The International Agency for Research on Cancer (IARC) continues to closely monitor the COVID-19 situation and is currently involved in various initiatives and collaborations to assess the impact of the disease on cancer and cancer prevention. Studies to investigate the effects of the COVID-19 virus (SARS-CoV-2) on cancer mortality and survival are being conducted together with IARC’s international partners. Some of IARC’s contributions at the intersection of cancer and COVID-19 are described here.
- COVID-19 and Cancer Taskforce
IARC joined the global COVID-19 and Cancer Taskforce to help coordinate efforts to synthesize and rapidly disseminate data on how the COVID-19 pandemic is affecting cancer outcomes worldwide. Together with other leading organizations, IARC posted a Call for Expressions of Interest for researchers interested in joining a modelling consortium that can help quantify the impact of the pandemic on cancer outcomes, resulting from disruptions in the delivery of preventive, screening, and therapeutic interventions.
In addition, IARC staff joined the regional project “Impact of COVID-19 on Cancer” (IMCOCA), a Projet Structurant funded by Cancéropôle Lyon Auvergne Rhône-Alpes (CLARA) that aims to characterize and quantify the impact of the pandemic on cancer services regionally, as well as compare those impacts nationally and internationally.
Researchers from IARC and partners have conducted a global assessment of changes in tobacco smoking behaviours during the early phases of the COVID-19 pandemic (DOI 10.1016/j.eclinm.2022.101375). This study is part of the research being carried out as part of the COVID-19 and Cancer Global Modelling Consortium, which aims to summarize evidence on COVID-19 and cancer and to provide open platforms to inform decision-making in cancer control.
- Fighting two pandemics simultaneously: cancer and COVID-19
An Editorial by an IARC scientist explains that health-care systems need to be organized to fight two pandemics simultaneously: the ongoing cancer pandemic as well as the COVID-19 pandemic. Health systems need to look beyond controlling the pandemic and incorporate measures to return to normal the temporarily derailed control measures for noncommunicable diseases, to avoid a twin tragedy of large numbers of premature deaths occurring from both communicable and noncommunicable diseases (DOI 10.31557/APJCC.2020.5.S1.1.1-3).
- Impact of delay in treatment initiation in cancer patients
IARC scientists have developed an online tool that estimates the risk of cancer mortality related to delays to treatment caused by the COVID-19 pandemic and that informs strategies to mitigate this additional risk of dying due to longer time to treatment initiation. The team used head and neck cancer, a known time-dependent disease, as a model for the tool (PMID 33704627).
- Survey of cancer registries worldwide to assess impacts
IARC sent out a survey to population-based cancer registries worldwide through the International Association of Cancer Registries (IACR), the professional society of registries for which IARC provides the Secretariat. The aim of the survey was to assess the short-term and longer-term impacts of the pandemic on registry operations and subsequent data dissemination in different settings. Results about the impact of the COVID-19 pandemic on population-based cancer registry have been published (DOI 10.1002/ijc.33792).
- Potential genetic susceptibility to infection and progression
IARC researchers have shared genetic data from genome-wide association studies (GWAS) and epigenomic data from epigenome-wide association studies (EWAS) from all of the European Prospective Investigation into Cancer and Nutrition (EPIC) study cohorts in Italy with researchers in Turin, who are using these data to investigate potential genetic susceptibility to infection with the COVID-19 virus and progression of the disease.
- App to track COVID-19 symptoms and diagnoses
IARC experts are also taking part in research initiatives on the implementation of a smart device application to track COVID-19 symptoms and diagnoses in all EPIC study centres, via an application that was developed by Massachusetts General Hospital and Harvard University and is being applied to many cohorts within the COronavirus Pandemic Epidemiology (COPE) Consortium.
- BCNet training for facilities processing samples for COVID-19 testing
Many biobanks and laboratory facilities that collaborate with IARC on research on cancer in low- and middle-income countries (LMICs) have been asked to stop their normal operations in order to process samples for COVID-19 testing. IARC has significant experience in providing safety training to laboratory technicians, and the Agency provides training on mitigating the risks of handling potentially pathogenic samples. For example, IARC organized webinars to train members of the LMICs Biobank and Cohort Building Network (BCNet) in Kenya and Nigeria using its online Biobanking Learning platform, and relevant information on COVID-19 has been provided by BCNet partner institutions to all BCNet members.
- Questionnaire about changes in laboratory and biobanking requirements
The Biobanking and BioMolecular resources Research Infrastructure (BBMRI) and the International Society for Biological and Environmental Repositories (ISBER) have joined forces to document the changes in laboratory and biobanking requirements during this period. IARC researchers were part of the team that designed the questionnaire, which has been distributed globally and has already resulted in several publications (e.g. PMIDs 32871085, 33147072, 33164554, and 33226280).
- Digital pathology platform
The Alliance for Digital Pathology, which includes the United States National Cancer Institute, Harvard University, and the International Collaboration for Cancer Classification and Research (IC3R), is creating a digital pathology platform, available online, to curate pathology-related information. IARC is in discussions to collaborate on this initiative, along with other international organizations.
- Scientific publications on related topics
IARC researchers are currently collaborating on several scientific publications on a variety of related topics. Some examples are “Considerations for diagnostic COVID-19 tests” (PMID 33057203), “Healthcare leadership opportunities and challenges during the COVID-19 pandemic” (DOIs 10.1136/leader-2020-000276 and 10.1136/leader-2020-000282), and “Anti-cancer drugs and COVID-19 therapies: how should the oncologist proceed?” (DOIs 10.1159/000509434 and 10.1016/j.critrevonc.2020.102991). Researchers from IARC and partner institutions have also investigated the impact of the COVID-19 pandemic on incidence, time of diagnosis, and delivery of health care among paediatric oncology patients in Germany in 2020 (DOI 10.1016/j.lanepe.2021.100188), on the future incidence of acute lymphoblastic leukaemia in children in Germany (DOI 10.1002/ijc.33992), and on the practice of otolaryngology and head and neck surgery.
- Collaboration for pilot study on cervical cancer screening in Uzbekistan
The implementation of cervical cancer screening in countries with fragile health systems will be endangered for a long period. IARC, the World Health Organization (WHO) Regional Office for Europe, the United Nations Population Fund (UNFPA), and the French Embassy in Uzbekistan have joined forces to support Uzbekistan in running a pilot study of cervical cancer screening, with the aim of introducing human papillomavirus (HPV) testing as a screening method in the country. Preparatory work has continued during the COVID-19 pandemic through online consultations, with discussions focusing on development of the piloting scheme, assessment of different HPV test platforms and identification of the most effective option for Uzbekistan, and collection of information on demographic profiles of pilot areas. The pilot study is expected to lead to the launch of the national cervical cancer screening programme.
- Impacts on cancer screening programmes
IARC scientists and collaborators in the IARC COVID-19 impact study group have conducted a cross-sectional survey to assess the impact of the pandemic on the cancer screening continuum in selected LMICs. This study is the first to provide an overview of and document this impact in such settings (PMID 33533501). Several IARC scientists are authors of articles that provide guidance on reorganizing screening policies, governance, implementation, and programme monitoring in the COVID-19 pandemic era, to adjust to the new situation (DOIs 10.1200/GO.21.00033, 10.1016/j.ypmed.2021.106624 and 10.7554/eLife.86527).
- Impacts on cervical cancer prevention and control
The cervical cancer prevention and control agenda is facing substantial threats because of indirect consequences of the COVID-19 pandemic on delivery of health services. An article co-authored by an IARC scientist (DOI 10.1038/s43018-021-00178-9) discusses the indirect impacts of the pandemic on global cancer prevention and control efforts, particularly on progress towards the elimination of cervical cancer as a public health problem.
- Ethical implications of the pandemic
The IARC Ethics Committee will study the short-term and medium- to long-term ethical implications of the pandemic within the context of IARC’s areas of research.
- Technical assistance to the French National Cancer Institute
IARC is providing technical assistance to the French National Cancer Institute (INCa) in its efforts to monitor the scientific literature at the intersection of COVID-19 and cancer.
- COVID-19 and the role of new technologies in public health practices
IARC and researchers from partner institutions have published articles looking at health systems responses during the COVID-19 pandemic and elaborating on how the current lessons learned can be used to transform health care in the post-coronavirus era. “Healthcare transformation in the post-coronavirus pandemic era” outlines areas in which the pandemic has already accelerated the adoption and acceptability of data- and technology-driven solutions. “Global health and data-driven policies for emergency responses to infectious disease outbreaks” focuses on issues of data sharing, including current and envisioned digital solutions to improve access to data.