🇵🇭 Cancer in the Philippines

The Philippine Statistics Authority's provisional release of 26 September 2024 counts 127,371 deaths from ischaemic heart disease (18.7 per cent of registered deaths), 72,855 from neoplasms (10.7 per cent) and 68,708 from cerebrovascular disease in 2023, the same top three as in 2022. Later provisional releases, as reported in the press, count 51,904 neoplasm deaths in January to September 2025 (11.6 per cent) and 64,864 in January to November 2025 (11.4 per cent), with a final report for 2025 due in January 2027. GLOBOCAN 2024 puts breast cancer first with 28,124 new cases and 11,160 deaths, colorectal cancer second (17,462 cases) and lung cancer third (15,312 cases, 11,715 deaths). GLOBOCAN estimates 7,829 cervical cancers. The 2010 Philippine Cancer Facts and Estimates, written by the Manila and Rizal registries, ranked breast, lung, liver, colorectal and cervical cancer as the five commonest; liver cancer was 7,331 of its 82,468 cases and is 8,638 of GLOBOCAN's 149,852.

The Department of Health's 2024 terminal report names the Philippine Cancer Society's Manila Cancer Registry (Manila, Quezon City, Pasay and Caloocan, 266.5 square kilometres) and the Department of Health Rizal Cancer Registry (the original province of Rizal, 1,343 square kilometres, launched in 1974) as the country's two high-quality population-based registries; registries once run in Cebu and Davao were discontinued. During the project the two Metro Manila registries were still collecting cases diagnosed in 2018 to 2022, the Cebu and Davao registries began collecting for 2023 to 2027, and a method was proposed for linking registry cases with the Philippine Statistics Authority's death records, which registries need to measure survival. The National Integrated Cancer Control Act makes adult and childhood cancer notifiable, requires every hospital and clinic to keep a cancer registry, and makes submitting its data to the Department of Health a condition of renewing a hospital's licence to operate (Sections 28 to 30). The Philippine Cancer Society says Manila registry data appeared in IARC's Cancer Incidence in Five Continents from Volume VI (1983 to 1987 data).

Among 20,654 patients diagnosed from 1990 to 2012 with ten common cancers who received treatment, 35.1 per cent waited more than 30 days, 25.2 per cent more than 60 days and 20.0 per cent more than 90 days; longer waits were more likely for patients aged 0 to 19, men, those treated at non-private hospitals, those with more advanced cancer and those whose first treatment was not surgery. Among 21,740 patients diagnosed from 2000 to 2017 and followed to 2022, a wait of more than 90 days carried a five-year mortality risk ratio of 1.09 (95 per cent confidence interval 1.04 to 1.14) against a wait under 30 days, with the association significant for breast and cervical cancer and for cancer that had not spread, not for metastatic cancer. These are the registry's own patients in Rizal and part of Metro Manila. A 2022 count of specialists found 348 medical oncologists and 99 radiation oncologists for almost 110 million people, with five of 17 regions having no radiation oncologist, which is part of the distance patients outside Metro Manila travel.

Republic Act 11223, approved 20 February 2019, states that every Filipino citizen shall be automatically included in the National Health Insurance Program and that failure to pay premiums shall not prevent anyone from using its benefits. Direct contributors (employees, the self-employed, migrant workers) pay a premium that rose to 5 per cent of monthly income in 2024 and 2025, between an income floor of P10,000 and a ceiling of P100,000; the national government pays the premiums of indirect contributors. The National Integrated Cancer Control Act (Section 21) directs PhilHealth to expand its packages to cover screening, diagnosis, treatment, supportive care, survivorship, rehabilitation and end-of-life care for all types and stages of cancer in adults and children, through a prioritisation process such as health technology assessment, and to make both its benefits and the Cancer Assistance Fund available at public and private licensed cancer centres. PhilHealth pays radiotherapy at P3,900 a session with cobalt and P5,850 with a linear accelerator. A PhilHealth presentation of July 2025 described palliative and hospice care as still under development, and packages for lung, liver and ovarian cancer services as in development.

PhilHealth Circular 2024-0007, effective 30 March 2024, rewrote the breast cancer package, first introduced with the Z Benefits in 2012, following PhilHealth Board Resolution 2883 of 2024. It covers clinical stages 0 to IV, including patients already in treatment, from diagnostic tests and HER2 testing through surgery, hormone therapy, chemotherapy and surveillance; 1,000,008 pesos of it is for trastuzumab, paid in three tranches of 333,336 pesos, each six cycles. PhilHealth said no co-payment may be charged to patients in ward accommodation, and that 21 health facilities were contracted for the package when it announced the change in April 2024. The other cancer packages on PhilHealth's benefits page are acute lymphoblastic leukaemia at standard risk in children aged 1 to under 10 (P500,000), cervical cancer treated by chemoradiation or surgery (P120,000 with cobalt and low-dose brachytherapy, P175,000 with a linear accelerator and high-dose brachytherapy), low to intermediate risk prostate cancer in men up to 70 (P100,000) and colon and rectal cancer by stage (P150,000 to P400,000). At the Philippine General Hospital, 251 patients treated under the colorectal package in 2016 to 2018 had a three-year survival probability of 70 per cent, and 75 per cent kept to their treatment plan.

Joint Memorandum Circular 2023-0001 of the Department of Health and the Department of Budget and Management, signed in September 2023, sets the rules for the fund from fiscal year 2023. Its eight priority cancer types are breast cancer; childhood cancers; gynaecological cancers; liver, colorectal and other digestive cancers; adult blood cancers; head and neck cancers including thyroid; lung cancer; and prostate, kidney and bladder cancers. Access sites are Department of Health hospitals and other government hospitals that meet the requirements of Administrative Order 2022-0013 on the Cancer and Supportive-Palliative Medicines Access Program, defined as the mechanism for giving free medicines not yet covered by PhilHealth, plus Department of Health cancer specialty centres and other health facilities that meet the department's minimum criteria; non-Department of Health hospitals receive the money by fund transfer. For cancer cases the fund is to be charged before the Medical Assistance to Indigent Patients programme, and it complements PhilHealth and the Malasakit centres. The department is to report the fund's disbursements to the Office of the President and Congress each quarter. The circular cites a study in which many patients had spent at least P181,000 on cancer care after 12 months. The current list of access sites, the medicines on the programme's list and the fund's recent budgets were not read; see gaps.

Section 34 of Republic Act 11223 makes the assessment recommendatory to the Department of Health and PhilHealth but provides that investment in any health technology and development of any benefit package shall be based on its positive recommendations, with periodic review and reassessment as new evidence emerges. Its criteria are responsiveness to magnitude, severity and equity; safety and effectiveness, stated as each intervention having undergone a phase IV clinical trial with a systematic review and meta-analysis readily available; household financial impact; cost-effectiveness; and affordability and viability. The council sits within the Department of Health, may call on PhilHealth, the Food and Drug Administration, patient groups and clinical experts, must make its deliberations public, and was to transition within five years of operating into an independent body attached to the Department of Science and Technology. A 2026 University of the Philippines discussion paper, one of whose authors is at the Department of Science and Technology's Health Technology Assessment Division, states that the country has no explicit cost-effectiveness threshold and estimates one at P84,317 to P209,410 per quality-adjusted life year, 36 to 89 per cent of 2024 GDP per head; its appendix lists the faecal immunochemical test for colorectal screening from age 45 as positively recommended by the council.

Department of Health Administrative Order 2020-0045 established facilitated registration pathways, first applied to new drugs through FDA Circular 2022-004. FDA Circular 2022-004-A, dated 15 February 2024 and signed by Director General Samuel A. Zacate, extended them to generic drugs, which it says make up a substantial share of applications, and set the eligibility: abridged review when a product has been approved by one reference drug regulatory agency, verification review when approved by at least two. It added Korea's Ministry of Food and Drug Safety and the Saudi Food and Drug Authority as the fifteenth and sixteenth reference agencies, and requires a sworn assurance from the product owner that the product is the same in all respects as the one approved and has not been rejected or withdrawn by any reference agency for quality, safety or efficacy reasons. The US Commercial Service summarised the target times in April 2023 as no more than 45 working days for an abridged review and 30 for a verification review, from proof of payment with a complete dossier; a 2021 draft of the circular had proposed 90 and 45, and stated that approval by a reference agency does not oblige the FDA to approve. OnCo did not read the final text of Circular 2022-004 itself.

Section 23 of Republic Act 11215 directs the Department of Health and other agencies to support early access to essential and innovative medicines, including quick access to drugs for compassionate use, and requires the FDA to create a dedicated and streamlined process, not exceeding one year, for licensing innovator and generic cancer medication, subject to quality checks and minimum standards such as approval and use for cancer treatment in other countries. Section 7 asks the National Integrated Cancer Control Council, on which the FDA's Director General sits, to recommend medicine access programmes covering innovative medicines and compassionate use. OnCo did not find an FDA report of median approval times for cancer medicines, or a published account of how the one-year process is run, and the FDA's own web pages refused our requests (only its PDF files could be read). Registration is the first step: payment then depends on PhilHealth's packages or on the Department of Health's medicines access programme, each with its own process.

PhilHealth Circular 2025-0014 pays fixed rates to accredited screening facilities with no co-payment or balance billing in public or private facilities: mammogram P2,610, breast ultrasound P1,350, low-dose chest CT P7,220, alpha-fetoprotein P1,230, liver ultrasound P960, and screening colonoscopy P23,640. Its annex, citing the Department of Health's 2023 Omnibus Health Guidelines, lists mammogram or ultrasound for women aged 50 to 69 and high-risk women aged 40 to 49, low-dose CT yearly from age 50 for smokers, former smokers or people with a family history of lung cancer, colonoscopy every 10 years from age 50 or after a positive stool test, and alpha-fetoprotein with liver ultrasound every six months for people with hepatitis B or C, cirrhosis or other risk factors. Circular 2025-0025 sets bowel screening for adults aged 45 to 75 or with risk factors, with a yearly faecal immunochemical test and colonoscopy within nine months of a positive result; Circular 2025-0027 sets lung screening for adults aged 50 to 80 with at least 30 pack-years who smoke or quit within 15 years, or with a family history and a smoking history. The circular's rationale cites the Philippine Statistics Authority: cancer was the second leading cause of death, 11 per cent of recorded deaths in the first eight months of 2024.

An analysis of the 2022 Philippines National Demographic and Health Survey found that about 10 per cent of women of reproductive age (1,648 respondents) had been screened for cervical cancer, and that screening was more likely at ages 45 to 49, with higher education and in wealthier households. A 2022 review notes the absence of organised national breast and cervical screening programmes and that most patients are diagnosed at advanced stages. GMA News reported in January 2025 that the Department of Health was vaccinating Grade 4 girls in public schools through a school-based programme, two free doses six months apart at P4,000 a dose, with more than half a million given a first dose by 6 January 2025 against a target of over one million; in April 2025 a department medical officer said it expected to decide on a single-dose schedule, which the World Health Organization recommends, in the third or fourth quarter of 2025. Whether that decision was made was not confirmed. PhilHealth's July 2025 presentation lists the cervical cancer Z package among the benefits being expanded.

Section 25 of Republic Act 11215 provides that cancer patients, persons living with cancer and cancer survivors are considered persons with disabilities in accordance with Republic Act 7277, as amended, and Section 26 that they are accorded the same rights and privileges, with the Department of Social Welfare and Development to ensure that the benefits under that law are granted to them and the Department of Labor and Employment to promote work for those able to work. Section 22 requires a cancer control policy in every workplace, covering prevention including genetic counselling and testing through to palliative care, directs the Insurance Commission to require health maintenance organisations to cover genetic counselling and testing, screening, diagnostics and palliative care, and states that cancer-related absences shall be compensated by the sickness benefits of the Social Security System and the disability benefits of the Government Service Insurance System. Section 27 bars discrimination in school, workplace and community. OnCo did not read the implementing rules or the disability law itself, so which specific benefits a person with cancer can claim is not set out here.

The National Integrated Cancer Control Council is attached to the Department of Health and chaired by the Secretary of Health; its members include the secretaries of social welfare, labour and the interior, the heads of PhilHealth and the Food and Drug Administration, two oncologists, and three representatives of cancer patient organisations appointed by the President, and it must produce a national roadmap with annual targets and report each year. The law also asks the Department of Health, with academic institutions, to provide subsidies and scholarships for training oncology professionals such as radiation oncologists, medical physicists and oncology nurses. Section 10 created the Philippine Cancer Center under the Department of Health, headed by an executive director, with other comprehensive cancer centres to be designated outside Metro Manila. GMA News reported the groundbreaking on 8 March 2024 on a 5,000 square metre lot inside the Blood Bank Complex in Quezon City, with each floor planned as a sub-specialty centre; whether it has opened was not confirmed. The Philippine General Hospital, run by the University of the Philippines Manila, describes itself as the national university hospital and national government referral centre, and has its own Cancer Institute.

Republic Act 11215 defines patient navigation as individualised assistance, through all phases of the cancer experience, offered to patients, families and carers to overcome health system barriers and reach timely medical and psychosocial care, and Section 9 asks for standards and guidelines for cancer-focused navigation. The ACT NOW pilot navigates women through free early detection, with yearly clinical breast examination and breast ultrasound for those at high risk (described in the paper as biannual), to treatment. An extended cost-effectiveness analysis published in 2025 modelled scaling it up for healthy women aged 40 to 69 over five years and estimated 60,711 pesos (1,098 US dollars) per disability-adjusted life year saved, below the 2022 GDP per head of 178,751 pesos, with 57 breast cancer deaths and eight financial catastrophes averted per 100,000 women. The authors note that the Philippines has reformed financial protection for breast cancer but has no national early detection and treatment programme.

Counted from ClinicalTrials.gov participation data in OnCo's graph on 4 November 2026: 69 trials list the Philippines among their countries, 61 phase 3, 4 phase 2 and 4 phase 2/3. ClinicalTrials.gov gives 40 as active and not recruiting, 15 recruiting, 12 completed and 2 terminated. AstraZeneca is lead sponsor of 27 and Merck Sharp & Dohme of 14; non-small cell lung cancer is the first-listed cancer for 24, triple-negative breast cancer for 5 and HER2-positive breast cancer, liver cancer and urothelial cancer for 4 each. They include FLAURA and FLAURA2 in EGFR-mutant lung cancer, CLEOPATRA, APHINITY and DESTINY-Breast09 in HER2-positive breast cancer, REFLECT and EMERALD-3 in liver cancer and CALLA in cervical cancer. At least four compare a proposed biosimilar with pembrolizumab or bevacizumab. The trial with the fewest countries, a phase 3 trial of acalabrutinib against chlorambucil with rituximab in untreated chronic lymphocytic leukaemia, lists five. One of the 69 is a bladder-function study in children, not a cancer trial. A 2022 commentary notes that trials are concentrated in Luzon, especially Manila, and that the country lacks comprehensive patient and trial registries.

OpenAlex, counting works whose primary topic is oncology and counting a paper for every country among its authors' affiliations, gives the Philippines 130 works in 2021, 113 in 2022, 133 in 2023, 131 in 2024 and 165 in 2025, 672 in total, of which 502 are open access and 16 highly cited. OnCo's OpenAlex snapshot of 8 September 2026 also records 1,353 ClinicalTrials.gov studies of all conditions with a site in the Philippines. Studies from Philippine data on this page include two analyses of the Rizal Cancer Registry on treatment delay (2025), the Philippine General Hospital's review of the colorectal Z package (2020), a national count of cancer specialists by region (2022), an extended cost-effectiveness analysis of the ACT NOW breast cancer pilot (2025) and an analysis of cervical screening in the 2022 national household health survey. The Philippine Cancer Society's Manila Cancer Registry and the Rizal Cancer Registry prepared the 2010 Philippine Cancer Facts and Estimates with the cooperation of the Department of Health, the University of the Philippines Manila and the Finnish Cancer Registry.

The Philippine Statistics Authority's 2023 causes-of-death release was read from an Internet Archive copy; its 2025 figures were read from a Daily Tribune report, and a GMA News report of 64,864 neoplasm deaths covers January to November 2025, not the full year. The FDA's circular on the reliance routes was read from its PDF (scanned, read by OCR), while the base Circular 2022-004 with its target times could not be found, so the times come from the US Commercial Service. The Department of Health's Administrative Order 2022-0013 on the Cancer and Supportive-Palliative Medicines Access Program, its list of access sites and medicines, the implementing rules of the cancer law and the National Integrated Cancer Control Strategic Plan 2021 to 2030 were not read. The council's published recommendations on cancer medicines, and the Philippine National Formulary, were not read.

The 2015 Philippine Cancer Facts and Estimates, which PhilHealth's 2025 bowel screening circular still cites, could not be found online; the registries' recent incidence tables were not published in the 2024 terminal report, which states that cases for 2018 to 2022 were still being collected. The 2010 edition gives five-year relative survival for breast cancer in Metro Manila residents diagnosed in 1993 to 2002 of 59 per cent, which is too old to describe care today. The fund's appropriations in recent budgets, the number of access sites and patients served, PhilHealth's membership counts and claims for the cancer packages, and coverage of HPV vaccination after January 2025 were not found from a primary source. Whether the Philippine Cancer Center has opened, and whether the Health Technology Assessment Council has become independent of the Department of Health, were not confirmed.