Center for Global Health Publications
The Center for Global Health contributes to the development and promotion of resources that advance global cancer research and collaboration in low- and middle-income countries.
For additional resources, visit Resources for International Partners.
E-Cigarette Use among Polish Students: Findings from the 2016 Poland Global Youth Tobacco Survey
The article E-Cigarette Use among Polish Students: Findings from the 2016 Poland Global Youth Tobacco Survey describes the recent increased use of tobacco around the world and provides comprehensive national estimates of e-cigarette and tobacco use among Polish youth.
Follow-Up Care for Breast and Colorectal Cancer across the Globe: Survey Findings from 27 Countries
The article Follow-Up Care for Breast and Colorectal Cancer across the Globe: Survey Findings from 27 Countries describes follow-up care for breast and colorectal cancer survivors in countries with varying levels of resources and highlight challenges regarding posttreatment survivorship care.
Promise of Smartphone-Enabled Teleconsultation for Global Cancer Prevention
A plethora of factors, including new and emerging technologies, study methods, data sources, and analytic techniques, are expanding the toolkit of possible solutions to bolster cancer prevention and control in low-resource settings globally. In the editorial, Promise of Smartphone-Enabled Teleconsultation for Global Cancer Prevention, author Paul Pearlman looks at two publications in the Journal of Global Oncology that have recently leveraged smartphone-based mobile platforms that rely on a teleconsultation approach to improve cancer screening at the community level in Tanzania.
The Responses of Biobanks to COVID-19
The Responses of Biobanks to COVID-19 surveys experts in the field from different regions and resource contexts around the globe to describe the impact of the COVID-19 pandemic on biobanking, and discuss how experiences and expertise gained from forward-affected geographies and infrastructures can inform policies and practices of those impacted later in the event.
Non-Dioxin-Like PCBs: The Key Air Pollutant associated with Lung Cancer in 15 Cities in Silesia
Non-Dioxin-Like PCBs is an analysis of data on air pollution and lung cancer in an industrial area in south of Poland led by the Medical University of Silesia. Key conclusion: The results of our study suggest that while overall pollution levels in Silesia have decreased, substantial disparities remain in pollution exposure and in lung cancer incidence.
Smoke-Free Hospitals in Poland: A Cross-Sectional Survey
Smokefree hospitals in Poland surveys hospitals about tobacco control policies and activities. Key conclusion: Overall, hospitals in Poland have been successful in implementing smokefree policies but greater attention is needed to providing cessation services.
Areca Nut and Betel Quid Control Interventions: Halting the Epidemic
Areca nut (AN) and betel quid (BQ) use presents a complex public health problem worldwide. Use of AN/BQ contributes to increased rates of oral cancer, cancer of the esophagus and liver cancer, as well as to increased risk for metabolic disease, cardiovascular disease, maternal and child health issues, and all-cause mortality. There is pressing need for a balanced and comprehensive mix of interventions to address the growing burden associated with AN/BQ.
In this commentary review article, Areca Nut and Betel Quid Control Interventions: Halting the Epidemic, published in the Substance Use & Misuse journal, 21 interventions were identified targeting AN/BQ use between 1990 and 2018. These strategies include product bans, media campaigns, education, cessation, and taxation at individual and population level, and they present varying evidence of impact. While there are some encouraging findings, particularly regarding the impact of product bans, mass media campaigns, and cessation interventions, research on interventions for AN/BQ use remains limited. However more importantly, countries that plan to address AN/BQ use can consider developing and integrating evidence-based, locally contextualized solutions into similar interventions to make them more effective.
Findings in this article can lead to the development of impactful interventions and help guide policy makers and program managers create evidence-based policies to regulate these products.
Characteristics of Current Betel Quid/Chewing Tobacco Users, Smokers and Dual Users in Indonesia: An Analysis of GATS 2011 Data
Indonesia has the third largest population of smokers in the world, but little is known about tobacco/betel quid use in-country. To better understand the tobacco/betel quid user population and to inform future research, Characteristics of Current Betel Quid/Chewing Tobacco Users, Smokers and Dual Users in Indonesia: An Analysis of GATS 2011 Data researched characteristics of users in Indonesia.
Research used the 2011 Indonesia Global Adult Tobacco Survey (GATS) data set which includes 8,176 adults ages 15 and older. Data is weighted to be nationally representative. For analysis, SAS 9.4 was used. Estimated national prevalence rates for exclusive chewing tobacco/betel quid use was 0.9%, for exclusive smoked tobacco use was 33.9% and for dual use was 0.8%. Multivariate logistic regression analyses showed that exclusive chewing tobacco/betel quid users were significantly more likely to be female, and to be older adults (45–64); while smokers are more likely to be male and younger (25–44).
These findings highlight characteristics of users by product type and underscores that users’ demographics vary by their product of choice. Subsequently, these results can help inform researchers and practitioners about the burden of chewing tobacco/betel quid use in Indonesia. Information learned about chewing tobacco/betel quid use patterns can help identify user populations who need quit tobacco interventions.
Interventions to Address Barriers and Delays to Cancer Diagnosis and Care in LMICs: Systematic Literature Reviews
Two articles recently published in The Oncologist feature a two-part systemic literature review of barriers and delays challenging low- and middle-income countries (LMICs) that affect cancer diagnosis and cancer care. Delays and Barriers to Cancer Care in Low- and Middle-Income Countries: A Systematic Review, published in 2019, takes an in-depth look at the delays and types of barriers to cancer care in LMICs. The review found the majority of studies reported knowledge as an outcome measure, rather than clinically significant measures that improve cancer‐related outcomes, such as delay intervals or down-staging of disease.
Interventions Addressing Barriers to Delayed Cancer Diagnosis in Low‐ and Middle‐Income Countries: A Systematic Review, published in 2020, identifies and characterizes interventions studied across cancers, within LMICs. The review shows the urgent need for more studies that examine delays to cancer care and barriers in a standardized manner, and recommends that future intervention studies address clinically relevant measures to better assess efficacy of interventions in LMICs.
Moving Towards an Evidence-Informed Cancer Control Strategy: A Scoping Review of Oncology Research in Kenya
The article Moving Towards an Evidence-Informed Cancer Control Strategy: A Scoping Review of Oncology Research in Kenya, currently in press for publication in the June 2020 issue of Journal of Cancer Policy, outlines the published oncology research conducted in Kenya from 2007 to 2017. The scoping review identified the types of research and types of cancers studied, geographic settings, and collaborating institutions. In addition, the article highlights the research gaps and opportunities in order to inform the development of a national cancer research agenda as mandated within Kenya’s National Cancer Control Strategy 2017–2022.
The scoping review was conducted as a collaborative partnership with the NCI Center for Global Health, the NIH Library, the NCI of Kenya, the Field Epidemiology and Laboratory Training Program at the Kenyan Ministry of Health, the African Population and Health Research Center, and the Kenya Medical Research Institute. Future planned publications within the scoping review project include a network analysis of research collaborations in Kenya, and a compilation of the grey/unpublished literature for the same time period. These and additional publications will provide a more complete picture of the research being conducted, how it is funded, and areas for potential future partnership and research focus areas. In addition, the multi-institution project has provided opportunities for research mentorship and capacity strengthening for the researchers involved from each institution.
Qatar Biobank Milestones in Building a Successful Biobank and Quality Matters: A Global Discussion in Qatar
Two articles on biobanking, Qatar Biobank Milestones in Building a Successful Biobank and Quality Matters: A Global Discussion in Qatar, were recently published in Biopreservation and Biobanking. The initial article presents an overview of the Qatar Biobank strategic framework and the information technology infrastructure supporting its mission, while the latter publication reports on the findings from the International Biobanking Conference titled Quality Matters: A Global Discussion in Qatar, which was held on March 25–27, 2019, in Doha, Qatar. Highlights from the report include the role of biobanking in medical research and advancing healthcare and improving clinical outcomes.
Challenges and Opportunities in the Creation and Implementation of Cancer Control Plans in Africa
The article Challenges and Opportunities in the Creation and Implementation of Cancer Control Plans in Africa, published in the special issue of the online journal ecancermedicalscience, describes how collaborative partnerships increase access to evidence-based cancer control planning tools, mentoring and technical assistance, and have the potential to bridge the capacity gap and catalyze better implementation of national cancer control plans; and how to address the gaps that inhibit cancer control in Africa. This special issue contains 16 articles describing some of the major challenges experienced in the oncology community in Africa.
Cancer Preparedness around the World: National Readiness for a Global Epidemic
The report on Cancer Preparedness around the World: National Readiness for a Global Epidemic, written by the Economist Intelligence Unit, describes the diverse landscape of cancer challenges worldwide and introduces the Index of Cancer Preparedness, an evaluation of 45 data points from 28 countries addressing cancer control research and policy.
Integration of Research Priorities in Low and Middle-Income Countries: A Qualitative Analysis of National Cancer Control Plans
The Integration of Research Priorities in Low and Middle-Income Countries: A Qualitative Analysis of National Cancer Control Plans, published in the Journal of Cancer Policy, explores the inclusion and description of research priorities in select low- and middle-income countries’ cancer control plans to explain gaps and collaborative opportunities.
Advancing Cancer Research in Africa through Early-Career Awards: The BIG Cat Initiative
The burden of cancer in Africa is growing rapidly, and increased cancer research on the continent is a critical component of an effective response. Toward this goal, in 2010, NCI's Center for Global Health, in partnership with the African Organization for Research and Training in Cancer, launched the Beginning Investigator Grant for Catalytic Research (BIG Cat), a pilot initiative that supported cancer research conducted by early-career African investigators. BIG Cat has three goals: (1) to advance cancer research conducted on the African continent; (2) to support cancer research career development among African investigators; and (3) to build local capacity for cancer research in Africa.
In 2017, NCI evaluated BIG Cat’s early outcomes for cancer research, career development, and local cancer research capacity. Findings are reported in an article entitled, Advancing Cancer Research in Africa through Early-Career Awards: The BIG Cat Initiative, published in the Journal of Global Oncology in April 2019. Findings highlight that BIG Cat–supported research projects have generated locally relevant findings that address a range of cancer sites and multiple areas of scientific interest. The 11 survey respondents produced 43 scholarly products (e.g., publications, presentations) about findings from their BIG Cat research. They reported increases in cancer research funding applications and awards after receipt of the BIG Cat award compared with before the award. They also reported increased resources for cancer research, participation in teaching and mentoring on cancer research, and supervision of cancer research staff. Investigators identified scientific mentoring as a key facilitator of the success of their BIG Cat projects and limited time and funding as key challenges. These findings help to inform future directions for the BIG Cat initiative and the design of related initiatives.
Knowledge Summaries for Comprehensive Breast Cancer Control: Feedback from Target Audiences in Kenya
The Knowledge Summaries for Comprehensive Breast Cancer Control (KSBCs) are a series of evidence-based publications intended to support cancer control planning at various resource levels. Knowledge Summaries for Comprehensive Breast Cancer Control: Feedback from Target Audiences in Kenya evaluates the extent to which the KSBCs could be useful to policymakers, health care providers, and breast cancer advocates in Kenya, and whether introducing the KSBCs led to their uptake, and if so, how they were used.
National Cancer Control Plans: A Global Analysis
There is increasing global recognition that national cancer plans are crucial to effectively address the cancer burden and to prioritize and coordinate programs. The Lancet Oncology did a global analysis of available national cancer-related health plans using a standardized assessment questionnaire to assess their inclusion of elements that characterize an effective cancer plan and, thereby, improve understanding of the strengths and limitations of existing plans. The results show progress in the development of cancer plans, as well as in the inclusion of stakeholders in plan development, but little evidence of their implementation. Areas of continued unmet need include setting of realistic priorities, specification of programs for cancer management, allocation of appropriate budgets, monitoring and evaluation of plan implementation, promotion of research, and strengthening of information systems.
Research, shown in the International Cancer Control Partnership's Achieving Measurable Progress Towards the NCDs Targets: The Importance of National Cancer Control Plans, found that countries with a noncommunicable disease plan but no national cancer control plan were less likely than countries with a national cancer control plan and noncommunicable disease plan or a national cancer control plan only to have comprehensive, coherent, or consistent plans. As countries move towards universal health coverage, greater emphasis is needed on developing national cancer control plans that are evidence based, financed, and implemented to ensure translation into action.
Is It Time to Move Beyond Visual Inspection with Acetic Acid for Cervical Cancer Screening?
This editorial of Global Health: Science and Practice describes successes and lessons from a limited scaling up of a cervical cancer prevention program in Burkina Faso based on visual inspection with acetic acid.
The Lancet Series: Global Pathology
Pathology and laboratory medicine (PALM) is an important part of any health system. Diagnosis, choice of treatment, predicting outcomes, and monitoring disease progression are in many cases impossible without pathology and laboratory services. Global cancer and surgery strategies are incomplete with attention to PALM. And yet, in the discussion about universal health coverage, especially for low-income and middle-income countries, PALM has been hardly mentioned at all. This series of three papers aims to start and accelerate global efforts to strengthen this neglected part of medicine. The first paper examines the current barriers in resource-poor settings. The second paper suggests ways of overcoming these barriers, and the third paper issues eight recommendations and calls for concerted efforts of all to ensure the provision of effective and sustainable PALM services. Download The Lancet Series on Pathology and Laboratory Medicine in Low-Income and Middle-Income Countries.