Cancer in the US Associated Pacific Islands (UASPI): history and participatory development

The US-associated Pacific Island jurisdictions (USAPI) have great disparities in health care and comprehensive cancer care compared to the United States. Cancer mortality ranks first or second among the leading causes of death in most of these island nations. The USAPI has formed the Cancer Council of the Pacific Islands (CCPI), an indigenous council to identify and address the cancer health disparities of the region. The CCPI efforts were formally launched in 2002 with the support of the Center to Reduce Cancer Health Disparities, a Center of the National Cancer Institute (CRCHD-NCI) and the National Center for Minority Health Disparities, a Center of the National Institutes of Health (NCMHD-NIH). Facilitating partners are the Department of Family Medicine and Community Health, University of Hawai'i and 'Imi Hale - Native Hawaiian Cancer Network, a program of Papa Ola Lokahi. The objectives of this initiative are to describe and address the cancer health disparities in the USAPI. Over the past 2 years there has been considerable progress in identifying and prioritizing cancer prevention and control needs; launching cancer prevention and control efforts in each of the jurisdictions; and leveraging additional funding to support ongoing activities. The support from the Center to Reduce Cancer Health Disparities in fostering a participatory model of development has been landmark in the establishment and implementation of this initiative. This manuscript provides a historical background on cancer in the USAPI and prefaces 9 cancer assessments in this journal from the Commonwealth of the Northern Mariana Islands, Guam, American Samoa, Republic of the Marshall Islands, Republic of Belau, and the four states (Yap, Pohnpei, Kosrae and Chuuk) of the Federated States of Micronesia.