1 in 5 Cambodian adults are at risk of stroke as noncommunicable disease risks increase

Noncommunicable diseases (NCDs) are the leading cause of death in Cambodia, responsible for approximately 60 000 deaths annually. This translates to nearly one in four Cambodians dying prematurely between the ages of 30 to 70 years due to conditions like cardiovascular diseases, diabetes, cancer and chronic respiratory diseases.

NCDs place significant strain on the country’s healthcare system, requiring a comprehensive approach to effectively address the broad array of health issues. As part of this strategy, the WHO STEPwise approach to NCD risk factor surveillance (STEPS) is a global tool that provides a standardized method for collecting, analyzing, and disseminating data on key behavioral and biological NCD risk factors. In Cambodia, the Ministry of Health, with technical support from WHO and funding from Bloomberg Philanthropies, most recently conducted the STEPS Survey in 2023, with its Country Report launched in August 2024. Building on two previous surveys conducted in 2010 and 2016, this latest survey reveals concerning trends.

Key findings include an increased average salt intake among adults, now at 9.5 grams per day, nearly double the WHO's recommended limit of less than 5 grams per day. Additionally, alcohol consumption has surged, with one in four adults reporting heavy episodic drinking in the past month. The prevalence of raised blood pressure has also risen sharply, now affecting nearly one in five adults (17%).

“The 2023 STEPS survey reflects the significant impact that unhealthy lifestyles are having on the health of Cambodians. We must act swiftly to promote healthier behaviors and strengthen our health systems capacity to provide the necessary services to prevent and manage NCDs,” stated His Excellency Professor Chheang Ra, Minister of Health.

The survey also highlights that 6.3% of adults have raised blood glucose or have been diagnosed with diabetes, which is closely linked to unhealthy dietary patterns, urbanization and a rising obesity rate. Currently, 19.4% of adults are classified as overweight, and 4.3% are classified as obese. Additionally, one in four adults (25.5%) have raised total cholesterol or are on medication for it.

A health worker at a health centre in Siem Reap Province consulted a patient with hypertension who was experiencing dizziness and abdominal pain. © WHO / Alan Esquillon

Tobacco use remains a critical public health issue, with 20% of adults still smoking, and stagnation in smoking among women, despite ongoing tobacco control efforts. This behavior poses a significant challenge to reducing NCDs, particularly chronic respiratory diseases exacerbated by smoking and air pollution.

As a result, 12.5% of Cambodians aged 40-69 years have a 1 in 5 chance of experiencing a heart attack or stroke within the next 10 years, a staggering figure that could overwhelm the health system due to a potential NCD epidemic in coming years, if not addressed.

Cancer, particularly cervical and liver cancers, continue to be a major concern. The survey found that only one in five women (20.3%) aged 30-49 have undergone cervical cancer screening.

“Addressing this burden requires all of us to work together with urgency and determination. Without intensified efforts to address NCDs, progress in other development areas could be undermined, leading to a strained healthcare system, setbacks in poverty reduction and a decline in the overall quality of life,” explained Dr Marianna Trias, WHO Representative to Cambodia. “Collective involvement and coordinated action from all relevant stakeholders are essential to build a resilient health system capable of addressing the dual burden of diseases in Cambodia and ensuring that all communities, especially the most vulnerable, are protected from the devastating impacts of noncommunicable diseases.”

Since the last STEPS report in 2016, significant efforts have been made with WHO’s support to advance NCD management. NCD services in primary health care have been established in about 25% of all health centres across the 25 provinces. In 2018, a National Cancer Center was established at the Calmette Hospital, a leading medical facility in Cambodia. This was followed by the creation of the Cambodian NCD Alliance in 2019, which now includes over 40 member organizations. 

 A health worker provides a consultation to a patient on adopting a healthier lifestyle at Prey Thnorng Health Centre in Cambodia. The centre offers a range of health services, including treatment and counseling for hypertension and diabetes, lifestyle counseling, and childhood vaccinations. © WHO / Tytaart

The data from the 2023 STEPS survey is instrumental in identifying progress and gaps as well as informing national strategies to meet the goals outlined in the National Strategic Plan for the Prevention and Control of NCDs 2022-2030.

WHO will continue supporting the Ministry of Health to translate this data into actions. However, the challenges posed by NCDs are multifaceted, extending beyond the health sector. As Cambodia prepares to transition from Least Developed Country status in 2029, addressing the growing threat of NCDs will be critical to achieving long-term health and sustainable economic development.

Read the full STEPS Survey Country Report 2023 here