The situation with cancer control in Vietnam.

Vietnam is one of the poor, developing countries. Malnutrition and infectious diseases are still major health problems. Cancer ranks in a relatively modest position of priority. The reason is partly explained by a shortage of treatment facilities and poor quality of health and vital statistics. The leading cancers in the country are lung, liver, stomach, colon-rectum and nasopharynx in males and breast, cervix, stomach, liver, colon-rectum and lung in females. Although the country has some common patterns of cancer such as a relatively high incidence of nasopharynx, liver and stomach and a relatively low incidence of breast and prostate cancer compared with international data, the geographical distribution of cancer is not homogenous within the country. The most remarkable difference is observed in cancer of the cervix uteri, of which the incidence in the South is, at least four times higher than that in the North. Other less extensive differences are observed in cancer of the lung, stomach, nasopharynx and breast, the incidence of which seems to be higher in the North than in the South, and the liver, which seems to be more frequent in the South than in the North. It was estimated that in 1990 the cancer incidence in Vietnam was about 133 per 100 000 in males and 91.7 per 100 000 in females and that the mortality was 105.9 and 58.5 per 100 000, respectively (standardization to the world's population). In that year, Vietnam had at least 52 700 new cancer cases and 37 700 dead from cancer. Although the National Cancer Control Program is still in preparation, some efforts by the government have already been made with tobacco control, improving the cancer treatment net, mass media education and production of vaccine against HBV. Cancer control in Vietnam still has to deal with challenges such as poor quality of cancer morbidity and mortality data, shortage of resources for establishing a comprehensive cancer control network from the center to the peripheries, lack of data for an anti-tobacco program and misunderstanding or limited knowledge of general practitioners and the public about the disease.