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Cancer control

Study sites:	Not applicable
Principal investigator (PI) from IARC:	P. Basu
PIs from collaborating institutions:	Antonio Ponti and Nereo Segnan, CPO Piemonte, Italy Joakim Dillner, Karolinska Institutet, Sweden Ahti Antilla, Finnish Cancer Registry Silvana Luciani, Pan American Health Organization (PAHO) Silvina Arrossi, National Cancer Institute, Argentina Marianna de Camargo, Brazilian National Cancer Institute Catterina Ferreccio, University of Chile Mauricio Maza, Basic Health International, El Salvador Stephen Taplin, United States National Cancer Institute Pam Tobin, Canadian Partnership Against Cancer Mona Saraiya, United States Centers for Disease Control and Prevention (CDC)
Start date:	2017
Closure date:	Ongoing
Objectives:	The purpose of the project is to collect standardized information on the characteristics and performance of cancer screening programmes around the world, and to disseminate that information to enable improved programme management and informed policy, strengthen health information systems, and support research. Systematic, standardized reporting of programme characteristics and quality indicators will be of great value not only to the participating programme managers to improve programme quality, but also to others striving to make their programmes more effective. CanScreen5 will be an online portal for the collection, analysis, and dissemination of information on cancer screening programmes and activities in countries around the world, with the core objective of motivating and enabling countries to collect and use cancer screening data in a consistent manner.
Methodology:	The project methodology will be based on the IARC Screening Group’s recent experience reporting the status of implementation and performance of breast, cervical, and colorectal cancer screening programmes in the 28 member states of the European Union (“Cancer Screening in the European Union”, 2017). A network of collaborators and institutions will be formed in order to access qualitative and quantitative information on cancer screening programmes in various countries. A protocol for standardized data collection will be developed, along with data collection tools. A web-based platform will be created for data collection and dissemination of the analysed data. The IARC Screening Group will serve as the project secretariat, and the project will be implemented in phases. Quality checks will be carried out to ensure that the data collected from each country meet a defined set of minimum standards. Ethical issues, protection of data privacy, and regulatory issues that apply to sharing data will be thoroughly reviewed.
Funding:	Intramural funding from IARC; support from the Pan American Health Organization (PAHO)

Study sites:	Morocco: Casablanca, Fez, Rabat
Principal investigator (PI) from IARC:	R. Sankaranarayanan
PIs from collaborating institutions:	Professor El Rhazi, Institut de Recherche sur le Cancer, Fez Dr Bendahhou, Centre Mohammed VI pour le traitement des cancers, Casablanca Professor Errihani, Medical School, Mohammed V University, Rabat
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Start date:	2016
Closure date:	Ongoing
Objectives:	To develop protocol for quality assurance of the national breast and cervical cancer screening programme of Morocco using standardized methodology and tools To evaluate the performance of the programme by calculating some of the process and outcome indicators and comparing them with established standards To prepare a quality improvement plan in consultation with the national stakeholders To deliver the quality assurance protocol and the tools to the programme focal points to be incorporated into the programme
Methodology:	The evaluation will be based on information obtained through in-depth interviews of the key functionaries of the programme, focus group discussions with various categories of service providers, and supervisory visits to randomly selected facilities offering screening and diagnostic services.
Publications:	Basu P., Selmouni F., Belakhel L., Sauvaget C., Abousselham L., Lucas E., Muwonge R., Sankaranarayanan R., Khazraji Y.C. Breast Cancer Screening Program in Morocco: Status of implementation, organization and performance. Int J Cancer. 2018 Jul 14. PMID: 30006933 Selmouni F., Zidouh A., Belakhel L., Sauvaget C., Bennani M., Khazraji Y.C., Benider A., Wild C.P., Bekkali R., Fadhil I., Sankaranarayanan R. Tackling cancer burden in low-income and middle-income countries: Morocco as an exemplar. Lancet Oncol. 2018 Feb;19(2):e93-e101. PMID: 29413484 Selmouni F., Belakhel L., Sauvaget C., Abousselham L., Lucas E., Muwonge R., Sankaranarayanan R., Khazraji Y.C., Basu P. Evaluation of the national cervical cancer screening program in Morocco: achievements and challenges. J Med Screen. 2019 Jan 16:969141318824627. PMID: 30651034
Funding:	Lalla Salma Foundation for Cancer Prevention and Treatment

Study sites:	imPACT Reviews have been carried out in: Algeria (2015), Bangladesh (2013), Benin (2013), Bosnia and Herzegovina (2015), Botswana (2013), Burundi (2017), Cambodia (2013), Croatia (2014), Fiji (2014), Georgia (2014), Kyrgyzstan (2015), Lebanon (2013), Madagascar (2015), Malaysia (2013), Mauritania (2012), Mongolia (2011), Myanmar (2015), Nepal (2012), Pakistan (2013), Rwanda (2014), Tunisia (2013), Viet Nam (2015)
PIs from collaborating institutions:	The International Atomic Energy Agency (IAEA), WHO, IARC
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Start date:	2011
Closure date:	Ongoing
Objectives:	To carry out a comprehensive assessment of the country’s cancer control capacity in the areas of cancer control planning, cancer information, prevention, early detection, diagnosis and treatment, palliative care, training, and civil society activities To carry out a capacity and needs assessment for the effective implementation of the country’s radiation medicine programme as a component of a comprehensive national cancer control programme (NCCP) To explore suitable project proposals and potential sources of funding for cancer control interventions
Methodology:	Assessment is carried out through meetings with the focal point at the Ministry of Health, field visits at the three levels of care, discussions with health-care providers, and interaction with the local officers of the various health-related UN agencies (mainly WHO) and IAEA country offices.
Funding:	International Atomic Energy Agency (IAEA) Programme of Action for Cancer Therapy (PACT)

Study sites:	Dhaka, Bangladesh
Principal investigator (PI) from IARC:	R. Sankaranarayanan
PIs from collaborating institutions:	Dr Ashrafun Nessa, Bangabandhu Sheikh Mujib Medical University (BSMMU)
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Start date:	2006
Closure date:	Ongoing
Objectives:	To provide technical support to help organize a screening programme for cervical cancer prevention in Bangladesh
Methodology:	The following technical support is provided: Training of health providers on visual inspection with acetic acid (VIA), colposcopy, and thermocoagulation Guidance for the local team on the organization of the screening programme and services Evaluation of the programme by estimation of the cervical early detection process measures
Publications:	Nessa A., Hussain M.A., Rahman J.N., Rashid M.H., Muwonge R., Sankaranarayanan R. Screening for cervical neoplasia in Bangladesh using visual inspection with acetic acid. Int J Gynaecol Obstet. 2010;111(2):115-8. PMID: 20674919 Sankaranarayanan R., Bhatla N., Gravitt P.E., Basu P., Esmy P.O., Ashrafunnessa K.S., Ariyaratne Y., Shah A., Nene B.M. Human papillomavirus infection and cervical cancer prevention in India, Bangladesh, Sri Lanka and Nepal. Vaccine. 2008;26(Suppl 12):M43-M52. PMID: 18945413

Study sites:	National Cancer Institute / National Cancer Control Programme, Sri Lanka
Principal investigator (PI) from IARC:	R. Sankaranarayanan
PIs from collaborating institutions:	Suraj Perera
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Start date:	2006
Closure date:	Ongoing
Objectives:	To provide technical support to the national cancer control programme
Methodology:	The following technical support is provided: Training of health providers Guidance for the local team on the organization of the screening programme and services Evaluation of the programme
Publications:	Sankaranarayanan R., Bhatla N., Gravitt P.E., Basu P., Esmy P.O., Ashrafunnessa K.S., Ariyaratne Y., Shah A., Nene B.M. Human papillomavirus infection and cervical cancer prevention in India, Bangladesh, Sri Lanka and Nepal. Vaccine. 2008;26(Suppl 12):M43-M52. PMID: 18945413

Study sites:	Thailand
Principal investigator (PI) from IARC:	R. Sankaranarayanan
PIs from collaborating institutions:	Weerawut Imsamran, Suleeporn Sangrajrang, Pattarawin Attasara, National Cancer Institute, Bangkok, Thailand
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Start date:	2006
Closure date:	Ongoing
Objectives:	To provide technical support to the national cancer control programme
Methodology:	The following technical support is provided: Training of health providers (monitoring and evaluation) Guidance for the local team on the organization of the screening programme and services Evaluation of the programme (cytology programme and quality assurance)
Publications:	Deerasamee S., Srivatanakul P., Sriplung H., Nilvachararung S., Tansuwan U., Pitakpraiwan P., Kaewkungwal J., Singhasivanon P., Nimnakorn P., Sankaranarayanan R. Monitoring and evaluation of a model demonstration project for the control of cervical cancer in Nakhon Phanom province, Thailand. Asian Pac J Cancer Prev. 2007 Oct-Dec;8(4):547-56. PMID: 18260727 Khuhaprema T., Attasara P., Srivatanakul P., Sangrajrang S., Muwonge R., Sauvaget C., Sankaranarayanan R. Organization and evolution of organized cervical cytology screening in Thailand. Int J Gynaecol Obstet. 2012;118(2):107-11. PMID: 22613493

Study sites:	Morocco: Casablanca, Fez, Marrakech, Rabat
Principal investigator (PI) from IARC:	R. Sankaranarayanan
PIs from collaborating institutions:	Saber Boutayeb, Oncology Centres of Casablanca Karima Bendahhou, Oncology Centres of Rabat Khalid Hassouni, Oncology Centres of Fez Rhislane Belbaraka, Oncology Centres of Marrakech
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Start date:	2016
Closure date:	Ongoing
Objectives:	To document cancer site and stage at diagnosis for all patients registered at four oncology centres for a period of 1 month To document time intervals in the care pathway, from symptom onset to the date of initial health-care contact, date of final diagnosis, and date of beginning of treatment To assess how sociocultural and economic factors, accessibility of the oncology centre, beliefs, perceived risks, and health-care provider–related factors influence stage at diagnosis and delays over the cancer path To document the barriers to reaching cancer treatment facilities, through group discussions with cancer patients and health-care providers
Methodology:	The basis of the study is a face-to-face qualitative questionnaire survey.
Funding:	Lalla Salma Foundation for Cancer Prevention and Treatment

Study sites:	Ministry of Health, Morocco
Principal investigator (PI) from IARC:	R. Sankaranarayanan
PIs from collaborating institutions:	Dr Abousselham, Population, Ministry of Health Dr Belakhel, Epidemiology and Disease Control, Ministry of Health Dr Chami, Lalla Salma Foundation for Cancer Prevention and Treatment Dr Lardi, United Nations Population Fund (UNFPA)
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Start date:	2014
Closure date:	Ongoing
Objectives:	To provide technical support to improve the current information system for monitoring the breast and cervical cancer screening programme
Methodology:	We propose for the Breast and Cervical Cancer Early Detection Programme to standardize data collection, to facilitate the tracking of women, to identify screening defaulters, and to generate quality control indicators.
Publications:	Basu P., Selmouni F., Belakhel L., Sauvaget C., Abousselham L., Lucas E., Muwonge R., Sankaranarayanan R., Khazraji Y.C. Breast Cancer Screening Program in Morocco: Status of implementation, organization and performance. Int J Cancer. 2018 Jul 14. PMID: 30006933 Selmouni F., Zidouh A., Belakhel L., Sauvaget C., Bennani M., Khazraji Y.C., Benider A., Wild C.P., Bekkali R., Fadhil I., Sankaranarayanan R. Tackling cancer burden in low-income and middle-income countries: Morocco as an exemplar. Lancet Oncol. 2018 Feb;19(2):e93-e101. PMID: 29413484
Funding:	United Nations Population Fund (UNFPA) Morocco

Study sites:	Low- and middle-income countries
Principal investigator (PI) from IARC:	R. Sankaranarayanan
Start date:	2014
Closure date:	2016
Objectives:	To establish an observational prospective cohort of women receiving cervical cancer screening in selected countries implementing cervical cancer screening programmes in order to estimate key process and outcome indicators not currently measurable through routine information systems, and also to validate the tools for data collection
Methodology:	A cohort of participants in the existing cervical cancer screening programme was actively followed-up until they underwent the second round of screening, so that key indicators could be measured: screen positivity rate, treatment through single-visit approach (where applicable), compliance with referral, treatment rate (overall), compliance with repeat screening, cervical cancer detection rate, treatment failure rate, failure rate of the screen-and-treat approach (where applicable), and success rate of the screen-and-treat approach (where applicable). Establishment of the observational cohort enabled the implementation of a questionnaire survey on the screen-positive women who did not comply with recommended treatment or referral, to assess the reasons for non-compliance with treatment and referral.
Funding:	CDC Foundation, USA

Study sites:	Hong Kong Cancer Registry, Hong Kong SAR, China Qidong Cancer Registry, Qidong, China Shanghai Cancer Registry, Shanghai, China Tianjin Cancer Registry, Tianjin, China Universidad de Costa Rica, Costa Rica Registro Nacional de Cáncer de Cuba, Cuba National Cancer Registry of The Gambia, The Gambia Barshi Cancer Registry, Barshi, India Bhopal Cancer Registry, Bhopal, India Madras Metropolitan Tumour Registry, Chennai, India Natural Background Radiation Registry, Karunagappally, India Mumbai Cancer Registry, Mumbai, India Karachi Cancer Registry, Karachi South District, Pakistan Manila Cancer Registry, Manila, Philippines Rizal Cancer Registry, Rizal, Philippines Busan Cancer Registry, Busan, Republic of Korea Incheon Cancer Registry, Incheon, Republic of Korea Seoul Cancer Registry, Seoul, Republic of Korea King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia Singapore Cancer Registry, Singapore Chiang Mai Tumour Registry, Chiang Mai, Thailand Khon Kaen Provincial Cancer Registry, Khon Kaen, Thailand Lampang Cancer Registry, Lampang, Thailand Songkhla Cancer Registry, Songkhla, Thailand Izmir Cancer Registry, Izmir, Turkey Kampala Cancer Registry, Kampala, Uganda Zimbabwe National Cancer Registry, Harare, Zimbabwe
Principal investigator (PI) from IARC:	R. Sankaranarayanan
PIs from collaborating institutions:	R. Swaminathan, H. Brenner, B. Ganesh, A. Mathew, M. Hakama, K. Jayant
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Start date:	1990
Closure date:	2011
Objectives:	The dearth of reliable survival statistics from developing countries was very evident until the mid-1990s. This prompted IARC to undertake a project that facilitated hands-on training and thereby the transfer of knowledge and technology on cancer survival analysis to researchers from the participating population-based cancer registries, which culminated in the publication of the first volume of the IARC Scientific Publication on cancer survival in developing countries in 1998. The present study is the second in the series, with wider geographical coverage, and is based on data from 27 registries in 14 countries in Africa, Asia, the Caribbean, and Central America. The calendar period of registration of incident cases for the present study ranges between 1990 and 2001. Data on 564 606 cases of 1–56 cancer sites from different registries are reported. Data from 11 registries were used to determine survival trends and data from 17 registries for reporting survival by clinical extent of disease. The publication includes chapters on each registry and general chapters on methodology, the database, and an overview. Comparative statistics on cancer survival by participating registry or by cancer site are also available online in the form of tables and graphs (http://survcan.iarc.fr).
Methodology:	Population-based cancer survival data (a key indicator for monitoring progress against cancer) are not widely available in low- and middle-income countries. Cancer-specific survival of patients diagnosed in 1990–2001, and followed-up to 2003 in 25 population-based cancer registries from 12 countries in sub-Saharan Africa, Central America, and Asia were analysed by actuarial methods. Visit the SurvCan website
Publications:	Sankaranarayanan R., Swaminathan R. Cancer survival in Africa, Asia, the Caribbean and Central America. Lyon: International Agency for Research on Cancer. IARC Scientific Publication No. 162; 2011. Visit the book’s IARC Publications page Sankaranarayanan R., Swaminathan R., Brenner H., Chen K., Chia K.S., Chen J.G., Law S.C., Ahn Y.O., Xiang Y.B., Yeole B.B., Shin H.R., Shanta V., Woo Z.H., Martin N., Sumitsawan Y., Sriplung H., Barboza A.O., Eser S., Nene B.M., Suwanrungruang K., Jayalekshmi P., Dikshit R., Wabinga H., Esteban D.B., Laudico A., Bhurgri Y., Bah E., Al-Hamdan N. Cancer survival in Africa, Asia, and Central America: a population-based study. Lancet Oncol. 2010;11(2):165-73. PMID: 20005175
Funding:	Worldwide Cancer Research, St Andrews, United Kingdom Association pour la Recherche sur le Cancer (ARC), Villejuif, France Bill & Melinda Gates Foundation, Seattle, USA

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