to share best practices for a Cancer-Free Pacific of which a Cancer-Free FSM is an integral part.
Our cancer burden remains high with preventable or early detectable cancers as leading causes of mortality (Tobacco-related Oral Cavity & Pharynx – 19.8*; Lung & Bronchus – 17.9*; Cervical Cancer – 28.8* Breast – 26.8*; Liver – 11.2* Uterus – 16.5*; Prostate – 12.5; Colon & Rectum – 5.5*; Stomach – 4.7*; Leukemia – 3.6*) (*Crude rates from Regional Cancer Registry 2007 – 2019), but much progress has been made since the inception of the CCC programs in 2007. We have turned stumbling blocks into steppingstones. The establishment of cancer registries in all 4 States has also allowed our programs to capture and access valuable data that helps us articulate our cancer burden better and identify areas where interventions are needed. FSM Nat. and the 4 States each have a diverse coalition of stakeholders critical to the cancer fight locally and nationally. They have all agreed to implement the same objectives focusing on the three CDC priority areas – cancer prevention, screening, and survivorship quality of life. For prevention, our focus is on reducing the risk for oral, cervical, and liver cancer through education and awareness on risk factors and the promotion of vaccination. For screening, our focus is cervical cancer. FSM is looking to increase cervical cancer screening coverage, including exploring the use of latest high-performance screening methods for HPV DNA testing. For survivorship and quality of life, we will be working on establishing survivor-focused surveillance systems, strengthening community-clinical linkages, and friendly patient navigation support. While addressing the three priority areas over the next five years, we are committed to ensuring that health equity is at the heart of our planning and implementation efforts. Our efforts in these areas are also in line with the Healthy People 2030 vision.