Pacific Cancer Programs

Chuuk State Comprehensive Cancer Control Program

Chuuk is one of four states which composes the FSM, which in turn is part of a unique family of 6 US associated Pacific island nations. The reality of the Chuuk’s geographic, political and economic environment necessitates planning in context of those spheres of influence. Therefore Comprehensive cancer planning in accounted for cancer care systems required at the state, national and Pacific regional levels.

The related and synergistic cancer plans that will serve Chuuk are: Chuuk State CCP, FSM National CCC Plan USAPIN Pacific Regional CCCP. This degree of comprehensive cancer planning reflects the dearth of health resources in Chuuk, Chuuk’s absence of a meaningful infrastructure to address cancer, and the necessity for Chuuk, the FSM, and the Pacific region to coordinate plans for cancer care.

The evolution of Chuuk state CCCP will be described in greater detail on the Chuuk 5-year plan. The evolution of FSM CCP is detailed in that plan. The USAPIN regional CCP is added to the Chuuk state plan. The Pacific regional plan is designed to complement the Chuuk state and the FSM national comprehensive cancer plans. What Chuuk State, and the FSM will have a difficult time Chuuk State Comprehensive Cancer Control Plan accomplishing because of limited resources, small size or distant location—the regional cancer plan will address. The Pacific regional plan allows more possibilities through synergism and economies of scale for comprehensive cancer prevention and treatment. Without a regional plan much less will be possible to address cancer in each individual jurisdiction in the Pacific.

In 2004 the University of Hawaii in partnership with the CCPI and USAPIN applied and received the Pacific CDC Comprehensive Cancer Planning grant. The USAPIN and CCPI moved towards framing a comprehensive cancer plans for the 4 states of the FSM, 6 Pacific National plans, and assessing the need for a regional cancer registry.

The initial cancer coalition in Chuuk, composed of ten members, met every other month.
Although very astute and community based, they found it difficult to sustain a working relationship with the CDC and the coordinator. Many members expected to receive sitting fees for meetings. The budget and planning process was prohibitive to this request. Seven of the original ten coalition members resigned in February and March 2006. Before departure they had completed the data and program matrix, and developed most of the cancer plan except for all the quality of life and data portions of the plan.

New members were recruited and joined the cancer coalition between April and June 2006. Chuuk’s cancer coalition now has 30 members representing 20 communities-based, faith-based, and government-based individuals or organizations. The members were selected for their areas of expertise, their ability to advocate for their community, and their dedication to the comprehensive cancer planning process in Chuuk.

At the first general meeting of new members in June 2006, the coalition selected a core group to continue the planning process. This group reported to the larger coalition for their input and approval. The Coalition meetings were run by an elected chairperson. In September 2006 three additional members joined the coalition. Since September 2006 there have been two general meetings and multiple core meetings. Decision making was based on majority vote. Meeting venues and agenda were decided upon by the Coalition and arranged by the Cancer Program staff.

The FSM national comprehensive cancer plan was developed with the input from Chuuks’ cancer coordinator and Chuuk’s coalition leadership. At a regional level, there were several face to face meetings of all members of the CCPI. The cancer coordinators from each FSM state, the FSM national government and Pacific jurisdiction worked with the CCPI and UH to develop the regional plan.

Technical assistance was provided by the UH over the 3 years planning process to develop a coalition, provide assistance with understanding the available cancer data, provide assistance with the planning process, trouble s hoot difficulties with particular areas of plan, and to review the plan as it developed in Chuuk. The UH took a lead role in facilitating the meeting between the FSM states and the FSM national government, and facilitated the regional cancer planning with the CCPI.

Comprehensive Cancer Control (CCC) Plan:


To have a cancer free Chuuk


To Decrease Cancer Burden and Disparity in Chuuk by increasing cancer public awareness and education; improving early detection and treatment, improving the quality of life for cancer patients; and improving our cancer data collection and utilization through a regional cancer registry


The challenges are many, and the resources are limited. We will not be able to save the lives of all our cancer patients, but if we could save one, that will make a world of difference

Dr. Kino S. Ruben, first Director of the Chuuk Comprehensive Cancer Control Program.

The 2001-2002 cancer needs assessment in Chuuk revealed that cancer was the third leading cause of mortality in Chuuk. Many of Chuuk’s people remain unaware of the burden of cancer in Chuuk and are unable to relate these results with their lifestyle, diet, habits, and behaviors. Most of the people of Chuuk people do not understand what cancer is, its risk factors and its negative impact on families, the community and the country.

Public systems for mass communication about health issues are limited The single public broadcasting radio station only operates from 7:00 am to 11:30 am each day due to power limitations. There are only a few health educators, and none dedicated to cancer awareness and education programs. The public school systems do not have regular health education curricula. Chuukese now enjoy their western type lifestyles, and are consumers of unhealthy western products and foods. They have lost many of their valuable traditions which promoted healthy lifestyles and diets. The consequences of this change have resulted in a surge of chronic illnesses, including cancer which the present health system is unprepared.

New systems to deal with cancer in Chuuk are needed. These include modes of cancer education, prevention, risk reduction, treatment, caring for the people and the families who suffer from cancer, and improving cancer data management. A comprehensive cancer plan which accounts for the economy, geography, culture, disparity, available human resource, and the level of infrastructure development is needed.

The main underlying goals of the Chuuk State CCC Program:

  1. Prevent cancers which are associated with the highest morbidity and mortality rates in Chuuk from occurring. (liver, lung, cervical, stomach, breast, cervical, uterine, prostate) Securing funding for cancer prevention and control planning and activities
  2. Detect cancer at the earliest possible stage in Chuuk.
  3. To be able to treat and medically manage every cancer patient, as early as possible, with the most cost effective, practical, and evidence based therapies.
  4. To provide the best quality of life to cancer patients, cancer survivors, and their families that is practical and attainable in Chuuk.
  5. To improve cancer-related health data systems in Chuuk state.

Comprehensive Cancer Control (CCC) Plan Download

Cancer Council of the Pacific Islands (CCPI) Members

Dr. Kino S. Ruben

Dr. Siana Shapucy

  • Title: Chuuk CCPI Director
Dr. Yoster Ychiro

Dr. Yoster Ychiro

  • Title: Chuuk CCPI Director
Dr. Yoster Ychiro

Ms. Frita Fritz Irons

  • Title: Chuuk CCC Coordinator

Contact Information


Anster Cruz

  • Title: Chuuk Cancer Registry Assistant
  • Tel: (691)
  • Email:
  • Address:
    Chuuk State Cancer Registry
    P.O. Box 609
    Neauo Weno, Chuuk FM 96942
Amanto Emuch

Amanto Emuch

  • Title: Chuuk Cancer Registry Support Staff
  • Tel: (691) 330-6490
  • Email:
  • Address:
    Chuuk State Cancer Registry
    P.O. Box 609
    Neauo Weno, Chuuk FM 96942

Funding for this website was made possible by a cooperative agreement from the Centers for Disease Control and Prevention, through the following:
Pacific CEED, award #: 5U58DP000976,USAPI Community Health Interventions Project (CHIP), award #: 1U58DP005810,
Pacific Regional Central Cancer Registry, award #: 5U58DP003906; Regional Comprehensive Cancer Control Program, award #: U55/CCU923887.
The views expressed on this site do not necessarily reflect the official policies of the Department of Health and Human Services;
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Funding Sources: PRCCR: #: 5U58DP003906  | Pacific REACH: #: 1U58DP005810 | RCCC: #: U55/CCU923887 

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