Cancer is the third leading cause of death in Indonesia. According to data from the Global Cancer Observatory (Globocan), there were over 408,661 new cases and nearly 242,099 deaths in Indonesia in 2022, with the highest numbers of deaths caused by breast cancer, cervical cancer, lung cancer, colorectal cancer and liver cancer. The most common cancer in women is breast cancer, while in men is lung cancer. These epidemiological data align with the hospital-based cancer registry (HBCR) data from 26 districts in 14 provinces about cases from 2008–2017. Additionally, cancer prevalence data from Social Security Agency on Health (BPJS Kesehatan) in 2022 show a similar trend.
In accordance with these cancer epidemiology and burden data, the National Cancer Control Plan (NCCP) focuses on addressing six types of cancer: breast, cervical, lung, colorectal, liver and childhood cancers (cancer in children under 18 years). Although accounting for only about 3%–5% of all cancer cases in Indonesia, childhood cancer is also prioritised because, according to global experience, the six common types of childhood cancer are highly curable with adequate diagnostic access, appropriate therapy, and sufficient support services.
The financial burden of cancer in Indonesia has continued to increase, rising from ninth place in 1990 to second place in 2019. In addition to the healthcare system’s financial burden, cancer also has financial implications for patients and cancer survivors. A study at Cipto Mangunkusumo Hospital showed that even though patients receive the National Health Insurance (JKN) benefits through BPJS Kesehatan, 79% of respondents experienced financial toxicity in meeting their daily household needs. This is partly because not all essential cancer diagnostic tests and treatments are covered by the JKN programme. The government’s initiative through the NCCP is expected to reduce the financial burden of cancer, which is predicted to continue increasing.
The government continues to strive to improve national health indicators in Indonesia through six pillars of health transformation. These six pillars guide Indonesia’s health development policies, including cancer control efforts. In formulating NCCP strategies, a situational analysis was first conducted to understand the current state of national cancer services. The analysis examined various aspects and cancer services within each health transformation pillar.