Current Research Topics
Cancer registry support and development:
Direct liaison with registries, through the Global Initiative for Cancer Registry Development (GICR) and through collaborations with the International Association of Cancer Registries (IACR), is a critical activity for the Section of Cancer Surveillance (CSU) in its mission of supporting the implementation and advancement of cancer registration worldwide. The Section provides technical guidance, training, and advocacy in order to increase the availability of high-quality data for national cancer control planning purposes in low- and middle-income countries (LMICs), and these high-quality data are also a critical component of the Section’s estimation and research programmes.
Congruent with the global political agenda aimed at tackling the increasing noncommunicable disease (NCD) burden worldwide, GICR is a multipartner initiative coordinated by IARC that will provide measurable improvements in the coverage, quality, and networking capacity of cancer registries in 50 LMICs by 2025. The collaboratively chosen model is one of increasing local infrastructure support for registries through the development of six IARC Regional Hubs within LMICs by the end of 2015 (in the regions of South, East, and South-Eastern Asia; sub-Saharan Africa; North Africa and Central and West Asia; Latin America; the Pacific Islands; and the Caribbean). The governance structure includes a Partners Group that decides on overall strategies for GICR, and a Hub Executive Group of Hub Principal Investigators that decides on priorities across Hubs, ensuring that appropriate assistance is provided to individual countries.
To support registry activities, CSU is developing online training materials to complement regional courses and is reconfiguring the content of the previous introductory Cancer Registration module offered as part of the IARC Summer School into a set of tailored courses for registry staff worldwide, the first of which (to be launched in June 2015) will focus on approaches to estimating cancer survival in LMICs. The Section is also developing its freely available open-source registry software, CanReg5, and is currently working on simplifying database migration and enhancing quality control and analytical functions. Train-the-trainer courses are being developed through GICR to ensure that a new cohort of CanReg experts can provide support, training, and implementation of CanReg5 to registries seeking assistance in every Hub region. CSU will also continue to work with IACR to update the international standards for classification and coding used by cancer registries worldwide, and will maintain and develop the corresponding check and conversion software.
Global cancer indicators: development and dissemination
The Section’s work revolves around the systematic and ongoing collection, collation, and analysis of cancer data nationally, regionally, and worldwide, and around the dissemination of these data for cancer control action. A cornerstone objective is the development of the Global Cancer Observatory, which aims to redefine the online experience of accessing global and national statistics on cancer. The Observatory will include an innovative and user-friendly interface that provides timely information on a broad range of instructive indicators developed from CSU’s major projects and databases: the GLOBOCAN project, the Cancer Incidence in Five Continents series (CI5), the Cancer Survival in Africa, Asia, the Caribbean and Central America series (SurvCan), the International Incidence of Childhood Cancer series (IICC), and the WHO Mortality Database.
Descriptive epidemiology of cancer: core activities and innovation
CSU’s research programme has several stable core elements, but the Section also continually seeks to innovate and to link its work with the constantly evolving NCD and development agenda. Current topics include:
- Global cancer surveillance: Using the databases held in the Global Cancer Observatory, studies are carried out to describe and elucidate global patterns and trends by cancer type. Priorities include demonstrations of synergistic aspects of incidence, mortality, and survival through examples and international assessments of progress against cancer.
- Trends in Cancer Incidence and Mortality Volume 2: This IARC Scientific Publication will comprehensively and systematically examine cancer incidence and mortality trends for 27 cancers over the period of 1960—2010. The publication will feature detailed tabular and graphical descriptions of temporal changes, including observed and modelled birth cohort analyses.
- Childhood cancer projects: These include the completion of the third volume of IICC, part of a comprehensive publication series on global childhood cancer burden and trends by tumour, which includes detailed studies of outcome (mortality and survival).
- Global surveillance linked with the NCD agenda to support cancer planning: CSU carries out ongoing work to develop baseline medium- and long-term predictions of cancer burden according to demography and risk changes over time.
- Cancer as a chronic disease: Inequalities in diagnosis and treatment increase global disparities in premature mortality and quality of life. CSU is working on national estimates of the following metrics:
- disability-adjusted life years, healthy life expectancy, and disability-adjusted life expectancy; and
- longer-duration prevalence (assigning survivors to different phases of care).
- Quantification of various risk factors and interventions to assess potential for prevention: CSU’s ongoing work includes the following activities:
- development of population attributable fractions for key risk factors worldwide and in-depth for selected countries and regions;
- assessment of the long-term future impact of selected interventions; and
- estimation of productivity loss due to premature mortality from cancer.
- Cancer and socioeconomic transition: An exploration is underway of trends in cancer incidence and mortality compared against the following variables:
- Human Development Index (HDI) level over time;
- spending on health care; and
- the direct impact of risk determinants (e.g. smoking).
- Determining uncertainty intervals for the country-specific estimates in GLOBOCAN to establish the uncertainty in the source information: Collaborative work is underway to take into account the inherent statistical uncertainty in the modelling exercises as well as the more qualitative relative deficiencies in the quality and availability of the source information at the national level.