Global Health and Cancer Epidemiology
- Examples of EGRP's Global Health Interests and Activities
- EGRP- and NCI-Sponsored Global Health Workshops
- Global Health Funding & Training Opportunities
- Selected EGRP Staff Publications
- Global Health Research Resources
- EGRP Contacts for Global Health and Cancer Epidemiology
In 2012, there were 14.1 million new cancer cases and 8.2 million new cancer deaths. The World Health Organization (WHO) projected that by 2035, these figures could increase to 24 million new cases and 14.6 million cancer deaths worldwide. The majority of the global cancer burden is shifting from the more developed world to economically disadvantaged countries.
Nearly 70 percent of cancer incidence will occur in economically disadvantaged countries where survival rates are less than half of those in developed countries. Population growth and aging are the largest contributors to the increasing numbers of cancer cases in low- and middle-income countries.
The population aged 65 and over in low- and middle-income countries is expected to increase from 247 million to 982 million between 2000 and 2050, due to increased attention and resources to combat HIV/AIDS and other infectious diseases. The Epidemiology and Genomics Research Program (EGRP) supports NCI's priorities for global health. The Program works with NCI's Center for Global Health (CGH) and other partners to develop initiatives that build capacity for cancer control and prevention.
Examples of EGRP's Global Health Interests and Activities
Burden of Non-Communicable Diseases in Caribbean
The Caribbean region, with a population of about 43 million, is both culturally and ethnically diverse, with wide variations in exposures to environmental factors, infectious agents, and access to quality health care. With the exception of Haiti, the demographic indicators of the Caribbean nations are consistent with health outcomes expected of middle-income countries and have implications for increased prevalence of non-communicable diseases (NCDs). The Caribbean region has the highest NCD morbidity and mortality rates of the Americas.
For all NCDs, cancer is the second leading cause of death. Cancers related to lifestyle or environmental factors such as reproductive behaviors, dietary patterns and obesity, and tobacco use are higher in incidence and mortality. Prostate, lung, colorectal, and stomach cancers are the highest in incidence and mortality among Caribbean men; whereas breast, lung, colorectal, and cervical cancers are the highest in incidence and mortality among women.
EGRP is currently working with the CGH to help Caribbean nations build their capacity to address the increasing health burden of cancer and related risk factors. Active engagement is sought with stakeholders within the Caribbean and globally, with the Program assisting the CGH in these activities.
Cancer and Household Air Pollution from Solid-Fuel Combustion
Household air pollution (HAP), derived largely from use of solid-fuels for cooking and heating, affects about 3 billion people worldwide, resulting in substantial adverse health outcomes including cancer. Women and children in developing countries are the most exposed.
NCI has a multi-phase initiative in the HAP arena:
- In phase I, a large, trans-Agency workshop, "The Health Burden of Indoor Air Pollution on Women and Children in Developing Countries," held in 2011, worked closely with the Global Alliance for Clean Cookstoves. Findings from the workshop include encouraging studies of HAP effects on cancers other than lung; genetic factors that modify susceptibility; determining whether HAP effects are mediated via germline, somatic, and/or epigenetic changes; and studies of the effects of HAP exposures via dermal and/or oral routes.
- In phase II, a Trans-NIH Working Group formed to collaborate on an NIH Guide for Grants and Contracts' Notice for administrative supplements to stimulate the development of teams for cookstove research. (Administrative Supplements for Health Impacts of Household Air Pollution on Women's Health and Child Survival (Admin Supp - PA-12-202)) As part of these supplements, an NIH Fogarty International Center Research Training Institute on Household Air Pollution was held in 2012, which included research teams from North America, Central America, Africa, India, and Asia.
Cancer in Africa
Emergence of cancer in Africa has become a major public health priority. Africa is experiencing one of the largest increases in incidence and death rates due to cancer. An estimated 681,000 new cancer cases and 512,000 cancer deaths occurred in 2008, and corresponding figures are projected to increase to over one million cancer cases and deaths by the next decade if current methods of diagnosis and treatment remain the same.
New research partnerships are being established to strengthen the capacity for cancer research in Africa. EGRP works closely with the CGH to develop initiatives that will reduce the risk, incidence and deaths from cancer. What appears to be lacking, however, is a cohesive plan for collaboration and opportunities for all vested parties, such as stakeholders, researchers, and funders, to develop a clear strategy. The NCI's CGH and Division of Cancer Control and Population Sciences (DCCPS), of which EGRP is a part, partnered with the African Organization for Research and Training in Cancer (AORTIC), the Instituto Nacional de Câncer (INCA, Brazil), the Institut National du Cancer (INCa, France), and the African-Oxford Foundation (AfrOx) to help establish a trans-national research network.
Attendees from the meeting "Cancer in Africa: Building Transnational Research Collaborations"
For the first part of this initiative, NCI in collaboration with the partners listed above, organized the conference "Cancer in Africa: Building Transnational Research Collaborations" in September 2012. The goals were to assess the current status of cancer research and training programs in Africa and begin to develop initiatives that strengthen existing and build new infrastructure for the sustainability of these programs. EGRP continues to work with the CGH on initiatives that will provide greater opportunities for building research and training capacity.
Infections and Cancer
A broad spectrum of infectious agents including viruses, bacteria, fungi, and parasites play a critical role in the etiology of certain human cancers. Together, these infectious agents affect populations worldwide. WHO estimates about 18 percent of the global cancer burden (2 million cases/year) is attributable to chronic infection with an infectious agent, of which 1.6 million occur in developing regions. Seven infectious agents have been identified as major human carcinogens, according to the International Agency for Research on Cancer (IARC).
Despite one in six cancers being caused by an infectious agent that may or may not be persistent in a host, it is still possible that certain cancers are treatable or preventable worldwide. As a result, need is ongoing for epidemiologic studies with a greater focus on prevention for individuals at greatest risk and to identify key factors that can elucidate the role of infectious agents in development of cancer. EGRP supports numerous national and international research projects investigating infectious agents and cancer risks.
Currently, NCI has Funding Opportunity Announcements (FOAs) for Research on Malignancies in the Context of HIV/AIDS (R01/R21). EGRP is also collaborating with the Centers for Disease Control and Prevention on the President's Emergency Plan for AIDS Relief (PEPFAR).
International Research Consortia
The differences observed in cancer disease prevalence among countries, geographic regions within a country, and ethnic/cultural groups in the same geographic location, present new research opportunities to address cancer etiology, course, and outcome that would inform the design and implementation of cancer control and prevention programs.
EGRP fosters formation of research consortia to address scientific questions that cannot be addressed by single investigators or institutions due to scope, population size, or resources. The Program currently supports a large number of international research consortia. These supported consortia contribute to accelerating the scientific output and present new research opportunities. Learn more about EGRP's research consortia.
U.S.-China Program for Biomedical Research Cooperation
Scientific cooperation between the United States and the People's Republic of China was initiated more than 30 years ago and has grown rapidly in recent years. The NIH Director and President of the National Natural Science Foundation of China (NSFC) signed a Memorandum of Understanding in October 2010, and subsequently, NIH and NSFC signed an agreement in December 2010 to develop a new U.S.-China Program for Biomedical Research Collaborative Research. Both NIH and NSFC have allocated funds to support joint activities. Fiscal Years 2011 and 2012 saw an opportunity for NIH grantees to request administrative supplement support for active grants to enhance ongoing research efforts through collaborations with Chinese scientists under the U.S.-China Program for Biomedical Research Cooperation.
The Initiative, implemented in Fiscal Year 2013, seeks to stimulate collaborative basic, translational, and applied research between the United States and Chinese-based researchers in the areas of allergy, immunology, and infectious diseases, including HIV/AIDS and its co-morbidities and co-infections, cancer, mental health, Parkinson's disease, and stroke. NCI collaborated with NIH's National Institute of Allergy and Infectious Diseases, National Institute of Mental Health, and National Institute of Neurological Disorders and Stroke on this research grant initiative, which was issued in April 2012 and for which applications were due September 2012, with the earliest start date August 2013.
US- and China-based scientists listen intently during the Pollutants, Hazards, and Solutions plenary session of the "Joint China-U.S. Workshop on Environmental Pollution and Cancer" in Guangzhou China
NCI and other NIH Institutes and Centers led a team in developing a workshop with China on environmental pollution and cancer hosted by the Guangzhou Institute of Biomedicine and Health of the Chinese Academy of Sciences (CAS) in Guangzhou, China, in 2010. The workshop's purpose was to identify top emerging areas for research cooperation between China and the United States on cancer and environmental health. This joint workshop focused on identifying environmental factors that trigger pathogenesis of lung cancer, elucidating the carcinogenesis of pollutants, and developing novel therapeutic strategies for patients. Sessions were also devoted to NIH and CAS funding mechanisms that could potentially support joint funding of scientific projects. View the workshop report. [PDF - 325 KB]
EGRP- and NCI-Sponsored Global Health Workshops
- Sub-Saharan Africa Regional Grant-Writing & Scientific Peer Review Workshop (November 2013)
- Prostate Cancer in Men of African Descent: Opportunities for Global Research Collaborations (October 2011)
- Joint China-U.S. Workshop on Environmental Pollution and Cancer (January 2010)
Global Health Funding & Training Opportunities
NCI-sponsored Funding Opportunity Announcements (FOAs) related to infectious diseases and risk of cancer include:
- Cancer Detection, Diagnosis, and Treatment Technologies for Global Health – expires March 7, 2015, unless reissued
EGRP joins with other NCI Divisions, Offices, and Centers and other Institutes and Centers at the National Institutes of Health (NIH) to fund grant applications submitted in response to FOAs. View the full list of EGRP FOAs.
EGRP also encourages investigator-initiated grant applications related to global health and cancer.
The NIH's Fogarty International Center website also contains information about global health research funding opportunities.
NCI's Center for Global Health (CGH) website includes information about the Short-Term Scientist Exchange Program, which promotes collaborative research between established U.S. and foreign scientists from low, middle, and upper-middle income countries by supporting, in part, exchange visits of cancer researchers between U.S. and foreign laboratories. Applications are accepted throughout the year, with application deadlines of June 1, September 1, December 1, and March 1. The CGH website also includes a list of relevant funding opportunities available through other organizations.
The Mount Sinai International Exchange Program for Minority Students is an internship program that supports students and recent graduates to conduct mentored research in other countries. The program emphasizes collaboration and the exchange of scientific and cultural knowledge in an atmosphere of support for diversity. Minority Bachelor's, Master's, and Doctoral degree students are selected to participate from around the United States. Applications are due January 31, 2015. Learn more about this program.
Selected EGRP Staff Publications
- Adewole I, Martin DN, Williams MJ, Adebamowo C, Bhatia K, Berling C, Casper C, Elshamy K, Elzawawy A, Lawlor RT, Legood R, Mbulaiteye SM, Odedina FT, Olopade OI, Olopade CO, Parkin DM, Rebbeck TR, Ross H, Santini LA, Torode J, Trimble EL, Wild CP, Young AM, Kerr DJ. Building Capacity for sustainable research programmes for cancer in Africa. Natl Rev Clin Oncol. 2014 May; 11(5): 251 - 259
- Reid, BC. Visual Screening for Oral Cancer May Reduce Oral Cancer Mortality in High-risk Adult Populations Through Early Diagnosis and Treatment. J Evid Based Dent Pract. 2013 Dec;13(4):174-6.
- Lam TK, Schully SD, Rogers SD, Benkeser R, Reid B, Khoury MJ. Provocative questions in cancer epidemiology in a time of scientific innovation and budgetary constraints. Cancer Epidemiol Biomarkers Prev. 2013 Apr;22(4):496-500.
- Reid BC, Ghazarian AA, DeMarini DM, Sapkota A, Jack D, Lan Q, Winn DM, Birnbaum LS. Research opportunities for cancer associated with indoor air pollution from solid-fuel combustion. Environ Health Perspect. 2012 Nov;120(11):1495-8.
Global Health Research Resources
For more information on global health at the NCI and NIH, go to:
- DCCPS International and Global Health Activities
- NCI Center for Global Health
- NIH Fogarty International Center
- NIH Common Fund Global Health Program
- National Heart, Lung, and Blood Institute (NHLBI) Office of Global Health
- National Human Genome Research Institute (NHGRI) Center for Research on Genomics and Global Health
- National Institute of Allergy and Infectious Diseases (NIAID) Global Research
- National Institute of Child Health and Human Development (NICHD) Office of Global Health
EGRP Contacts for Global Health and Cancer Epidemiology
- Damali Martin, Ph.D., M.P.H. - EGRP's Global Health Coordinator, cancer in Africa, non-communicable diseases in the Caribbean
- Gary Ellison, Ph.D., M.P.H. - U.S. - China Program for Biomedical Research Collaboration
- Tram Lam, Ph.D., M.P.H. - U.S. - China Program for Biomedical Research Collaboration
- Somdat Mahabir, Ph.D., M.P.H. - Non-communicable diseases in the Caribbean
- Britt Reid, D.D.S., Ph.D. - Household air pollution
- Daniela Seminara, Ph.D., M.P.H. - International research consortia
- Vaurice Starks - Infections and cancer
- Mukesh Verma, Ph.D. - Infections and cancer