Online Exclusive - January 26, 2009
The National Cancer Institute oversees the U.S. National Cancer Program and also is dedicated to the promotion of global health and cancer control. The National Cancer Act of 1971 directed the NCI to collect, analyze, and disseminate research on the prevention, diagnosis, and treatment of cancer, to share cancer research information globally, and to support research conducted by highly qualified foreign nationals outside the United States. The landmark law also mandated that NCI support collaborative research involving American and foreign participants, and support the training of American scientists abroad and foreign scientists in the United States. The following article provides a glimpse of the broad spectrum of NCI’s activities to promote cancer prevention, education, and treatment around the world.
NCI Provides Research Grants, Contracts in the Developing World
In a typical year, NCI provides approximately 80 foreign grants and 10 contracts to countries such as Australia, Belgium, Canada, China, Denmark, Finland, France, Germany, India, Israel, Italy, Jamaica, Netherlands, Russia, Senegal, South Africa, Spain, Sweden, Switzerland, and the United Kingdom. During the 2006 fiscal year, NCI foreign grants totaled $24.5 million, and foreign contracts totaled an additional $3.7 million. More than half (57%) of international grants in 2006 went to research on the causes of cancer. Eighteen percent of funding dollars went into treatment research. Research on the biology of cancer accounted for 15%of funding; 6% was for detection and diagnosis, and the other 4% went into cancer control efforts (2%) and manpower development (2%).
Basic Research
Working with international researchers, NCI participates in several research projects studying the environmental and genetic factors that contribute to the development of cancer. For example, NCI's Chernobyl Research Unit is working with researchers in Ukraine and Belarus to research thyroid cancers and other thyroid-related disease among Ukrainians and Belarusians exposed to radiation as children during the Chernobyl nuclear accident in 1986 and cases of leukemia, lymphoma, and other blood diseases among Ukrainian workers who cleaned up after the accident.
Cancer Prevention
As part of its Tobacco Free Initiative (TFI), the World Health Organization (WHO) established a scientific advisory committee on tobacco product regulation. NCI scientists have been working with this group since 2002, developing recommendations to improve public health and scientific research on the effects of tobacco use.
NCI also has worked with WHO’s TFI to create an International Network for Tobacco Testing and Research for Regulation to address research issues related to building capacity for tobacco product testing and research worldwide. In addition, NCI takes part in a multi-agency collaboration to fund research on tobacco use and related illnesses in the developing world.
Cancer Detection and Diagnosis
NCI researchers work with scientists at the University of Tokyo, which hosts one of the world’s premier fluorescence imaging laboratories, to develop a new optical imaging system to detect smaller cancers with a higher sensitivity. NCI scientists also work with researchers from Princess Margaret Hospital in Toronto to improve magnetic resonance imaging (MRI)-guided prostate biopsy techniques, which improves the ability to visualize the anatomy and pathology of the prostate.
NCI established the AIDS and Cancer Specimen Resource, a repository of tissue and biological samples available to researchers working in the fields of AIDS, cancer, virology, and others, to encourage research on AIDS and cancer. The repository contains more than 100,000 specimens, including samples from Africa, Brazil, Russia, and Thailand.
Cancer Treatment
The NCI supports the International Center for Studies of Traditional Chinese Medicine, a partnership between the University of Texas M.D. Anderson Cancer Center and the Cancer Hospital of Fudan University in Shanghai, China, to study the benefits of some traditional Chinese medicine treatments for cancer patients.
In addition, the NCI has a liaison office in Brussels, Belgium, which coordinates several of the Institute’s research and treatment programs in Europe. The goal of the NCI liaison office is to facilitate the exchange of information, ideas, and research between NCI and its European partners. The office works with universities, research institutions, and other organizations through a mixture of informal partnerships and formal agreements with international organizations, such as the European Organization for Research and Treatment of Cancer (EORTC), Cancer Research U.K., the Southern Europe New Drugs Organization, the European Drug Development Network, and the International Network for Cancer Treatment and Research.
Quality of Care
The National Cancer Institute has been involved in a number of workshops and training programs to improve the quality of care in various nations. In collaboration with the International Network for Cancer Treatment and research, NCI co-sponsored a series of workshops for health care providers in developing countries about the latest tools and techniques in the treatment of cancer and symptom relief. These conferences have been held in China, the United Arab Emirates, Jordan, the Palestinian Authority, Egypt, and Iraq.
Training of Scientists
Each year, approximately 1,000 visiting scientists from more than 74 countries contribute to intramural research projects at NCI's Center for Cancer Research through the NIH Visiting Program. Formal researcher exchange programs also exist through the U.S.-Japan Cooperative Cancer Research program and the Ireland-Northern Ireland-NCI Cancer Consortium. The NCI Office of Nursing Affairs has hosted nurses from Ireland and Jordan to provide mentoring on core oncology nursing training, cancer genetics, and clinical trials. Each summer, NCI's Division of Cancer Prevention hosts a course on the Principles and Practice of Cancer Prevention and Control that draws a number of international attendees from countries such as China, Ghana, India, Lithuania, Russia, and Turkey. In addition, the NCI Office of International Affairs hosts a Scientist Exchange program in which NCI partially funds the training of scientists from developing countries in non-NCI laboratories in the United States and other developed countries.
Building Capacity and Infrastructure
The All-Ireland NCI Cancer Consortium, also known as the “Ireland-Northern Ireland-NCI Cancer Consortium” was established to facilitate collaboration between the governments and cancer research communities of the United States, Ireland, and Northern Ireland in order to improve the infrastructure for cancer research and cancer care in Ireland. The Consortium also works to develop joint research programs and educational exchange programs between the two countries.
The consortium has several working groups, such as the prevention working group, which has participated in several workshops in Ireland related to tobacco control and obesity. This group also is working to build an Ireland-wide community of prevention-oriented scientists and caregivers.
The King Hussein Cancer Center (KHCC) in Jordan forged a cooperative agreement with NCI to enhance medical sciences and improve care in the Middle East region. Major achievements of this cooperation include the launch of the TELESYNERGY® system, a system that combines cameras, microscopes, audio equipment and other devices to enable clinicians and scientists to collaborate from multiple locations.
Jordan also is part of the Middle East Cancer Consortium (MECC), a coalition between the United States and the Ministries of Health in Cyprus, Egypt, Israel, Jordan, the Palestinian Authority, and Turkey. Their principal initiative, the Cancer Registry Project, supports the development of population-based cancer registries in all of the member countries. The first report on cancer incidence, which includes date from Cyprus, Egypt, Israel, and Jordan, was released in 2006 and is available on the NCI website.
In Africa, the NCI, in cooperation with other parts of the National Institutes of Health, provides awards to establish and maintain several Centers for AIDS Research (CFARs), including one at Case Western Reserve University that conducts research on prevention, detection, and treatment of HIV, AIDS and AIDS-related malignancies with Makere University in Kampala, Uganda. NCI also supported the sixth annual International Conference on the Burden of Cancer in Africa, which was held in October 2007 in Cape Town, South Africa.
The NCI also provides capacity-building assistance through an expansion of its Comprehensive Cancer Control Leadership Institutes (CCLI). As a collaboration between the NCI’s Cancer Information Service, the American Cancer Society, the U.S. Centers for Disease Control and Prevention, and the Intercultural Cancer Council, the CCLIs provide an opportunity for highly-skilled, influential individuals to support cancer control implementation efforts in their local areas. After a successful run in the United States, the program has expanded to Peru, Mexico, Brazil, and Uruguay.
