According to data from the National Cancer Control Programme, cancer incidence has more than doubled in Sri Lanka in the last 20 years, rising from 70 cases per 100 000 in the adult population in 2005 to 151 in 2021. Many cancers are diagnosed at advanced stages, with 37% of breast cancer, 45% of cervical cancer and 63% of oral cancer cases identified at stage III or IV.???

Oral cancer, which ranks as the 13th most common cancer worldwide, is the most prevalent cancer among men in Sri Lanka, followed by lung cancer, while breast and cervical cancers are the highest in women. Childhood cancers remain an important issue, with a surge in incidence from 73.1 per million population in 2005 to 107.8 in 2019, according to national data.??

Several of these cancers can be prevented and associated mortality reduced through early interventions.??

“Research shows that between 30% and 50% of cancer deaths could be prevented by modifying environmental and behavioural risk factors, including infection control,” said Rui De Jesus, WHO Country Representative in Sri Lanka. He also noted that recent surveys show a rise in the prevalence of behavioural risk factors, such as tobacco use, which highlights the need to effectively and holistically implement cost-effective interventions to reduce the cancer burden.? ?

The imPACT review encompassed desk reviews, discussions with national health authorities, medical staff and key stakeholders, as well as an in-country mission in March 2025. During the mission, the team visited healthcare facilities in the capital, Colombo, and in the cities of Ratnapura, Kandy and Galle to gather first-hand information. They also met with representatives from the Sri Lanka Atomic Energy Board to review radiation safety infrastructure and services and participated in a national workshop on cancer control with Ministry of Health leadership and representatives from national medical associations and universities.??

At the end of the country visit, the imPACT review team presented preliminary findings and recommendations to the Minister of Health and Mass Media and other senior officials. The recommendations include establishing an inter-ministerial body to oversee national cancer policies and programmes; increasing oral cancer early detection interventions for at-risk populations, including estate workers, fishermen and agriculture workers; streamlining the national referral system; improving quality standards across facilities and levels of care; integrating palliative care early in the cancer continuum; and strengthening population-based cancer registries and reporting.??

The team also identified opportunities for programmatic support and advisory services that can be provided by the IAEA, WHO, IARC and other partners to further enhance Sri Lanka’s capacity to meet its needs in cancer prevention and control.??

“The IAEA remains committed to supporting Sri Lanka’s needs in cancer care, including to enhance national capacities in radiation medicine for safe and effective diagnosis and treatment,” said Tomoaki Tamaki, Head of the IAEA’s Applied Radiation Biology and Radiotherapy section.?

The IAEA supports countries in strengthening radiation medicine services, including through its Programme of Action on Cancer Therapy, its human health programme and the Rays of Hope initiative, which aims to increase access to radiotherapy, diagnostic imaging and nuclear medicine in underserved populations.??