Noteworthy Reports

Report Published from 2011 Workshop on the Health Burden of Indoor Air Pollution (IAP) on Women and Children in Developing Countries
Indoor air pollution (IAP) derived largely from the use of solid fuels for cooking and heating affects approximately 3 billion people worldwide, resulting in substantial adverse health outcomes, including cancer. A workshop was held in Arlington, Virginia, May 9-11, 2011, to better understand women's and children's potential health effects from IAP in developing countries. Workshop participants included international scientists, manufacturers, policy and regulatory officials, community leaders, and advocates, who held extensive discussions to help identify future research needs. In commentary published in November 2012, the state of the science in understanding IAP and its associations with cancer is described and research opportunities are identified for improving understanding of the issues. IAP from indoor coal use increases the risk of lung cancer. Installing chimneys can reduce risk, and some genotypes, including GSTM1-null, can increase risk. Additional research is needed regarding the effects of IAP on other cancers and the effects of different types of solid fuels, oral and dermal routes of IAP exposure, genetic and epigenetic mechanisms, and genetic susceptibility. 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. Epub 2012 Jul 30. PMID:22846419

International Incidence of Childhood Cancer, Volume 3
Lynn Ries has accepted an invitation to be an editor of International Incidence of Childhood Cancer, Volume 3, published by IARC. The other editors are from Argentina, Korea, United Kingdom, France, and Africa. The study is presented at the Web site https://iicc.iarc.fr and it is well into its half-life now.

Next Steps for Adolescent and Young Adult Oncology: A Scientific Update
Lynn Ries was also invited and accepted an invitation to participate in the Epidemiology Work Group, which is to draft a report for Next Steps for Adolescent and Young Adult Oncology: A Scientific Update, a meeting slated for September 2013 being organized by Nita Seibel (DCTD) and Ashley Wilder Smith (ARP, DCCPS).

Tobacco Control Reports
Mark Parascandola is the co-editor and a contributing author for Smokeless Tobacco and Public Health in India: A Scientific Report, expected to be released in the fall. The report is co-sponsored by India’s Ministry of Health & Family Welfare (MoHFW), Healis, Public Health Foundation of India (PHFI), WHO, CDC, and NCI. Dr. Parascandola recently participated in the authors’ and editors’ meeting in Delhi, India.

He also met with representatives from the India MoHFW, US HHS officials in Delhi, and other partners (WHO South-East Asia Regional Office, WHO India Country Office, and PHFI) to discuss the timeline and plans for release of the Global Smokeless Tobacco Report (co-sponsored by CDC and NCI) in the spring of 2013.

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Meeting Reports

The Cancer and Primary Care Research International Network (Ca-PRI) Meets in Australia
DCCPS’ Stephen Taplin and Carrie Klabunde, along with David Weller of Scotland, organized a meeting that brought together 75 investigators from Europe, Asia, Australia, Canada, and Latin America to discuss primary care’s involvement in cancer screening. The session was held on October 23, 2012, in conjunction with the International Cancer Screening Network biennial meeting in Sydney, Australia. Stephen Taplin, as well as investigators from Canada, Costa Rica, the United Kingdom, and Australia, each made a presentation regarding the role of primary care in cancer screening in their country. Discussion among the 75 investigators emphasized the various levels of independence and integration between primary care and organized screening around the world, the challenge of follow-up on abnormalities if organized programs don’t do it themselves, and the relatively high rate of screening within the United States, despite the absence of organized screening programs. Carrie Klabunde and Stephen Taplin will be working with colleagues on an international collaborative paper related to these topics.

Dr. Taplin also participated in the planning meeting for the Ca-PRI meeting that will be held in Cambridge, UK, in April 2013. He and others are planning a session for the 2013 meeting that will focus on early detection in European countries.

International Cancer Screening Network Holds Biennial Meeting in Australia
The International Cancer Screening Network (ICSN) is a voluntary consortium of 33 countries that have active population-based cancer screening programs and active efforts to evaluate and improve the processes and outcomes from cancer screening in practice. The ICSN includes efforts to evaluate cancer screening for a number of cancers where screening has been demonstrated to be effective, including breast, colon, cervical, and lung cancers.

The ICSN convened its most recent biennial meeting on October 23-25 in Sydney, Australia, in conjunction with the Sydney International Breast Cancer Congress. Nearly 180 cancer screening researchers, evaluators, and program leads from 24 countries attended the three-day meeting.

Scientific presentations focused on the following topics:

• Evaluating new technologies and their readiness for incorporation into cancer screening programs
• Benefits, harms, and costs of cancer screening programs, and factors that influence policy and decision-making about screening programs
• Roles of allied health professionals and lay health workers in cancer screening
• Feasible technology approaches to screening in low-resource countries

Key issues that emerged from the sessions included the need for accurate measures of cancer screening’s harms and benefits so that meaningful comparisons across programs and countries can be made; identifying ways to reduce false positives, overdiagnosis, and overtreatment; how to implement individualized screening within population-based programs; incorporating comorbidity into determinations of stopping ages for cancer screening; evaluating cervical cancer screening strategies in the presence of HPV vaccination and testing; use of specific technologies and non-physician health workers to deliver cancer screening in low-resource countries; and integrating research into screening programs and practice.

Stephen Taplin and Erica Breslau participated in the meeting. In addition, two papers on the detection and management of ductal carcinoma in situ, which Dr. Taplin has been working on with colleagues from Europe, were also presented. Dr. Taplin facilitated a session that included 10 papers addressing the benefits, harms, and costs of screening programs. Half of the papers used mathematical modeling as a method to estimate effects, adding impetus to the work of the Cancer Intervention and Surveillance Modeling Network (CISNET) and others to increase modeling efforts in the United States. Dr. Breslau presented a poster regarding using a prognostic indicator to facilitate a discussion of screening and targeting it appropriately among older adults. After the meeting, Dr. Breslau presented on the same topic for staff at St. Vincent’s hospital in Sydney.

The scientific sessions were further augmented by a day of meetings devoted to the ICSN’s four working groups and two interest groups. The ICSN members decided to meet next in 2015 in the Netherlands, with the cancer screening unit of Erasmus University Medical Center to co-host the meeting with NCI.

University of Newcastle and St. Vincent’s Hospital Australia
Erica Breslau presented on quality of care and work at NCI to researchers and faculty at the University of Newcastle, Research Center for Health Behaviour. She met with Dr. Rob Sanson-Fisher and others to discuss research projects that ranged from understanding determinants of clinical network success, to improving psychosocial outcomes for cancer patients, to delay in seeking treatment for colorectal cancer among older adults. Dr. Breslau will continue to explore potential collaborations that use data systems to evaluate problems and successes in care when patients move from screening to diagnosis, treatment to survivorship, or survivorship to end of life.

Flinders University, Australia
Stephen Taplin was invited to speak at Flinders University, where he presented two papers: 1) the challenges of communicating screening guidelines based on experience with the 2009 United States Preventive Services Task Force report on mammography, and 2) multilevel interventions in health care delivery. While there, he also met with representatives of organized screening programs for breast and colorectal cancers. Dr. Taplin learned about the data systems and potential for collaboration with researchers in Australia who are interested in improving primary care involvement in their screening programs. Despite having organized screening in Australia, there are relatively low participation rates (60%) and a lack of clarity regarding the proportion of people with abnormal screenings who are appropriately evaluated. The findings and challenges are relevant to NCI's Population-Based Research Optimizing Screening through Personalized Regimens (PROSPR) initiative.

Caribbean Regional Interest Group Aims to Strengthen Cancer Registries, Cancer Prevention, Research, and Training
The co-chairs of the Caribbean Regional Interest Group, Damali Martin (EGRP) and John Flanigan (CGH), along with Somdat Mahabir (EGRP) visited four Caribbean nations (Grenada, Barbados, Guyana, and Trinidad and Tobago) to assess avenues for strengthening cancer registries, cancer prevention activities, and research and training collaborations. They met with several key stakeholders including academic researchers from St. George’s University and the University of the West Indies, cancer registrars, ministers for health, chief medical officers, representatives from the Pan American Health Organization (PAHO) and the Caribbean Health Research Council, and Dr. Rudolph Cummings, the program manager for Health Sector Development for the Caribbean Community (CARICOM). Drs. Martin, Flanigan, and Mahabir promoted immediate efforts for strengthening registries in the Caribbean. They assessed needs for cancer registry development and cancer prevention programs at Ministries for Health and also investigated possible collaborations for research and training capacity building for Caribbean universities in general as well as for specific projects.

Drs. Martin and Flanigan also met with key stakeholders for cancer research and cancer prevention and control planning in The Bahamas and appeared on a one-hour talk show to discuss issues surrounding prostate cancer in men of African descent. Future plans for building capacity in the Caribbean include increasing attendance of Caribbean nationals at the NCI’s Summer Curriculum for Cancer Prevention and planning a workshop on non-communicable disease surveillance this February in Miami, Florida. Goals include assessing the needs, challenges, and opportunities associated with the establishment of regional cancer registry training; collaboration among key stakeholders in the Caribbean; and discussing opportunities and challenges for expanding from cancer surveillance to non-communicable disease surveillance in the Caribbean.

Brenda Edwards also participated in the conference as a resource expert on cancer surveillance. In addition, Dr. Edwards presented a talk entitled "Important Elements of Cancer Registries in Resource Challenged Settings" at the November 1 Conference Workshop.

Annual Meeting of the International Federation of Gynecology and Obstetrics (FIGO 2012)
Yvonne Prutzman participated in a session titled “Research to Prevent Tobacco Use and Secondhand Smoke Exposure in Pregnancy” at the 2012 meeting of the International Federation of Gynecology and Obstetrics (FIGO) in Rome, Italy, from October 7-12, 2012. The session discussed research needs focused on the development of culturally appropriate and effective tobacco control interventions for use by OB/GYNs, midwives, and other health professionals.

WHO TobLabNet “Science-Based Tobacco Regulators Meeting”
Mirjana Djordjevic attended the WHO TobLabNet meeting, “Science-Based Tobacco Regulators Meeting,” on October 11-12, 2012, in Geneva, Switzerland. The goal of this meeting was to develop strategic approaches to foster more effective implementation of the provisions of the Framework Convention for Tobacco Control (FCTC), particularly with regard to Articles 9 and 10. A roadmap was created in this meeting outlining recommendations for Tobacco-Free Initiative technical work in tobacco product regulation for the next five years.

Classification of Laws Associated with School Students (CLASS)
Tanya Agurs-Collins, Frank Perna, and Leigh Greathouse, a Cancer Prevention Fellow, presented posters related to NCI’s CLASS project at the May 2012 annual meeting of the International Society of Behavioral Nutrition and Physical Activity, in Austin, Texas. The CLASS Web site scores state-level codified laws for physical education (PE) and nutrition in schools. The scoring criteria for these systems are based on current public health research and national recommendations and standards for PE and nutrition in schools. Their presentations at the meeting described the methods and results of empirical analyses detailing changes in state-level school nutrition laws over time and its concordance with state-level soda taxation policy. Together, these posters provide an empirical methodology to measure and describe intersecting environmental contexts that have been associated with dietary intake and childhood obesity.

Cancer Prevention Begins at Home: The Role of Parents
Heather Patrick, Erin Hennessy, April Oh, and Kate McSpadden gave an invited presentation at the International Society of Behavioral Nutrition and Physical Activity’s (ISBNPA's) Pre-Conference Workshop on emerging issues in parenting measurement. The presentation reported on the discussions that occurred at the NCI-sponsored meeting “Cancer Prevention Begins at Home: The Role of Parents.” This presentation served as the basis for a manuscript that has been submitted as part of a special issue of the International Journal of Behavioral Nutrition and Physical Activity.

Also as part of the ISBNPA's Pre-Conference Workshop on emerging issues in parenting management, Erin Hennessy participated in a working group that focused on several topics, including general parenting, parenting and nutrition, physical activity, and screen media domains. The result of this workshop discussion was a manuscript that also has been submitted as part of a special issue of the International Journal of Behavioral Nutrition and Physical Activity.

Croatia-United States Workshop on Cancer Prevention
Mark Parascandola participated in the Croatia-United States Workshop on Cancer Prevention via Tobacco Control and Smoking Cessation in Zagreb, Croatia, on November 5-6, 2012. This workshop was the result of a signed memorandum of understanding between NCI and the Croatian Ministry of Health to promote research collaboration and information exchange in cancer prevention with Croatia and the surrounding region. Croatia has made some progress in tobacco control, including a comprehensive tobacco advertising ban, and will be furthering its efforts by adding additional measures of control when the country joins the European Union next year. Yet, they have had some setbacks: the 100% smokefree workplace law implemented in 2009 was later altered to exempt cafes and bars. The workshop concluded with recommendations for future collaboration on tobacco control research and data collection.

International Agency for Research on Cancer, Lyon, France
Cynthia Vinson met with leaders at the International Agency for Research on Cancer (IARC) in Lyon, France, on November 13, 2012, to discuss how to incorporate implementation science research into IARC’s cancer prevention and control grants, opportunities for partnerships in training and fellowships related to implementation science, and issues related to national cancer control planning.

National Cancer Control Planning Meeting, Geneva, Switzerland
Cynthia Vinson participated in a national cancer control planning meeting convened by NCI’s Center for Global Health and co-hosted by the Union for International Cancer Control on November 14-15, 2012. During the two-day meeting, international organization representatives discussed the possibility of partnering to support national cancer planning efforts in low- and middle-income countries (LMIC). At the end of the meeting, all participants agreed that this was an important endeavor and that the partnership among the organizations should continue. A follow-up meeting will be held in May 2013, to report on progress made in developing/organizing materials, creation of trainings, and organization of registry data to support national cancer control planning in LMIC.

Global Alliance for Vaccine Initiatives Meeting, Geneva, Switzerland
On November 16, 2012, Cynthia Vinson participated with members of NCI's Center for Global Health in a meeting with the Global Alliance for Vaccine Initiatives. The group discussed incorporating national cancer control planning efforts into their cervical cancer/HPV demonstration project. They also discussed the possibility of supporting leadership forums to assist demonstration sites with developing national cancer control plans that place cervical cancer as a key priority and action item for the coming years.

Workshop Explores Survey Error Issues
The International Total Survey Error Workshop, held in the Netherlands in September 2012, served as the venue for an international group of survey researchers to explore the various elements of Total Survey Error (TSE), including coverage, sampling, non-response, instrument-based, and processing errors. Participants discussed ideas for minimizing the overall level of error in survey estimates by balancing these different sources, while also controlling costs. The workshop is likely to lead to a follow-up meeting in two years to assess progress in this area. Gordon Willis presented a paper outlining sources of error associated with development and fielding of a survey questionnaire, particularly in a cross-cultural or multilingual context.

Multidisciplinary Conference Advances Survey Methodology for Hard-to-Reach Populations
The International Conference on Methods for Surveying and Enumerating Hard to Reach Populations (H2R), held in November 2012, in New Orleans, convened survey methodologists, sociologists, statisticians, demographers, ethnographers, policy analysts, and other professionals from numerous countries to present innovative concepts and techniques for surveying hard-to-reach populations. The conference addressed statistical and survey design aspects of including hard-to-reach groups. Researchers reported findings from censuses and surveys and other research related to the identification, definition, measurement, and methodologies for surveying and enumerating undercounted populations. Gordon Willis served as a member of the Conference Steering Committee and is co-editor of a special issue of the Journal of Official Statistics that will be devoted to the H2R conference.

PRO-CTCAE Presented at Quality-of-Life Research Annual Meeting
At the 19th annual meeting of the International Society for Quality of Life Research (ISOQOL) in Budapest, Hungary, in October 2012, Steven Clauser presented on symptom frequency and severity as non-overlapping attributes of symptomatic treatment toxicity in the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). Dr. Clauser also presented a poster on evaluation of severity and frequency levels that optimally differentiate between levels of interference for symptoms in the PRO-CTCAE.

International Congress Advances Physical Activity Surveillance and Assessment
Rick Troiano attended the 4th International Congress on Physical Activity and Public Health (ICPAPH) in Sydney, Australia, in November 2012. As noted by the president of the International Society for Physical Activity and Health (ISPAH), which organizes the conference, ICPAPH is the only international professional congress that focuses solely on research and promotion of physical activity and public health. ICPAPH has a key focus on population surveillance of physical activity and physical activity assessment. Dr. Troiano presented a tutorial session on NCI/NIH-supported measures of physical activity, sleep, and body strength in the National Health and Nutrition Examination Survey (NHANES). He also moderated a session on global trends in physical activity and participated in a panel discussion called 2020 Vision that focused on advances in physical activity assessment.

Satellite Events to the 16th International Congress of Dietetics, New South Wales, Australia
“What do people really eat? A guide to assessing dietary intake in the context of obesity” was a satellite meeting to the 16th International Congress of Dietetics held in August 2012, in Newcastle, New South Wales. The meeting was intended to enhance knowledge and skills to assess dietary intake, evaluate misreporting, and interpret findings in the context of obesity. Sharon Kirkpatrick gave a keynote presentation on measurement error in dietary intake data and delivered a workshop on addressing and reducing measurement error. Key takeaways included learning how others are currently approaching the collection and analysis of dietary intake data, identifying gaps in knowledge that will inform our approaches to dissemination of knowledge and methods on this topic, and networking with researchers, with the potential for future collaborations. Another satellite meeting was held in September 2012, “New Age Dietetics: How Can We Harness Technology for Practice?” The event introduced global perspectives and explored future directions in the application of technology to dietetics and dietary assessment. Sharon Kirkpatrick gave an overview and demonstration of the NCI’s Automated Self-Administered 24-Hour Dietary Recall (ASA24) system as an example of technological advancements in dietary assessment. ASA24 advances the field of dietary assessment by making it economically feasible to collect high-quality dietary intake data in large studies, improving our ability to understand relationships between diet and cancer and other chronic diseases. In addition to informing the Australian dietetic community about the availability of this tool and the potential to use it with different populations, takeaways included learning about other technological advancements in dietary assessment as well as the use of technology in interventions, screening, and other initiatives.

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Ongoing Projects

Community-based Primary Healthcare Team Grant
Stephen Taplin is a reviewer for the Community-based Primary Healthcare Team Grant competition in Canada. This is a research initiative to examine models for improving primary care delivery by testing different approaches to teamwork. It is funded by the Canadian Institutes for Research.

DCCPS Contributing to Trans-NIH Research Capacity Building Program
NCI joined the third issuance of the International Tobacco and Health Research and Capacity Building program, a trans-NIH research initiative led by the Fogarty International Center and co-sponsored by the National Institute on Drug Abuse. The goal of this Request for Application continues to be to support research and research-capacity-building projects focused on observational, interventional, or policy research that addresses the large and growing burden of tobacco use in low- and middle-income countries (LMICs). As in the past, research projects must represent collaborations between scientists in the United States or other high-income country and scientists from one or more LMICs, the proposed research must be of local relevance, and research capacity strengthening must be an integral and significant part of the proposal. Projects will also be required to disseminate research findings to broad audiences, incorporate strategies for regional impact, and take steps to ensure the project's sustainability following the conclusion of the grant period. Applications were reviewed in January 2012, and eight projects were selected for funding. The projects proposed for funding include collaborations with 13 LMICs throughout diverse regions of the globe including the Americas, Eastern Mediterranean, Africa, and Eastern Asia.

China Smoking Cessation Program Using Text Messages
This project will engage a combination of public and private partners to perform an mhealth/text-based smoking cessation intervention demonstration project based on a country-specific modification of the QuitNowTXT library in China. The project will assist in determining the potential effectiveness and acceptability of a health-based short message service (SMS) messaging program within China’s large population of smokers. If effective, text-based programs would provide a low-cost means to increase public education and knowledge on the harmful effects of smoking, and also to deliver a smoking cessation intervention. Pre-trial testing and a very successful demonstration project have been completed. The two-phase randomized control trial of a cessation messaging program is expected to begin in early 2013.

HINTS China
The Health Communication and Informatics Research Branch (HCIRB) continues to collaborate with China’s Renmin University and Health Promotion Bureau on the development and implementation of the first large-scale health communications survey in China, modified and translated from HCIRB’s Health Information National Trends Survey (HINTS). The HINTS China is a new biennial national survey to access key health communication topics, including health information seeking, Internet use, health care utilization, and cancer-related attitudes, beliefs, and behaviors. The Chinese research team completed the collection of pilot data in two cities, Beijing and Hefei, in November 2012. Focus group interviews began in December 2012 to complement and refine preliminary survey data.

Canadian Study Investigating Causes of Cancers and Other Chronic Diseases
The Canadian Partnership for Tomorrow Project is a pan-Canadian cohort study taking place in five geographic sites across the country. Its objective is to establish a large, high-quality “population laboratory” of a size and scale not previously seen in Canada that will help researchers understand the causes of cancer and other chronic diseases. At the meeting of the International Scientific Advisory Board of this study in November 2012, the principal investigators of each site presented progress in recruitment, the collection of biological specimens, collection of endpoints through administrative databases, and data harmonization, as well as plans for the next five-year funding period of the Canadian Partnership Against Cancer. In addition, proposals were reviewed for the enrichment of the cohort sample with cardiovascular risk factors and endpoints. Amy Subar is a member of the study’s Scientific Advisory Board.

NCI-Europe Collaboration Focuses on GVHD
A project development meeting focused on graft-versus-host disease (GVHD) was held on December 12, 2012, in Bethesda. The initiative is sponsored by the NCI Center for Global Health, and the meeting brought together European leaders of the Late Effects Working Party of the European Group for Blood and Marrow Transplantation (EBMT) and experts from NCI, including Julia Rowland, Russ Glasgow, Sandra Mitchell, and a representative from the Chronic Graft Versus Host Disease (cGVHD) Consortium, which receives funding and/or programmatic support from NCI (DCTD) and the NIH Office of Rare Diseases Research. A key objective of the initiative is to launch an EBMT-wide (55 countries) effort focused on advancing education and training in GVHD, with a particular emphasis on cGVHD, the most prominent late effect in cancer survivors after allogeneic transplant.

Project proposals are being developed through the EU funding mechanisms, and NCI is contributing its scientific capacities. The meeting objectives were to produce a proposal focused on two-way, long-term educational programs and consider a prospective observational study in the EBMT. The ultimate goal is to develop a mechanism that will facilitate the understanding and overcoming of great disparities in post-transplant care and research across Europe as well as advance research in this area by fostering collaborations on both sides of the Atlantic. Post-allogeneic transplant survivorship is an attractive model to study cancer survivorship due to the abundant medical and quality-of-life issues in these patients.

Database Provides Objective Physical Activity Data for Children and Youth
The International Children’s Accelerometry Database (ICAD) is a partnership of organizations and initiatives from the United States, Brazil, Europe, and Australia. The database pools data for more than 32,000 people 3-18 years of age from studies conducted in those countries. All of the studies collected physical activity data using similar accelerometers and data collection protocols. The ICAD became available as a public resource, via open access proposals, in April 2012. Rick Troiano participates in the ICAD consortium, which developed the ICAD and has representation from 20 organizations.

The Breast Health Global Initiative
Julia Rowland is working with the Breast Health Global Initiative to help develop guidelines for components of survivorship care for countries with different levels of economic resources.

NCI-Ireland-Northern Ireland Collaboration
Julia Rowland and NCI's Irish colleagues are in the process of selecting a joint research project. One potential project would modify the Survey of Physician Attitudes Regarding the Care of Cancer Survivors for administration to physicians in Ireland.

United States-China Biomedical Program for Biomedical Collaborative Research (R01)
DCCPS joins the Center for Global Health in a trans-NIH effort to support the United States-China Biomedical Program for Biomedical Collaborative Research (R01). This initiative seeks to stimulate collaborative basic, translational, and applied research between US and Chinese 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 is particularly interested in research that focuses on the links between infection and cancer important in the United States and China. Applications have been assigned and review began in January 2013. Gary Ellison represents DCCPS.

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Global Health Research and Training Initiatives

Household Air Pollution Research Training Institute Sponsored by NIH and USAID in Bethesda, MD, October 9-12, 2012
This course, sponsored by the Fogarty International Center, the National Institute of Environmental Health Sciences, the Eunice Kennedy Shriver National Institute of Child Health & Human Development, the National Heart, Lung, and Blood Institute, and the United States Agency for International Development, was designed for scientists from the United States and low- and middle-income countries interested in developing research projects on the health effects of traditional and improved cookstoves. Over the course of three days, faculty from diverse backgrounds, including DCCPS, used a mix of didactic and participatory methods to enable approximately 20 investigators to better define and understand the health risks associated with household air pollution (HAP); the critical role of the social, behavioral, and cultural factors influencing stove adoption; and the complex and evolving technologies for improved stoves and fuels, exposure monitoring, and biomarker development. The Epidemiology and Genomics Research Program’s Britt Reid represented NCI and provided instruction to participants on the epidemiological study designs that can be used to investigate HAP.

Middle East Cancer Consortium Steering Committee Meeting and Training and Research Meeting
Brenda Edwards participated as a cancer surveillance expert in the Middle East Cancer Consortium (MECC) Steering Committee Meeting (October 9-10, 2012) and in the Training and Research Meeting, "Use of Cancer Registry Data in Clinical Cancer Research" (October 11-12, 2012). The training meeting considered case studies for breast and colon cancers from seven countries from the perspective of a clinician, pathologist, and the cancer registry. Dr. Edwards is a new member of the MECC Steering Committee. In addition, she was an external co-lead with David Forman, Head of the Cancer Information Section, International Agency for Research on Cancer (IARC), at the site visit (October 8, 2012) of the Izmir Cancer Registry. Izmir has been identified as a new Hub for the middle east and north Africa regions within IARC’s Global Initiative for Cancer Registry (GICR) Development in low- and middle-income countries (https://gicr.iarc.fr). Meetings were held with senior officials in the Turkish Ministry of Health with administrative responsibility for cancer registries, policies, and funding.

WHO Western Pacific Intercountry Workshop for Non Communicable Diseases Surveillance and Monitoring, Seoul, Korea
Brenda Edwards participated as a resource person at the WHO Western Pacific Intercountry Workshop for Non Communicable Diseases Surveillance and Monitoring December 3-7, 2012, in Seoul, Korea. The National Cancer Center of Korea, which has responsibility for the Korean cancer registry, hosted the meeting and also served as members of the training faculty. The Korean Centers for Disease Control provided information and served as an exemplar and resource for the surveillance system. The workshop for the five participating countries was structured around WHO’s approach for the initial development of country and regional action plans based on standard WHO training materials. The workshop was organized by staff responsible for Non Communicable Disease and Health Promotion at the WHO Regional Office for the Western Pacific Region (WPRO - Manila, Philippines), and the WHO Headquarters in Geneva, Four senior participants and the WHO country representatives from Cambodia, Laos, Vietnam, Mongolia, and the Philippines received a week of training. The WHO Non Communicable Disease surveillance framework has identified 25 indicators and nine (voluntary/tracer) global targets for diabetes, heart diseases, cancer, and chronic pulmonary disease. The national capacity for surveillance and monitoring is limited in most of the low- and middle-income countries. The workshop covered WHO measures and surveys for risk factors, mortality/vital systems, cancer registries, health systems, and public policies. Ann Chao, the NCI Director for Cancer Research Programs, East Asia, from the Center for Global Health, participated in the meeting. This facilitated establishing stronger relationships among NCI, WHO, and other leaders and agencies within these six East Asian countries. This will be followed up with travel to some of the participant countries as well as continuation of the relationship previously established among the Korean cancer control and research communities.