Colorectal, Gastric and Esophageal Cancers Pose Serious Human Security Threat in the Solomon Islands


The Pacific Islands Region has one of the highest Helicobacter pylori (commonly known as H. pyroli) infection rates in the world. A recent study conducted in Pohnpei, Federated States of Micronesia suggests that nearly 90% of Pacific Islanders could be infected.[1]

The Solomon Islands is no exception. Early testing indicates that infection rates there could tip 50% of the population.[2]

These high rates pose a serious threat to human security - the “most chronic bacterial infection in the world” is known to cause stomach ulcers, bleeding, and even cancer.[3]

Unfortunately, Helicobacter pylori is not the only serious infectious disease threat facing Pacific Islanders. In the Solomon Islands, one in five has contracted the Hepatitis B virus. (commonly known as HepB).[4]

Again, the Solomon Islands is not alone. The region is plagued by a hyper-endemic rate of HepB infection. And, this too poses a major public health risk – the disease, which is largely transmitted from mother to child at birth, can lead to irreversible liver damage.

One of the major problems facing the Pacific Islands Region is that doctors and public health specialists across the region lack the capacity to confront these infectious diseases. As a consequence, colorectal, gastric and esophageal cancers are killing Solomon Islanders without giving them a fighting chance for cure.

What is urgently needed is better diagnostic methods and preventive healthcare for the causes of gastrointestinal diseases.

It is with this in mind that the Solomon Islands Living Memorial Project (SILMP) created a partnership between doctors and nurses from the United States, Australian and Solomon Islands in order to develop the means to diagnose and treat these deadly gastrointestinal diseases.

With the support of the Olympus America, Pentax, Cook Medical, and Scanlan International, SILMP has helped the doctors in Solomon Islands establish a state of the art endoscopy unit at the National Referral Hospital (NRH) in Honiara, Guadalcanal.

For the past two years, American and Australian gastrointestinal endoscopist teams have also been traveling to the NRH to train Solomon Islander doctors and nurses on how to perform safe, effective endoscopy techniques. And, this training has led to over 450 upper endoscopies and 100 colonoscopies being performed by Solomon Islander doctors.

Perhaps not surprisingly, the initial findings from these operations reveal significant Helicobacter pylori-induced gastritis, duodenitis, ulcers, stomach cancers, and duodenal cancers. They also demonstrate an unusual pattern of esophageal cancer involving largely the mid-esophagus.

This may be due to heightened risk factors among the population, including smoking, alcohol consumption, and possibly betelnut chewing.

Endoscopy procedure findings are also providing strong evidence of the continued threat posed by colorectal cancer to Solomon Islanders. Among the project’s sample population, the distribution of tumors is remarkably like what was seen in developed countries 30 to 40 years ago - largely on the left side only near the rectosigmoid junction.[5]

In the months ahead, the partnership team plans to pull its data from these procedures. They then plan to publish early results of their findings. Their hope is that their work will help the local doctors in Solomon Islands to identify the types and patterns of endemic gastrointestinal diseases and provide insights into the best care lines and/or protocols for confronting these diseases.

Those affiliated with the project are also in the process of organizing a symposium on defining lines of care for colorectal cancer that work in the Solomon Islands. The symposium will include input from the Ministry of Health, health educators, public health as will as health providers in order to outline a comprehensive, country-wide strategy on educating the public on causes of and early detection of colorectal cancer.

These care lines are expected to include cost effective, context specific screening programs that include endoscopic evaluation as well as treatment of established disease including surgery, chemotherapy and palliative care.

Such findings and follow-on projects are of great interest to public health professionals. But, they should matter to the average Pacific Islander

In the US and Australia, less than 1% of all endoscopies yield a diagnosis of cancer.[6] Compare this with the Solomon Islands, where 12% of all endoscopies yield a diagnosis of cancer.[7]

Something must be done to close this gap.

 

The views expressed and data shared are those of the author.

 

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[1] Isaac B. Helicobacter Pylori infection rates at a family practice in Pohnpei, Federated States of Micronesia. Health in Palau and Micronesia 2005; 12(1).
[2] Solomon Islands Living Memorial Project Data.
[3] Polk DB, Peek RM. Helicobacter pylori: gastric cancer and beyond. Nat Rev Cancer 2010; 10(6) 403-414
[4] Furusyo N, Hayashi J, Kakuda K, Sawayama Y et al. Markedly high seroprevalence of Hepatitis B virus infection in comparison to Hepatitis C virus and Human T Lymphotrophic virus Type-1 infections in selected Solomon Islands Populations. Am J Trop Med Hyg 1999; 61(1) 85-91.
[5] Solomon Islands Living Memorial Project Data.
[6] Ibid.
[7] Ibid.

 

 

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