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Breaking the Tide in the Global Cancer Epidemic

BCRF investigator Dr. Daniel Hayes discusses how ASCO is addressing the global burden of cancer.

According to the World Health Organization, breast cancer is the most prevalent cancer in women worldwide and is increasing, particularly in developing countries where the majority of cases are diagnosed in late stages. In a report issued last year, the American Cancer Society predicted that the global burden of cancer would result in 26.1 million new cancer cases per year and 13 million annual deaths by 2030, up from and 13.2 million cases and 8.2 million deaths in 2013.

The global cancer burden is disproportionately felt in low- and middle-income countries (LMCs). The International Agency for Research on Cancer (IARC) estimates that approximately two thirds of all cancer deaths and nearly 60 percent of new cancer cases occur in LMCs. Furthermore, IARC has projected that by 2030, new cases of cancer in LMCs will be nearly double those in high-income countries, and more than twice as many cancer deaths will occur in LMCs than in high-income countries. BCRF spoke with outgoing ASCO President and BCRF investigator Dr. Daniel Hayes about the challenges in addressing the global cancer epidemic.  Here are excerpts from the conversation.

BCRF: ASCO is the largest international oncology organization. How is it leveraging its international membership to address cancer globally, particularly in low resource settings?

Dr. Hayes: Approximately one third of ASCO members practice outside the United States, and of these international members, one quarter practice in LMCs, which represents a significant and growing constituency. Thus, the ASCO Board of Directors has made it a priority to consider their needs and interests. There are some incredible members of ASCO–people like Drs. Julie Gralow, Gabriel Hortobagyi, Larry Shulman, Funmi Olopade–all BCRF investigators – devoting years of their lives to global oncology, and to helping low income countries develop systems that help them take better care of patients with cancer. Any they face a lot of challenges.

One challenge with practicing global oncology is that it takes academic investigators away from their institutions, which can affect their career progression if the institution doesn’t value their global work. The good thing is that efforts are being made to institutionalize the academic stature of global oncology efforts. For example, ASCO now publishes the Journal of Global Oncology (JGO), which is an online, open access journal focused on cancer care, research and care delivery issues unique to countries and settings with limited healthcare resources.  JGO has quite successfully provided a venue for publication of research results related to global oncology.

NIH has initiatied new grant applications that can incentivize institutions to support the efforts of their faculty doing global oncology research.  In this regard, the NCI is supporting more global oncology grants both to Americans to conduct research internationally, but also to people who live in Low- and Middle-income countries.

Another way ASCO is working to professionalize global oncology, is through a collaboration with the College of American Pathologists (CAP) to advance pathology in low resources countries. Two years ago, we convened a meeting with a medical oncologist and a pathologist from four different low-income countries: Vietnam, Uganda, Honduras, and Haiti. One result of that is an effort to develop a pilot education system in Honduras. If we’re successful there, we’ll offer it to other countries.

In addition, a global task force, led by Drs. Gabriel Hortobagyi with Eduardo Cazap, Larry Shulman and others, led to a three-part global oncology strategy of professional development, improvement of access to quality care, and acceleration of global oncology research. I’m excited about that progress.

The Conquer Cancer Foundation of ASCO, recently created a new funding program called the Global Oncology Research Fund. This program will provide research funding to early-career investigators to encourage and promote quality research in global oncology and address global health needs, specifically in low-resource settings. It will begin issuing awards in 2018.

ASCO is just one player, but can be a mobilizer of many stakeholders. Improving the resources in oncology in low- and middle-income countries will require alliances among international NGOs, governments, advocacy, funding and medical organizations, academic research centers and the international oncology community.

Read more of our conversation with Dr. Hayes in parts one and two of this series.

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