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Cancer control

Study sites:	India (the states of Kerala, Tamil Nadu, Rajasthan)
Principal investigator (PI) from IARC:	P. Basu
PIs from collaborating institutions:	PIs from collaborating institutions: Richard Sullivan (King’s College, London) Other investigators: Richard Muwonge (IARC) Arunah Chandran (IARC) Eric Lucas (IARC) R. Sankaranayanan (IARC, Advisor to Govt of Tamil Nadu and Kerala) Arnie Purushotham (King’s College, London) Ishu Kataria (RTI International) Rachel Nugent (RTI International) Moni Kuriakose (Cochin Cancer Research Centre) Swaminathan Rajaram (Cancer Institute [WIA]) Rohit Rebello (American Indian Institute of Medical Sciences Rajasthan & GBH Cancer Hospital [AIIMS]: Jerad Selvam (Ministry of Health, Tamil Nadu) CS Pramesh (Tata Memorial Hospital & NCG [NCG]) Chris Booth (Kingston University, Canada) Kunal Oswal (Tata Trusts) Project Assistant: Loubna Boulegroun
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Start date:	2022
Closure date:	Ongoing
Objectives:	Primary objective of the study is to: design and evaluate a new multi-level strategy, integrated to the local health system, contextualized to the local settings, and co-developed through stake-holder engagement to improve access to the early detection and downstream care continuum for oral, breast and cervical cancers in vulnerable, rural populations in India. Secondary objectives are to: Understand and (re)design upstream and downstream pathways both to access interventions and downstream, where necessary, to access definitive care Investigate scale up costs (capital and recurrent) and design affordable programmes within a UHC framework through social insurance and free-at-point of care models. Develop models for embedding scaled up interventions in state and national cancer control plans through a health-systems strengthening approach
Methodology:	The aims will be delivered through 6 integrated work packages (WP) described in the figure.
Funding:	Medical Research Council (UK) and Global Alliance for Chronic Diseases (GACD)

Study sites:	Ireland, Lithuania, Poland, Spain (Manresa, Galicia)
Principal investigator (PI) from IARC:	A. Chandran, P. Basu
PIs from collaborating institutions:	Hendrik van Poppel(European Association of Urology) Monique Roobol (Erasmus MC)
Start date:	2023
Closure date:	Ongoing
Objectives:	The PRAISE-U project aims to reduce morbidity and mortality caused by prostate cancer in EU Member States through smart early detection. In partnership with the consortium, PRAISE-U works to encourage early detection and diagnosis of prostate cancer through customised and risk-based screening programmes. The goal is to align protocols and guidelines across Member States and enable the collection and distribution of relevant data to reduce prostate cancer morbidity and mortality rates in Europe.
Methodology:	Work Package 1 acts as the template for the overview, coordination and quality assurance of the project. Progress will be assessed by tracking the timely completion of milestones and deliverables, and the monitoring of planned resources. Work Package 2 acts as the foundation to Work Packages 3, 4, and 5 by developing a living state of play document, a needs assessment report, performance indicators, and the Platform Knowledge Hub on Prostate Cancer screening. Work Package 3 will build upon the results of Work Package 2 to design the protocols and other research tools for the different pilots to evaluate the risk based screenings. Work Package 4 is the setup and coordination of pilot studies in the host countries. The objectives of this is to facilitate the sharing of knowledge between the pilot sites and core scientific team, ensure the implementation of the agreed protocol and tools, and streamline data collection and monitoring of indicators. Work Package 5 will assess the functionality, feasibility, and sustainability of screening pilots by analysing performance of all the pilot sites, comparisons between pilot sites, and comparisons with the pre-pilot situation, using amongst others, the performance indicators as defined in Work Package 2. Work Package 6 runs in parallel with the other Work packages during the entire lifecycle of the project, focusing on the communication and dissemination of the project's aims, approach and results. Work Package 6 will support all partners to ensure information flow from other Work Packages and to enable for external dissemination and communication. Its key purpose is to ensure that all relevant information.
Publications:	Van Poppel H., Roobol M.J., Chandran A. Early Detection of Prostate Cancer in the European Union: Combining Forces with PRAISE-U. Eur Urol. 2023 Dec;84(6):519-522. doi: 10.1016/j.eururo.2023.08.002. Epub 2023 Sep 12. PMID: 37704541 Gómez Rivas J., Leenen R.C.A., Venderbos L.D.F., Helleman J., de la Parra I., Vasilyeva V., Moreno-Sierra J., Basu P., Chandran A., van den Bergh R.C.N., Collen S., Van Poppel H., Roobol M.J., Beyer K., On Behalf Of The Praise-U Consortium. Navigating through the Controversies and Emerging Paradigms in Early Detection of Prostate Cancer: Bridging the Gap from Classic RCTs to Modern Population-Based Pilot Programs. J Pers Med. 2023 Dec 1;13(12):1677. PMID: 38138904
Funding:	The project leading to this application has received funding from the EU4Health programme under Grant Agreement n° 101101217

Study sites:	Not applicable
Principal investigator (PI) from IARC:	P. Basu and A. Carvalho
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. Visit the CanScreen5 website.
Funding:	Intramural funding from IARC; support from the Pan American Health Organization (PAHO)

Study sites:	East Africa
Principal investigator (PI) from IARC:	P. Basu and A. Carvalho
Start date:	2020
Closure date:	Ongoing
Objectives:	We aim to implement CanScreen5 project in selected East African countries through a partnership with Cancer Research Council UK. Specific objectives are: Collect and disseminate information on cancer screening practices and programmes in selected East African countries Harmonize data collection and data analysis for the comparative evaluation of screening programmes of the target countries Assist countries in organizing their health information system to collect standardized data for continuous quality improvement of cancer screening programmes Provide capacity-building of service providers and programme managers in collection of high-quality data for programme evaluation and quality improvement Conduct in depth situational analysis to identify the Strengths, Weaknesses, Opportunities and Threats (SWOT) related to the implementation and scaling up of the existing programmes Share the information with policy-makers, programme administrators, researchers, and other stakeholders, with the objective of improving planning, evaluation, and quality assurance of cancer screening programmes in the African nations
Methodology:	Training of the screening programme managers Under the framework of CanScreen5 project, the first training programme for selected African countries is being organized at IARC, as this will allow identification of quality indicators most relevant for the region, developing regional standards and ultimately regional implementation guidelines for the project. For the first training we invited representatives from the following countries: Angola, Botswana, Cameroon, Ethiopia, Eritrea, Ghana, Kenya, Malawi, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Uganda, United Republic of Tanzania, Zambia, and Zimbabwe. The participants have been nominated by the Ministry of Health of each country. We anticipate that at the completion of the course, participants will be able to: Describe the necessity and steps of screening programme evaluation and quality improvement Explain the elements of a health information system and its key role in programme monitoring and evaluation List the indicators and standards commonly used to evaluate a screening programme and describe how to estimate them Describe the actions that need to be taken by the programme managers to improve the quality indicators and thus improve the overall quality of the screening programme Describe the planning and implementation of scientific research using programme data Enumerate the core principles of an ethical approach to data collection and research implementation, follow-up, and evaluation Describe the harms of screening programmes and the process of minimizing such harms through continuous quality improvement Describe the steps of data collection, harmonization, and submission and the interpretation of data for the CanScreen5 project In depth situational analysis for selected countries CanScreen5 data will allow us to understand the protocol, organization and quality of the cancer screening programmes and also estimate some of the key performance indicators of screening. Based on the data collected regarding cancer screening through CanScreen5 project, we will select 3 African countries to perform an in-depth situation analysis with the following specific objectives: Prepare a comprehensive report describing the existing policy, protocol, governance, organization, status of implementation and quality assurance process of the screening programme Measure the performance of the program using a core set of quality indicators and identify the gaps and opportunities Define the national standards for at least for some key performance indicators of cancer screening programmes Perform a ‘strength, weaknesses, opportunities and threats (SWOT)’ analysis of the program and draft a quality improvement plan based on the SWOT analysis Disseminate the report among the policymakers, program managers, service providers and other stakeholders for ongoing quality improvement of the programme The implementation of the situation analysis will involve the following steps: constituting a core group of experts, desk review of the available documents, performing a landscape survey, in-depth interviews of programme focal points and other key functionaries, facility visits, collection of aggregate performance data through CanScreen5 and drafting the evaluation report (SWOT analysis).
Funding:	Medical Research Council UK

Study sites:	Community of Caribbean and Latin American States (CELAC): Antigua and Barbuda, Argentina, Bahamas, Barbados, Belize, Bolivia (Plurinational State of), Brazil, Chile, Colombia, Costa Rica, Cuba, Dominica, Dominican Republic, Ecuador, El Salvador, Grenada, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago, Uruguay and Venezuela (Bolivarian Republic of)
Principal investigator (PI) from IARC:	P. Basu
PIs from collaborating institutions:	Terje Andreas Eikemo, CHAIN - Centre for Global Health Inequalities Research, Norway Mirza Balaj, CHAIN - Centre for Global Health Inequalities Research, Norway Clare Bambra, Newcastle University, United Kingdom Adam Todd, Newcastle University, United Kingdom
Start date:	2019
Closure date:	Ongoing
Objectives:	Identification of evidence-based interventions to reduce barriers in breast, cervical and colorectal cancer screening participation Examination of existing healthcare policies in CELAC that may reduce inequalities in cancer burden through effective implementation of cancer screening Mapping of existing screening policies and performance against the burden of disease in CELAC
Methodology:	The study will be conducted in two simultaneous phases: A systematic review on the effect of interventions on the participation rates in breast, cervical and colorectal cancer screening, paying special attention to disadvantaged population worldwide. This review will include literature published since 2000 and indexed in Embase, Pubmed and Web of Science databases Cancer screening data collection from CELAC, through networking with the Panamerican Health Organization (PAHO). A series of workshops will be carried out and information will be obtained using the data collection tools of the CanScreen5 project (https://canscreen5.iarc.fr/), as well as through a questionnaire focusing on budget in cancer screening, training availability, knowledge generation, identification of eligible population, operation of the programme, follow-up, treatment, barriers and interventions in place
Funding:	Norwegian Research Council

Study sites:	Afghanistan, Bangladesh, Burundi, Cameroon, Central African Republic, Chad, Congo Democratic Republic, Congo Republic, Cote d'Ivoire, Democratic People’s Republic of Korea, Eritrea, Ethiopia, Guinea, Guinea Bissau, Haiti, Iraq, Kenya, Lebanon, Liberia, Libya, Malawi, Mali, Mauritania, Myanmar, Nepal, Niger, Nigeria, Pakistan, Sierra Leone, Somalia, South Sudan, Sri Lanka, Sudan, Syrian Arab Republic, Timor-Leste, Uganda, Uzbekistan, Yemen and Zimbabwe
Principal investigator (PI) from IARC:	A. Carvalho
PIs from collaborating institutions:	André Ilbawi, World Health Organization
Start date:	2020
Closure date:	Ongoing
Objectives:	To provide a cancer control overview on states in a prolonged situation of fragility To evaluate the trends of cancer burden in states regarding their current or recent fragile situation
Methodology:	The selection of countries to be analysed is based on their score in the Fragility State Index (FSI), since its creation in 2006. Three groups of states will be assessed: states more than 10 years in fragility and South Sudan (in fragility since its first measure in 2012), states in fragility for the majority of the period 2006-2012 and out of fragility most of the period 2013-2020, states out of fragility the majority of 2006-2012 and being fragile most of the period 2013-2020 Information on cancer incidence and mortality, burden, risk factors, policy response, health system capacity and expenditure will be collected for each country, when available, and analysed. Additionally, trends in cancer incidence, mortality and disability adjusted life years (DALY) and overall health indicators (maternal mortality, HIV prevalence, etc.) will be compiled. An evaluation of the correlation of trends of the FSI and trends in cancer burden (measured by trends in incidence, mortality and DALYs) and overall health indicators will be conducted.
Funding:	Intramural funds from IARC

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), Belarus(2016), Kazakhstan (2016), Liberia (2016), Burundi (2017), Afghanistan (Islamic Republic of) (2018), British Guyana (2018), Indonesia (2018), Mauritius (2018), Mexico (2018), North Macedonia (Republic of) (2018), Ukraine (2018), Armenia (2019), Ecuador (2019), Seychelles (Republic of) (2019), Sri Lanka (2019)
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:	Morocco: Casablanca, Fez, Marrakech, Rabat
Principal investigator (PI) from IARC:	C. Sauvaget
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:	Udaipur, India
Principal investigator (PI) from IARC:	P. Basu
PIs from collaborating institutions:	Manoj Mahajan (PI), Kirti Jain, Nilesh Patira, GBH Memorial Cancer Hospital, Udaipur, India
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Start date:	2017
Closure date:	Ongoing
Objectives:	To evaluate the feasibility and acceptability of the model of delivering community health worker (CHW)–driven home-based comprehensive noncommunicable disease (NCD) control services aimed to prevent premature deaths from cardiovascular diseases; stroke; and breast, cervical, and oral cancers in hard-to-reach men and women
Methodology:	The implementation research has two main components, which will be conducted simultaneously: Evaluation of the social, cultural, and behavioural factors that impact the uptake of the NCD prevention and control services among women, using the RARE methodology Evaluation of the feasibility and acceptability of delivery of the NCD early detection services by the trained community health workers in home settings Participants will be screened for hypertension, diabetes, oral cancer (for habitual users of tobacco products and/or consumers of alcoholic beverages), and cervical cancer (for women only, by HPV testing on self-collected specimens). Women will be made aware of common symptoms and signs of breast cancer. All services will be provided at home. The screen-positive men and women will be navigated to reach appropriate diagnostic and treatment centres.
Publications:	Basu P., Mahajan M., Patira N., Prasad S., Mogri S., Muwonge R., Lucas E., Sankaranarayanan R., Iyer S., Naik N., Jain K. A pilot study to evaluate home-based screening for the common non-communicable diseases by a dedicated cadre of community health workers in a rural setting in India. BMC Public Health. 2019 Jan 3;19(1):14. PMID: 30606132 Mahajan M., Naik N., Jain K., Patira N., Prasad S., Mogri S., Muwonge R., Lucas E., Faruq F., Sankaranarayanan R., Iyer S., Basu P. Study of Knowledge, Attitudes, and Practices Toward Risk Factors and Early Detection of Noncommunicable Diseases Among Rural Women in India. J Glob Oncol. 2019 Apr;(5):1-10. PMID: 30998427
Funding:	American International Health Management Ltd

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:	2019
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:	Centre for Epidemiology and Prevention in Oncology (CPO), Italy Cancer Society of Finland (CSF), Mass Screening Registry, Finland
Principal investigator (PI) from IARC:	R. Sankaranarayanan
PIs from collaborating institutions:	Antonio Ponti, Carlo Senore, Guglielmo Ronco, Nereo Segnan, CPO, Italy Ahti Antilla, CSF, Mass Screening Registry, Finland Representatives from EU Member States: Austria, Belgium, Bulgaria, Croatia, Cyprus, Czechia, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, United Kingdom
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Start date:	2015
Closure date:	2017
Objectives:	To update and expand the scope of the first report To report the updated status and organization of the population-based breast, cervical, and colorectal cancer screening programmes in the 28 EU Member States To estimate selected indicators on programme performance included in the EU quality assurance guidelines for breast, cervical, and colorectal cancer screening
Methodology:	More than 100 experts from the 28 Member States contributed to the preparation of the report. Qualitative data (nature and organization of the programme, protocol of screening and diagnosis, mode of invitation and recall, quality assurance practices, etc.) were collected through online questionnaires completed by the country data providers. The data providers were requested to provide the most up-to-date information as of July 2016. Performance data (screening rate, coverage by invitation/examination, participation rate, and other indicators) were collected for the index year 2013 for countries having population-based programmes using structured data tables. The completeness of data collection across the screening and diagnosis processes was estimated. Analysed data and the draft report were shared with the data providers and the scientific committee for review and validation.
Publications:	Basu P., Ponti A., Anttila A., Ronco G., Senore C., Vale D. B., Segnan N., Tomatis M., Soerjomataram I., Primic Zakelj M., Dillner J., Elfstrom K. M., Lonnberg S., Sankaranarayanan R. Status of implementation and organization of cancer screening in The European Union Member States-Summary results from the second European screening report. Int J Cancer; 2018; 142(1): 44-56. PMID: 28940326 Basu P., Ponti A., Anttila A., Ronco G., Senore C., Vale D.B., Segnan N., Tomatis M., Soerjomataram I., Primic Žakelj M., Dillner J., Elfström K.M., Lönnberg S., Sankaranarayanan R. Author's reply to: Cancer screening policy in Hungary. Int J Cancer. 2018 Aug 15;143(4):1005. PMID: 29524204 Basu P., Ponti A., Anttila A., Ronco G., Senore C., Vale D.B., Segnan N., Tomatis M., Soerjomataram I., Žakelj M.P., Dillner J., Elfström K.M., Lönnberg S., Sankaranarayanan R. Author's reply to: Implementation and organization of cancer screening in France. Int J Cancer. 2018 Jun 26. doi: 10.1002/ijc.31629. PMID: 29943811 Senore C., Basu P., Anttila A., Ponti A., Tomatis M., Vale D.B., Ronco G., Soerjomataram I., Primic-Žakelj M., Riggi E., Dillner J., Elfström M.K., Lönnberg S., Sankaranarayanan R., Segnan N. Performance of colorectal cancer screening in the European Union Member States: data from the second European screening report. Gut. 2018 Dec 10. PMID: 30530530 Vale D.B., Anttila A., Ponti A., Senore C., Sankaranaryanan R., Ronco G., Segnan N., Tomatis M., Žakelj M.P., Elfström K.M., Lönnberg S., Dillner J., Basu P. Invitation strategies and coverage in the population-based cancer screening programmes in the European Union. Eur J Cancer Prev. 2018 Mar 21. PMID: 29570103 View the report
Funding:	The European Union Public Health Programme (scientific and technical support to the European Partnership for Action Against Cancer)

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:	2017
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:	2017
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:	2017
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:	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:	2017
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
Map:
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 (https://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

Legend: Ongoing projects (blue), Completed projects (green)

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