First-ever Cancer Act proposed as Thailand faces rising caseload

Thailand’s Public Health Ministry is preparing to draft the country’s first Cancer Act, as officials seek to respond to a continuing rise in the number of patients, with around 140,000 new cancer cases and 86,000 deaths recorded each year.

Speaking at the Public Health Ministry on March 12, Public Health Minister Pattana Promphat said the newly established National Cancer Policy Board had been set up to bring together all agencies involved in cancer care, in both the public and private sectors, so they can share data and jointly determine policy and operations.

He said the work would cover treatment methods, technology investment and workforce planning under a Team Thailand approach. Four subcommittees have been appointed: a subcommittee on strategy for services and investment, one on personnel, one on benefit development and reimbursement, and one on education to study and draft the National Cancer Act.

Expanding access to radiotherapy

Pattana said one immediate priority was improving access to radiotherapy machines. Thailand currently has 138 radiotherapy machines nationwide, but around 50 ageing machines will need to be replaced over the next four years.

He noted that Bangkok alone has more than 50 radiotherapy machines, accounting for roughly one-third of the national total, while the rest are spread thinly across the country. A closer review found that 33 provinces still have no radiotherapy machine at all. The ministry also plans to coordinate workforce development, including the training of physicists and radiology specialists.

“If Thailand has around 138 radiotherapy machines, then across 77 provinces that would average almost two machines per province. But if you remove the more than 50 machines in Bangkok, that leaves only around 1.2 to 1.3 machines per province,” Pattana said.

He added that access may exist in theory, but the distribution remains poor, and officials are now studying where additional machines should be installed and whether hospitals should invest on their own or allow private-sector participation.

First move towards a dedicated cancer law

On the proposed Cancer Act, Pattana said Thailand has never had a law specifically governing cancer, relying instead on policy measures. Over the past decade, the number of cancer patients has continued to rise overall, even though some cancer types have fallen while others have increased.

He said the five cancers with the highest incidence in Thailand are liver and bile duct cancer, breast cancer, colorectal cancer, cervical cancer and lung cancer. The ministry has therefore assigned the relevant subcommittee to study and draft the legislation.

According to Pattana, the law is intended to create an integrated cancer-care system that is comprehensive from start to finish. At present, data, treatment methods and price standards remain fragmented, while rising patient numbers are also driving up treatment costs. He pointed to procurement and the purchase, use and disposal of radioactive materials for radiotherapy as examples of areas where fragmented systems can raise costs.

Reduce illness, expand access, lower costs

Pattana said cancer is a major national problem, and the goal of the law would be to cover everything from prevention and public awareness to treatment and cost management. He said many cancers can be treated more effectively and at lower cost if detected early, and that broader coverage could help reduce the long-term budget burden.

Asked whether lower treatment costs under the law could also extend to charges at private hospitals, Pattana said this issue would need further study and co-operation. Asked whether patients whose own risky behaviour contributed to illness — such as lung cancer linked to smoking — might be required to pay part of the treatment cost themselves, he said discussions had not reached that stage and that the subcommittee had only just been established to begin its study.

Other countries already have cancer laws

Dr Nattapong Wongwiwat, director-general of the Department of Medical Services, said Thailand has never had an enforceable cancer law, unlike some other countries. He said the National Cancer Institute had studied laws in Western countries and Japan, where legislation covers issues ranging from cancer risk factors such as food, to treatment systems, taxation and information management.

He said Thailand still lacks clear legal tools in areas such as public information, treatment processes and taxation linked to cancer prevention. He cited the example of Thailand’s sugar tax, which was introduced to help reduce diabetes, and said no similar legal framework exists for cancer.

For Thailand to reduce patient numbers and provide end-to-end care, he said, the country should have a law that addresses the issue from upstream prevention to downstream treatment, with a focus on practical measures such as health promotion and better use of health data.