Ongoing Global Health Projects
Webinar Highlights from CISNET’s International Work
A February 1 webinar hosted by the NCI Center for Global Health featured international components of NCI’s Cancer Intervention and Surveillance Modeling Network (CISNET). CISNET is a collaborative consortium (U01) of modelers in breast, prostate, colorectal, lung, esophagus, and cervical cancers, using surveillance data and simulation modeling to improve understanding of the impact of cancer control interventions on incidence and mortality.
Eric (Rocky) Feuer, Overall NCI Project Scientist for CISNET, gave an overview of the initiative and its support for international cancer control planning. CISNETinvestigators then shared global activities that are underway within four CISNET cancer site groups. Chin Hur (Massachusetts General Hospital) discussed the use of modeling to compare the cost-effectiveness of high-resolution microendoscopy vs. standard endoscopy for esophageal squamous cell carcinoma (ESCC) screening in China. Rafael Meza (University of Michigan) described modeling lung cancer in Mexico and Thailand, where CISNET funding is supporting the adaptation of smoking models to estimate the impact of tobacco control policies and screening on the lung cancer burden in those two middle-income countries. Jane Kim (Harvard School of Public Health) spoke about efforts to optimize cervical cancer screening in HIV- positive women in three countries with a high burden of both: Kenya, South Africa, and Uganda. Ruth Etzioni (Fred Hutchinson Cancer Research Center) described the CISNET prostate group’s efforts to modify models to evaluate cancer control programs in non-US populations and collaborate with investigators in the United Kingdom and the Bahamas to develop policies for their populations and resources. CISNET modelers are using individualized screening, biopsy, diagnosis, and treatment data to recalibrate models of prostate cancer’s natural history, and subsequent work will include using the recalibrated models to project long-term outcomes and harm-benefit trade-offs for various screening and treatment policies.
Damali Martin to Serve as US Government Collaborator to the GEOHealth Hub in the Caribbean
Damali Martin was nominated by Gary Ellison and selected by Fogarty International Center (FIC) to serve as the US government collaborator to the Global Environmental and Occupational Health (GEOHealth) Hub in the Caribbean. GEOHealth, a trans-agency initiative led by FIC, supports the development of leading institutions in low- and middle-income countries (LMIC) to serve as regional leaders in collaborative research, data management, training, curriculum development, and policy support. As the US government collaborator, Dr. Martin will facilitate award activities and provide advisory input, as well as synthesize and present progress updates to the funding partners, including FIC, the National Institute of Environmental Health Sciences (NIEHS), NCI, the National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention, and Canada’s International Development Research Centre. Dr. Ellison serves as NCI’s lead scientific contact for GEOHealth and will work closely with Dr. Martin, funding partners, and the GEOHealth Network to expand opportunities for cancer research associated with environmental and occupational exposures across the network.
Cancer Research UK
Becky Ferrer is collaborating with Jo Waller, a researcher at Cancer Research UK, and some of her colleagues on a study that looks at how different types of risk perceptions relate to one another depending on stage of change for colorectal cancer screening in a UK national sample. The study was partly inspired by a paper Dr. Ferrer published in Health Psychology in 2011.
National Collaborative on Childhood Obesity Research
David Berrigan chaired a symposium at the 2016 Society for Behavioral Medicine Annual Meeting in Washington, DC, titled “Importing, Adapting and Evaluating Open Streets & Ciclovia to Increase Physical Activity Levels.” The session, sponsored by the National Collaborative on Childhood Obesity Research, included speakers from the US and Latin America. Speakers included A. Hipp, North Carolina State University; M. Pratt, Emory University; O. Sarmiento, Universidad de los Andes; and G. Penalosa, 8-80 Cities. The session highlighted lessons from US and international efforts to promote physical activity and create vibrant healthy cities via Open Streets programs. The entire session is available on You Tube (https://www.youtube.com/watch?v=HUqZLYXpfVg); also see a related press release (https://www.nccor.org/2016/03/08/connect-explore-promisingstrategies/). The session demonstrated the potential to learn from international experiences in developing novel community-level interventions targeting diverse cancer risk factors, including lack of physical activity.
Ontario Institute of Cancer Research, Health Services Research Scientific Advisory Board
Joan Warren of the Healthcare Delivery Research Program is a member of the Health Services Research (HSR) Scientific Advisory Board sponsored by Cancer Care Ontario and the Ontario Institute of Cancer Research. The HSR Scientific Advisory Board meets every 18 months to provide review and guidance for Health Services Research projects funded by the Ontario provincial government. At a meeting on March 21-22, 2016, the Board reviewed five projects. These included 1) follow-up for patients with a positive fecal occult blood test (FOBT) who have not received colonoscopy; 2) assessment of pain in cancer patients, and whether patients felt that their pain was adequately managed; 3) use of claims data to assess use and costs of chemotherapy and supportive agents; 4) the relationship of diabetes and a cancer diagnosis; and 5) methods to integrate information from HSR studies into clinical practice.
Canadian Institutes of Health Research
Stephen Taplin of the Healthcare Delivery Research Program met with Eva Grunfeld and investigators in Canada funded by the Canadian Institutes of Health Research. Dr. Grunfeld and her team have a 5-year grant to evaluate the connection between primary care and cancer across the cancer continuum and then test an intervention that will improve some aspect of care. At the meeting, the group reviewed what they had found through their observational and survey studies during the first 2 years of the project and proposed several possible intervention ideas. Through an open and collaborative process, the group narrowed down the options and concluded with a vote to focus on comparing three interventions: 1) an automated online consulting service, 2) convening the physicians involved in follow-up to abnormal screening to establish a pathway for follow-up, and 3) a website with connections to relevant resources and organizations. In attendance at the meeting were representatives from the Canadian ministry of health as well as Canadian cancer center and primary care leaders.
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Global Health Research and Training Initiatives
Middle East Regional PEER Research Grantee Forum
Mark Parascandola, along with Marie Ricciardone of the NCI Center for Global Health, participated in the USAID/National Academy of Sciences Middle East Regional Grantee Forum in Amman, Jordan, March 13 -16, 2016. This workshop was targeted to grantees from the Partnerships for Enhanced Engagement in Research (PEER) and Middle East Research Cooperation (MERC) programs. Dr. Parascandola gave a presentation on NCI funding opportunities in global tobacco control and cancer prevention. Conference materials are available at https://sites.nationalacademies.org/pga/peer/pga_171394. Drs. Parascandola and Ricciardone also visited the King Hussein Cancer Center to discuss tobacco control efforts in the region and met with regional US health and development staff. NCI is working with USAID to include language around tobacco control and cancer in the next round of PEER grant solicitations.
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Paul C. Pearlman, Cynthia Vinson, Tulika Singh, Lisa M. Stevens, and Brenda Kostelecky, “Multi-stakeholder Partnerships: Breaking Down Barriers to Effective Cancer-Control Planning and Implementation in Low- and Middle-Income Countries,” Science & Diplomacy, Vol. 5, No. 1 (March 2016).
Cynthia Vinson and colleagues from NCI’s Center from Global Health are pleased to announce the publication of “Multi-stakeholder Partnerships: Breaking Down Barriers to Effective Cancer-Control Planning and Implementation in Low- and Middle-Income Countries” in the journal Science & Diplomacy. The publication outlines the role of NCI as a partner in the cancer control space, provides country-specific case studies, and highlights how effective partnership requires careful coordination, but is a mainstay of overcoming many barriers.
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IARC Caribbean Regional Cancer Registry Hub Site Visits to Barbados and Trinidad and Tobago
Damali Martin and Brenda Edwards performed site visits to cancer registries in Barbados and Trinidad and Tobago, April 25-26, 2016. This site visit was done as part of the Global Initiative for Cancer Registration (GICR) in developing countries, under the IARC Caribbean Regional Registry hub located at the Caribbean Public Health Agency (CARPHA) in Trinidad and Tobago. The purpose of these site visits was to assess the progress made on implementation of cancer registries in Barbados and Trinidad and Tobago; assess the registries’ organizational structures and plans for operation; discuss funding strategies and commitments, including plans for sustainability, and provide guidance and technical assistance; and examine the feasibility of establishing a formal agreement under the GICR for improving cancer surveillance in Barbados and Trinidad and Tobago. Drs. Martin and Edwards were joined by Mona Sairaya (CDC) and Glennis Andall-Brereton (CARPHA) and Betsy Kohler (North American Association of Central Cancer Registries). NAACCR is in the process of ensuring that their new learning management system will be accessible and useful for our Caribbean neighbors, as well as registries around the world, particularly countries with limited resources.
Latin American Cancer Epidemiology (LACE) Meeting: Behavioral Science Think Tank
Susan Czajkowski participated in a Latin American Cancer Epidemiology (LACE) Behavioral Science Think Tank for Physical Activity Promotion, April 14-16, 2016. This meeting included a group of multidisciplinary and international behavioral researchers, most from Latin America. The purpose of the Think Tank, held at Stanford University and co-chaired by Abby King and Robert Haile, was to discuss research needs and opportunities in the area of physical activity promotion in Latin America. Long-term goals of this collaborative effort are to develop a road map for future Latin American-US activities that includes establishing a comprehensive international research agenda in the physical activity promotion area; developing reciprocal training and capacity-building programs; and building partnerships between Stanford and Latin American researchers with interests in this area.
Meeting with Delegates from the People’s Republic of China
Brad Hesse and Sylvia Chou from the Health Communication and Informatics Research Branch participated in a full-day exchange of scholarly presentations on health communication with delegates from the People’s Republic of China on April 14, 2016. This scientific workshop was organized by Zixue Tai of the School of Journalism and Telecommunications at the University of Kentucky, and was co-sponsored by the Confucius Institute of Lexington, Kentucky. The Chinese delegation included representatives from Guangxi University, Beijing Normal University, and Zhejiang University. The meeting was held as a pre-conference before the biennial Health Communication Conference held by the University of Kentucky.
2016 Annual CUGH Global Health Conference
Mandeep Virk-Baker was an invited speaker at the Consortium of Universities for Global Health (CUGH) conference, which was held April 9-11, 2016, in San Francisco. The abstract “Dietary adequacy in tobacco-user and non-user households in Bangladesh” made their top rankings and was recently published in the Lancet Global Health Journal. She also presented a poster at the Global Cancer Research Symposium hosted jointly by the University of California, San Francisco (UCSF) and the NCI Center for Global Health. Authors on both presentations include Dr. Virk-Baker and Mark Parascandola. Dr. Virk-Baker is also collaborating with CDC's Office on Smoking and Health on two international projects related to tobacco and nutrition, and co-authored a manuscript that is currently under refereed journal review for publication: “Money gone up in smoke: The tobacco use and malnutrition nexus in Bangladesh.”
Tertiary Prevention in Oncology Symposium
In March 2016, Julia Rowland was a featured speaker at the first symposium on Tertiary Prevention in Oncology, sponsored by the ARC French Foundation for Cancer Research, the French National Cancer Institute, and the French Institute for Public Health Research. Her presentation, "Barriers and Facilitators to Behavior Change among Cancer Survivors," focusedon the rationale and challenges related to advancing healthy lifestyle practices among the growing population of cancer survivors. The meeting, which was held in Paris, built on previous discussions with Bill Klein and others in DCCPS and afforded the opportunity to disseminate information about our shared resources (e.g., Childhood Cancer Survivor Study [CCSS], Cancer Research Network [CRN]) and provide estimates of possible costs for piloting modest interventions.
International Cognition and Cancer Task Force (ICCTF)
Paige Green, Jerry Suls, and Todd Horowitz attended the 5th biennial International Cognition and Cancer Task Force (ICCTF) meeting, March 14-16, 2016, in Amsterdam, Netherlands. The event was held at the Netherlands Cancer Institute. The focus of the meeting was to share the latest developments in the effects of cancer and cancer treatments on cognition. Dr. Horowitz presented a poster titled “Rethinking attentional deficits in cancer-related cognitive impairment.” Dr. Green and Dr. Suls participated in an ICCTF adjunct meeting on preclinical models of cancer-related cognitive impairment.
Dr. Green met with Professor Marike van der Leeden from the VU University Medical Center Amsterdam to learn about how she developed a framework that supports clinical decisions for tailoring exercise interventions for common comorbidities and breast cancer treatment-induced adverse effects. Professor van der Leeden, Graham Colditz, and Jon Emery from the University of Melbourne in Victoria, Australia, have collaborated with Dr. Green and Dr. Suls to submit an invited symposium abstract for presentation at the International Congress of Behavioral Medicine to be held December 7-10, 2016, in Melbourne, Australia.
Global Workshop for mHealth for TB and Tobacco
Mark Parascandola participated in the Global Workshop for mHealth for TB and Tobacco at the American University in Cairo, New Cairo Campus, Cairo, Egypt, February 24-25, 2016. The purpose of this workshop was to gather TB and tobacco cessation experts, country representatives, World Health Organization (WHO) staff and partners for preliminary discussions and planning to develop mobile technologies to address tobacco use in the context of TB prevention and management using a human-centered design approach. The workshop was part of the WHO/ITU (International Telecommunications Union) ‘Be He@lthy, Be Mobile’ (BHBM) initiative. Following the workshop, the BHBM team, along with outside experts (including NCI), will further develop the message content and develop a handbook for implementing pilot mHealth interventions around tobacco and TB. Erik Augustson also serves on the mTobaccoCessation Informal Expert Group to BHBM and has collaborated on initiatives in other regions.
The Ontario Tobacco Research Unit (OTRU): Research on E-Cigarettes
Mirjana Djordjevic was invited by the OTRU to serve on the Expert Panel, together with Linda Bould of University of Sterling/UK, Maciej Goniewicz of Roswell Park Cancer Institute, Alan Shihadeh of American University of Beirut and Thomas Eissenberg of Virginia Commonwealth University, to aid the development of a comprehensive report on e-cigarettes. The Expert Panel meeting took place in Toronto, Canada, January 12-13, 2016. The OTRU, in partnership with the Centre for Addiction and Mental Health in Ontario, Canada, was awarded a grant by the Ministry of Health and Long-Term Care to undertake a multi-component research study of e-cigarettes (RECIG) that will inform the current evidence base and future provincial policy and legislation. The RECIG study addresses four research questions seeking to determine the prevalence, including patterns of e-cigarette use, especially among youth; the health effects of e-cigarette use; the effectiveness of e-cigarettes as a cessation aid; and the relationship between e-cigarette use and uptake of tobacco smoking.
WHO Study Group on Tobacco Product Regulation (WHO TobReg) Meeting
Mirjana Djordjevic attended the 8th WHO TobReg meeting, as a Temporary Adviser to WHO, in Rio de Janeiro, Brazil, December 9-11, 2015. The goal of the meeting was to develop recommendations on several topics to aid the implementation of Articles 9 and 10 of the Framework Convention on Tobacco Control (FCTC) in member countries (180 Parties to the Convention). The 6th Conference of the Parties (COP6) at the meeting in Moscow, Russia, in 2014, charged the WHO Tobacco Free Initiative (TFI) to facilitate review of the state of the science on 10 distinct topics as pertains to tobacco product regulation and develop science-based recommendations to inform policy, regulation, and research in member countries. WHO/TFI and TobReg members identified experts to write 10 background papers to inform discussions and deliberations on menthol in tobacco products; waterpipe toxicants and missions; applicability and adaptability of WHO TobLabNet methods (SOPs) for cigarette testing to waterpipe tobacco smoking; specific cigarette characteristics and design features; toxicants in smokeless tobacco products (STP); applicability and adaptability of WHO TobLabNet Methods (SOPs) for testing nicotine, TSNA, and BaP in cigarette tobacco and smoke to other tobacco products including STP; electronic nicotine delivery systems (ENDS) toxicants: e-liquids and aerosols; applicability and adaptability of the WHO TobLabNet Methods (SOPs) to ENDS; and exposure to aerosol from smoking-proxy electronic inhaling systems.
3rd International Conference on UV and Skin Cancer Prevention
As a member of the planning team with Cancer Council Victoria and US CDC, Anne Hartman co-chaired, gave oral presentations, and moderated discussion at the pre-conference Workshop on surveillance, methodology, and research related to assessment of skin cancer risk factors on December 8, 2015. This workshop was part of the International Conference on UV and Skin Cancer Prevention that took place in Melbourne, Australia, December 7-11, 2015. The Workshop covered surveillance of skin cancer risk factors, including methods used and lessons learned from various countries. Policy analysis and surveillance methods used to measure sun protection and indoor tanning policies were discussed. Participants discussed methods for improving existing measures and creating new ones in the context of new technologies and new survey methods. Participants had an opportunity to explore how to collect common behavioral measures across countries and initiate collaborations to facilitate skin cancer prevention research. During the main conference sessions on December 9-11, Dr. Hartman actively participated in discussion of relevant behavioral, policy, and communication interventions with her international colleagues. The venue was particularly relevant, as the Australians are models for the US and the rest of the world in skin cancer prevention, as well as tobacco control.
Frank Perna and Dr. Hartman are exploring ways that DCCPS can help co-sponsor/support the next conference, proposed to be held here in the US in late 2017. Dr. Perna and Alan Geller of Harvard have led a team to review and evaluate both published literature and our division’s research portfolio to identify research and knowledge gaps in this area and promote research opportunities in the future to fill these gaps. Drs. Perna and Geller and some others presented on this work at a symposium at the Society of Behavioral Medicine in April 2016.
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International Society of Behavioral Nutrition and Physical Activity
Shelley Bluethmann will be presenting a poster at the International Society of Behavioral Nutrition and Physical Activity 15th Annual Meeting on June 9, 2016, in Cape Town, South Africa. The poster, “Exploring Multi-component Physical Activity Assessment in Cancer Survivors versus the General Population,” includes some results of the 2015 Cancer Prevention Fellowship Program Transdisciplinary Research Award, in which Dr. Bluethmann, Sarah Keadle, and Frank Perna explored the potential for a Physical Activity Index during a 1-year grant award. Authors on the poster include Shelley Bluethman, Sarah Keadle, Katrina Serrano, James McClain, Charles Matthews, and Frank Perna.
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