Union for International Cancer Control

Cancer is more than just a medical diagnosis. Each person's journey with cancer is unique, shaped by their socioeconomic background, their cultural context, their values and preferences, their age, gender, and health. Health systems need to take these differences and individuals' unique situations into account to deliver care that not only meets medical needs but also addresses the emotional, social, and practical challenges that come with a cancer diagnosis. It helps ensure that people receive the care that they need when they need it. This year and for the next 2 years, UICC's new theme for World Cancer Day on 4 February, ‘United by Unique’,1 will focus on highlighting the connection between these unique experiences and life situations of individuals, and the health systems required to deliver tailored care to address them. With the United by Unique campaign, UICC calls for a fundamental shift in the delivery of cancer services toward a people-centred approach, where health systems place individuals and communities at the heart of healthcare decisions. This approach should lead to improved patient well-being, higher quality care, greater quality of life, and increased trust and satisfaction in healthcare providers.2 People living with cancer feel seen, heard, and empowered. People-centred care includes initiatives such as community health programmes tailored to local contexts, cultural competence training for healthcare providers, health literacy initiatives, telemedicine services, patient navigation programmes, and the engagement of people who have experienced cancer in the planning and delivery of cancer programmes and policies. Adopting people-centred care integrated into universal health benefits schemes and national cancer control plans should also help improve health equity by addressing some of the barriers that many people face in accessing care, both in low- countries and high-income countries: health literacy, late diagnosis, lack of treatment options, financial hardship, living far from cancer centres, and stigma and discrimination due to ethnicity, gender or sexual orientation.3 To address these disparities effectively, it is important to understand the unique challenges faced by different communities and understanding the specific cultural, economic, and systemic barriers that they face. Initiatives that actively involve community members in planning and implementing solutions, such as lung cancer screening services in New Zealand co-designed with Māori communities,4 are part of a people-centred approach to healthcare can help overcome these barriers. The ‘United by Unique’ campaign aims to highlight barriers and gaps in health systems as well as existing best practices in delivering people-centred care. Witness accounts can be found on the World Cancer Day website, such as the story of Kristin from Norway, who felt overwhelmed and vulnerable after being diagnosed with central nervous system lymphoma, and encountering different doctors at each visit. Or that of Sukanti from India, who noticed a lack of structured support systems for caregivers when his wife Soma was diagnosed with cancer at age 41 and was given 6 months to live. As we mark World Cancer Day, I urge policymakers, healthcare professionals, and advocates to embrace the principles of people-centred care and encourage people living with cancer, their families, and caregivers to speak out and share their experiences. Everyone is invited to share their story on the World Cancer Day website, participate in the Upside-Down Challenge on social media by posting a picture or video upside down and saying how cancer has turned their world upside down, or create an event to raise awareness about cancer risks, prevention, screening, early detection, and treatment. Every cancer patient's story is unique, but we can unite in a shared ambition to see governments implement policies to improve cancer prevention and deliver health systems that provide more compassionate and effective cancer care, resulting in more people surviving their cancer and leading longer and healthier lives.

The online nature of decision aids (DAs) and related e-tools supporting women's decision-making regarding breast cancer screening (BCS) through mammography may facilitate broader access, making them a valuable addition to BCS programs. This systematic review and meta-analysis aims to evaluate the scientific evidence on the impacts of these e-tools and to provide a comprehensive assessment of the factors associated with their increased utility and efficacy. We followed the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and conducted a search of MEDLINE, PsycINFO, Embase, CINAHL, and Web of Science databases from August 2010 to April 2023. We included studies reporting on populations at average risk of breast cancer, which utilized DAs or related e-tools, and assessed women's participation in BCS by mammography or other key cognitive determinants of decision-making as primary or secondary outcomes. We conducted meta-analyses on the identified randomized controlled trials, which were assessed using the revised Cochrane Risk of Bias 2 (RoB 2) tool. We further explored intermediate and high heterogeneity between studies to enhance the validity of our results. In total, 22 different e-tools were identified across 31 papers. The degree of tailoring in the e-tools, specifically whether the tool was fully tailored or featured with tailoring, was the most influential factor in women's decision-making regarding BCS. Compared with control groups, tailored e-tools significantly increased women's long-term participation in BCS (risk ratio 1.14, 95% CI 1.07-1.23, P<.001, I2=0%). Tailored-to-breast-cancer-risk e-tools increased women's level of worry (mean difference 0.31, 95% CI 0.13-0.48, P<.001, I2=0%). E-tools also improved women's adequate knowledge of BCS, with features-with-tailoring e-tools designed and tested with the general population being more effective than tailored e-tools designed for or tested with non-BCS participants (χ21=5.1, P=.02). Features-with-tailoring e-tools increased both the rate of women who intended not to undergo BCS (risk ratio 1.88, 95% CI 1.43-2.48, P<.001, I2=0%) and the rate of women who had made an informed choice regarding their intention to undergo BCS (risk ratio 1.60, 95% CI 1.09-2.33, P=.02, I2=91%). Additionally, these tools decreased the proportion of women with decision conflict (risk ratio 0.77, 95% CI 0.65-0.91, P=.002, I2=0%). Shared decision-making was not formally evaluated. This review is limited by small sample sizes, including only a few studies in the meta-analysis, some with a high risk of bias, and high heterogeneity between the studies and e-tools. Features-with-tailoring e-tools could potentially negatively impact BCS programs by fostering negative intentions and attitudes toward BCS participation. Conversely, tailored e-tools may increase women's participation in BCS but, when tailored to risk, they may elevate their levels of worry. To maximize the effectiveness of e-tools while minimizing potential negative impacts, we advocate for an "on-demand" layered approach to their design.

Although great progress has been made in many high-income countries in the past decade to prevent, detect, and treat cancers, progress has been slow in low-and middle-income countries (LMICs).Ironically, it is these countries that face the greatest burden of cancers in the future, but they do not have the means to treat many of the cancers that are successfully treated in high-income countries.Some organizations have been successful at securing medicines to address specific cancers in some countries (most notably, the Max Foundation), but sustainable commercial, viable, and comprehensive solutions have not emerged.In recent years, the World Health Organization has placed greater emphasis on cancer and established global initiatives raising the profile of childhood, cervical, and breast cancers.The scale of the challenge faced, however, will not be solved by individual organizations or companies acting alone.Programs such as the Max Foundation were established and continue to be incredibly successful, with humanitarian access to thousands of patients daily, but multiple long-term, sustained financial models that will support a growing oncology need in LMIC are necessary to cover all patients with all types of cancers everywhere.The US President's Emergency Plan for AIDS Relief's Go Further program from 2018 to 2023, which engaged dozens of foreign and local entities in partnership, increased screening by 5.7 million women in sub-Saharan Africa, 79% of whom had a first-time screening.As a result, treatment of precancerous lesions increased from 58% to 87% (overall, 76%).The International Atomic Energy Agency has launched its Rays of Hope program investments supporting radiology for oncology in 7 countries (Benin, Chad, Democratic Republic of Congo, Kenya, Malawi, Niger, and Senegal), working together with partners such as GE Health-Care, Roche, Sumitomo, TNS, and Technol as well as member states (eg, Sweden, Spain, the United States).These types of programs are needed across the entire cancer journey, must be sustained, and require integration for optimal patient outcomes and system efficiency.A common issue in cancer treatment is access to medicines and the diagnostic modalities needed to choose treatments.Anatomic pathology-specifically, surgical pathology services, including immunohistochemistry (IHC)-is the cornerstone of cancer diagnosis and the basis for 75% to 95% of cancer diagnoses and treatments.Yet when we review the reality of what is available to patients in LMIC, these essential, mandatory diagnostic tools are absent, lacking in quality, or incomplete.The Access to Oncology Medicines (ATOM) Coalition, an initiative of the Union for International Cancer Control, seeks to increase the number and availability of high-quality, lowest-cost medications (generics, biosimilars, innovative medicines) to patients in 46 target countries in 5 separate World Health Organizations regions.This effort includes not only medicine access but capacity strengthening, with a specific emphasis where needed on diagnostic tools.To determine the global financial needs to ensure that complete resources are available in the target 46 ATOM countries, we worked with the anatomic pathology model developed by LeJeune-Stodieck et al 1 to scale up, by population and adjusting for economies, to all target countries.The resulting numbers represent the operational expense ($100 million

Accurate staging is a fundamental step in treating patients with nasopharyngeal carcinoma (NPC) worldwide; this is crucial not only for prognostication, but also for guiding treatment decisions. The American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) tumor-node-metastasis (TNM) system is the global language for clinicians, researchers, and cancer registries. Continual improvement that aligns with contemporary pattern of care is essential. To improve the prognostic accuracy and clinical applicability of the eighth edition (TNM-8) for NPC. This multicenter study analyzed patients with NPC with detailed tumor features during January 2014 and December 2015 and was reviewed by experienced radiologists. The data analysis was completed in December 2023. The findings were further confirmed with internal and external validation. Statistical analyses and clinical considerations were reviewed by the AJCC/UICC multidisciplinary head and neck panels and attained consensus. The recommendations were evaluated by the AJCC Evidence-Based Medicine Committee before final endorsement as the ninth version (TNM-9). The primary end point was overall survival. Adjusted hazard ratios of different subgroups were then assessed for confirmation of optimal stage grouping. Of the 4914 patients analyzed, 1264 (25.7%) were female and 3650 (74.3%) were male; the median (SD) age was 48.1 (12.0) years. Advanced radiological extranodal extension (with involvement of adjacent muscles, skin, and/or neurovascular bundles) was identified as an independent adverse factor for all end points: this was added as a criterion for N3. Patients with nonmetastatic disease were regrouped into stages I to III instead of TNM-8 stages I to IVA. Significant hazard discrimination was achieved by grouping T1-2N0-1 as stage I, T3/N2 as stage II, and T4/N3 as stage III. Although the T1-2N0-1 subgroups had comparable 5-year overall survival, subdivisions into IA (T1-T2N0) and IB (T1-T2N1) were recommended due to the distinction in adjusted hazard ratios following adjustment for chemotherapy use. Metastatic disease was exclusively classified as stage IV, and prognostication was further refined by subdivision into IVA (M1a, ≤3 lesions) and IVB (M1b, >3 lesions). TNM-9 demonstrated superiority compared with TNM-8 in major statistical aspects. The results of this diagnostic study suggest that the ninth version of TNM staging for NPC, based on robust analyses and a comprehensive review by the AJCC/UICC staging committees, provides an improved staging system for global application and a framework for future incorporation of nonanatomical factors. This will be launched for global application in January 2025.

The COVID-19 pandemic poses an unprecedented health crisis in all socio-economic regions across the globe. While the pandemic has had a profound impact on access to and delivery of health care by all services, it has been particularly disruptive for the care of patients with life-threatening noncommunicable diseases (NCDs) such as the treatment of children and young people with cancer.The reduction in child mortality from preventable causes over the last 50 years has seen childhood cancer emerge as a major unmet health care need. Whilst survival rates of 85% have been achieved in high income countries, this has not yet been translated into similar outcomes for children with cancer in resource-limited settings where survival averages 30%. Launched in 2018, by the World Health Organization (WHO), the Global Initiative for Childhood Cancer (GICC) is a pivotal effort by the international community to achieve at least 60% survival for children with cancer by 2030.The WHO GICC is already making an impact in many countries but the disruption of cancer care during the COVID-19 pandemic threatens to set back this global effort to improve the outcome for children with cancer, wherever they may live.As representatives of the global community committed to fostering the goals of the GICC, we applaud the WHO response to the COVID-19 pandemic, in particular we support the WHO’s call to ensure the needs of patients with life threatening NCDs including cancer are not compromised during the pandemic. Here, as collaborative partners in the GICC, we highlight specific areas of focus that need to be addressed to ensure the immediate care of children and adolescents with cancer is not disrupted during the pandemic; and measures to sustain the development of cancer care so the long-term goals of the GICC are not lost during this global health crisis.

ObjectiveTo identify any medical or public health rationale for claims that the time to act is now.DesignPseudo-systematic review.Data sourcesPubMed.Study selectionStudies that included the claim “time is now” in the title, with or without exclamation marks. No language or date restriction was applied.Results512 articles were included for review. No relationship was identified between time to act and disease burden, severity, or specialty. Claims that the time to act was Christmas were almost entirely without basis. A clustering of claims that it is time to act in the first quarter of the year suggested a possible association with New Year’s resolutions.ConclusionsNow is as good a time as any.

Objective: The aim of the present study is to analyze four herbal dietary supplements containing genistein by liquid chromatography, quantitative nuclear magnetic resonance (qNMR), and diffusion ordered spectroscopy (DOSY) 1H NMR.&#x0D; Methods: Quantification of the active ingredient, genistein, is carried out by high-performance liquid chromatography (HPLC) and qNMR. Two-dimensional (2D) DOSY NMR also allows the qualitative analysis of the samples with the detection of active ingredient and excipients present in the formulations.&#x0D; Results: The validated HPLC and qNMR methods showed that all four supplements contain genistein in different amounts, and 2D DOSY NMR provides a clear image of all ingredients in the formulations.&#x0D; Conclusion: The use of the three techniques provides detailed information on each product and its contents, and all of them are currently used for the quality control of natural supplements by our laboratory.

To identify key factors for successful integration of translational science into cancer care. Organisation of the health care system matters to optimally bridge between public and private cancer research, cancer registries and routine care. Currently, there are deficits on various levels of connectivity. These hamper rapid and optimal transfer of innovation. To overcome the deficits, strategies of data sharing and infrastructures allowing fast-track implementation of translational research findings into routine care need to be developed.

Background: With an increasing global cancer burden governments and NGOs alike are struggling to meet current and future cancer patient needs. Public–private partnerships (PPPs) are suggested as a way to improve outcomes but receive a mixed welcome due to differing working practices between partners and conflict of interest concerns. While Pfizer is a long term Union for International Cancer Control (UICC) supporter, the two organizations had not developed a large project together until inception of the Seeding Progress and Resources for the Cancer Community (SPARC) Metastatic Breast Cancer Challenge. SPARC is an example of how a carefully managed PPP can avoid major issues and deliver positive benefits for all involved. Aim: SPARC is a global program created to address gaps in the services and support available to women and men with metastatic breast cancer (MBC) by offering grants to local organizations initiating novel ways to address unmet patient needs. Strategy: The program leverages UICC's strong history of grant making, capacity building, and diverse network of members and experts. As well as funding, Pfizer provided in-kind support for grant promotion and event coordination. Process: Prior to launch, UICC and Pfizer agreed on the program concept, support gap types, and selection advisory group (SAG) leadership. UICC ran the application process with an independent SAG to select grantees and managed postaward activities. Public communications and events were coled. Pfizer compliance approval for joint communications required sharing knowledge of selected awardees before public announcement. This stage needed careful discussion to maintain UICC's independent processes. Outcomes: Forty organizations from 30 countries have received SPARC grants since 2015. Grantees benefited from UICC's close monitoring and support, dedicated mentors and unparalleled access to UICC, Pfizer, and MBC advocacy communities. Pfizer was able to increase MBC patient engagement, and expand their commitment to patients and organizations globally. Through this PPP, UICC offered a holistic capacity building program for awardees to increase their project success, and share knowledge gained with the UICC community at the World Cancer Congress. What was learned: UICC has had a relationship with Pfizer for many years. SPARC enabled both parties to understand each other more fully and develop shared project goals. The level of trust built over time enabled frank and transparent discussions when dealing with sensitive issues. The balance of strong information boundaries to avoid actual or perceived conflicts of interest as well as the independent and transparent selection process drove SPARC's success. Additionally, the collaboration gave grantees networking and communication opportunities from both organizations they may not have had otherwise. PPPs are a novel and important way to address unmet patient needs in an increasingly complex healthcare environment globally.