Introduction
The global burden of cancer is large and growing larger. Each year, more than 11 million
people are diagnosed with cancer worldwide. By the year 2020, this number is expected
to increase to 16 million. In addition, cancer causes more than 8 million deaths each year
-- or approximately 13 percent of all deaths worldwide.
In many developed countries, including the United States, cancer accounts for more than
20 percent of all deaths. In less developed countries, overall cancer rates are generally
lower and cancer accounts for a lower percentage of deaths. However, it is within
developing countries that cancer is projected to increase most rapidly over the next
few decades. Unless current trends change, cancer in developing countries is expected
to represent 70 percent of the global cancer burden by the year 2030, a statistic driven
by demographic shifts toward more elderly populations and the movement toward more
Western lifestyles, most notably increased per capita tobacco consumption and higher
fat-lower fiber diets.
In the National Cancer Act of 1971, the National Cancer Institute (NCI) was charged to:
"Collect, analyze, and disseminate all data useful in the prevention, diagnosis, and treatment
of cancer…[and to] disseminate insofar as feasible the results of cancer research
undertaken in any country for the use of any person involved in cancer research in any
country." In addition, the Institute was directed to: "Support research in the cancer field
outside the United States by highly qualified foreign nationals…; support collaborative
research involving American and foreign participants; and support the training of
American scientists abroad and foreign scientists in the United States."
Clearly, it was the intent of the U.S. Congress that NCI should not only address the
challenge of cancer among American citizens but also among the citizens of all nations.
This challenge is daunting indeed, but it is one from which we cannot shrink.
A global perspective offers a myriad of research opportunities that a U.S.-only research
focus would not afford. For example, international studies enable us to investigate "rare"
cancers -- such as certain inherited, familial types of kidney cancer, melanoma, and other
cancers -- by providing access to much larger populations of patients than can be found
within the confines of our national borders. A global perspective also opens to us the
diversity of environments occupied by humans, providing unique opportunities to explore
relationships between genes and specific environmental exposures, including infectious
agents that may be associated with cancer.
Furthermore, international programs give us access to resources found only in other
countries. These resources allow for consistency in diagnosis and tumor classification.
NCI also recognizes the importance of investing in developing countries, especially with
respect to improving research and health care infrastructure. No nation exists in a
vacuum and cancer does not recognize international borders. NCI is committed to sharing
our expertise to foster cancer research and build research and health care infrastructure
around the world. Just as American researchers benefit from a broader perspective by
engaging in research outside U.S. borders, international researchers make significant
contributions to NCI's overall mission while acquiring knowledge, skills, and abilities to
enhance the research environment in their home countries.
The mission to train both American and foreign scientists to battle cancer is one that
NCI takes seriously. When we cooperate internationally to address a shared health
burden, knowledge is expanded, solutions are discovered more efficiently, and the health
of all people is improved.
Monitoring NCI's international activities, many of which are managed within the
Institute's intramural and extramural divisions, is the responsibility of the Office of
International Affairs (OIA). OIA also directs a range of activities that are intended to
catalyze research advances through individual and group training and through fostering
interactions between cancer researchers in the United States and abroad. These latter
activities include initiating, developing, and implementing bilateral and multilateral
agreements to share information and expertise with other nations and groups of nations.
One excellent example of this type of OIA activity is the Middle East Cancer Consortium
(MECC), which is described in
Building the Capacity and Infrastructure for Cancer Research and Care.
OIA also coordinates NCI's involvement in the global clinical trials enterprise. This key role for
OIA is demonstrated by the work of NCI's Liaison Office in Brussels, Belgium (see The NCI Liaison Office in Europe).
This report provides an overview and brief descriptions of NCI's international cancer control
and research programs, as well as the Institute's efforts to share scientific knowledge, build
and support cancer research infrastructure in other nations, and improve the delivery of
cancer information and care to people around the globe. You will find compelling reports that
demonstrate NCI's efforts towards addressing the global challenge of cancer. However, keep in
mind that the efforts and activities presented here are just a sample of the work being done by
NCI scientists, our grantees, and our international partners.
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