2nd Annual Intra-NCI Global Cancer Research Day: Highlighting Prevention and Screening
November 2, 2016, by Isabel Otero and Communications Team
Global Burden of Cancer
As cancer incidence continues to rise around the world, the National Cancer Institute (NCI) has taken on a significant role in global cancer control efforts. NCI Divisions, Offices, and Centers (DOCs) support global health research across the continuum of cancer and collaborate with many international agencies to translate research results into practice. To celebrate NCI’s increasing international presence, the Center for Global Health (CGH) hosted the 2nd annual Intra-NCI Global Cancer Research Day (GCR2016) on October 6 to highlight NCI’s advances in cancer prevention and screening worldwide. This one-day event was filled with exciting presentations from NCI experts on screening, role of vaccines in prevention, and global tobacco control. Attendees also had the opportunity to learn more about the diverse milestones NCI has reached in global health research through a gallery walk of the GCR2016 poster session.
Cancer Prevention in Global Health
The Symposium commenced with a keynote address from Dr. Barry Kramer, Director of the NCI Division of Cancer Prevention. He spoke about cancer prevention and screening in the context of global health, offering insights into the growing global cancer burden, fundamental principles of cancer prevention and screening, and the latest body of research supported by NIH. Key takeaways for the audience, comprised of NCI researchers and public health professionals working in the area of cancer and global health, included the importance of linking screening programs to treatment strategies when developing a cancer control program. Dr. Kramer also discussed the importance of selecting your endpoint, or health outcome, when developing and evaluating your program. He also underscored the need to be aware of biases when analyzing data; biases like lead time, which show that slow growing cancers are disproportionately detected earlier by screening than the faster growing cancers but the death outcome is the same for both. The need for strong evidence to support screening for cancers in the whole population was also highlighted.
The address was followed by a robust morning session chaired by Dr. Eric Engels from the Division of Cancer Epidemiology and Genetics, titled “Exploring Prevention through Vaccines”, which looked at vaccine-preventable cancers and the research NCI has been doing in this area. Presenters included Dr. John Schiller, NIH Distinguished Investigator, and co-lead investigator to the ground-breaking work that led to the initial development and characterization of the HPV prophylactic vaccine that ultimately became the commercial vaccines Cervarix and Gardasil. He spoke about his work in developing the HPV vaccine and laid out evidence-based strategies for implementation in the United States and abroad to combat cervical cancer. [On a side note, the American Society of Clinical Oncology (ASCO) recently published an update to their Secondary Prevention of Cervical Cancer Resource-Stratified Guideline, which has been endorsed by the International Gynecologic Cancer Society (IGCS) and the American Society for Colposcopy and Cervical Pathology (ASCCP).] Dr. Elizabeth Read-Connole from the Division of Cancer Biology, whose work led to the isolation of the retrovirus that causes AIDS, and the development of the blood test for HIV detection, discussed her involvement in the development of the Hepatitis B vaccine to prevent liver cancer. Dr. Wei Bu, with the Laboratory of Infectious Diseases at the National Institute of Allergy and Infectious Diseases, presented on NIH’s efforts to develop Epstein-Barr Virus (EBV) vaccination to prevent EBV-associated diseases to include epithelial cell malignancies (i.e. gastric carcinoma and nasopharyngeal carcinoma) and B cell lymphomas (i.e., Hodgkin lymphoma and Burkitt lymphoma).
After lunch, meeting attendees had the opportunity to take a gallery walk of the poster session on NCI initiatives and milestones around cancer prevention and screening. Posters included a comparative analysis of dietary adequacy among smoking and smokeless tobacco users in Bangladesh submitted by the NCI tobacco control branch. A review of a peer-to-peer/south-to-south knowledge exchange program to increase uptake of effective strategies for cancer care and control in Africa submitted by the Health, Nutrition and Population Global Practice team at the World Bank, a close partner of CGH, was also presented. GCR2016 attracted many people across the NCI DOCs, and presenters from other parts of the U.S. Department of Health and Human Services (HHS) were also invited to participate.
Dr. Thomas Novotny, Deputy Assistant Secretary for Health (Science and Medicine), HHS Office of the Assistant Secretary for Health, chaired the afternoon session on “Global Tobacco Control at the NCI”. Tobacco is the leading cause of preventable death worldwide and efforts to curb it have prevented nearly 800,000 deaths in the United States. The United States has made many advances to curb tobacco usage; however, tobacco control requires further research investments in other countries, particularly low-and middle-income countries, where policies and programs to curb tobacco use and promote cessation are often weak, not properly implemented, or nonexistent. The session also included Drs. Michele Bloch and Mark Parascandola from the Tobacco Control Research Branch at the NCI Division of Cancer Control and Population Sciences, who presented an overview of NCI’s global tobacco research portfolio and offered scenarios to end tobacco use globally, such as lowering nicotine levels in cigarettes to reduce chemical dependency. Michele and Mark have partnered with CGH to offer funding opportunities to stimulate new innovations in mhealth; develop and facilitate educational opportunities such as training workshops and technical assistance in tobacco control research; ensure that evidence-based research is translated into policy and programs; and, build further collaborations with other stakeholders working in tobacco control internationally. Dr. Neal Freedman, a scientist with the Division of Cancer Epidemiology and Genetics, presented on his work with smokeless tobacco, hookah, and e-cigarettes. One point of concern is the rise of e-cigarette usage among high school students in the United States (findings from the National Youth Tobacco Survey, 2011-2015). Dr. Mirjana Djordjevic with the Tobacco Control Research Branch gave a presentation on her work with the World Health Organization’s (WHO) Study Group on Tobacco Product Regulations (TobReg) and the science behind the WHO’s Framework Convention on Tobacco Control (FCTC) – the first international public health treaty negotiated under the auspices of the WHO. She discussed the evidence-based scientific recommendations from the working group, including WHO TobReg Advisory Note on Global Nicotine Strategy, as well as some challenges to the regulation of tobacco products internationally. Dr. Novotny closed the session with a presentation on tobacco use and infectious diseases, particularly HIV and tuberculosis. He spoke about the intervention research needed to reduce impact of global “syndemics,” which he defined as the synergistic interaction of diseases which can possibly worsen outcomes for one, or all of, the diseases in play. He presented on research already underway by the WHO to incorporate brief advice on smoking cessation in TB control programs.
Dr. Ted Trimble, CGH Director, closed the event reminding the audience that a majority of NCI global health research is being supported by a collaboration of various NCI DOCs. The GCR2016 was an opportunity to foster new partnerships between staff and identify and leverage the resources and infrastructures created by existing programs.