Research
Research projects related to etiology and primary prevention of carcinogenic infections
- Infection-attributable cancer burden: global and local
IARC is the global reference for estimates of the infection-attributable cancer burden (https://gco.iarc.who.int/causes/infections). These estimates require constant updating and improvement with pertinent exposure assessment tools and the latest global cancer incidence data. Current research priorities include estimates of the cancer burden due to HIV (e.g. cervical cancer, Kaposi sarcoma, anal cancer), Epstein–Barr virus (e.g. non-Hodgkin lymphoma, gastric carcinoma), and hepatitis viruses (see below). Given that infections are amenable to prevention, such estimates are key indicators for cancer control.
- Public health decision modelling: globally and locally
To support the design, implementation, and evaluation of HPV-related cancer control programmes in LMICs, EPR has developed expertise in quantitative modelling to model HPV transmission and the impact of vaccination and screening. IARC has developed a platform called METHIS (ModElling Tools for HPV Infection-related cancers), which hosts a range of open-source models that can be used to project the expected impact of cervical cancer control measures and to study phenomena that cannot be investigated with empirical data. These models are informed by EPR’s studies on the impact of HPV vaccination (see below).
Public Health Decision Science Team (PHDS)
METHIS modelling platform
- Studying impact of HPV vaccination programmes in LMICs
Evaluating the impact of HPV vaccination programmes in real-life conditions in LMICs is crucial to understand the best implementation strategies, inform cancer control programmes, and sustain stakeholders’ long-term commitment to HPV vaccination. EPR coordinates the CHRONOS initiative, an International Center of Excellence for Monitoring HPV Vaccination Impact in LMICs, and has launched a series of studies to capture HPV prevalence before and after vaccination. Studies are under way in Bhutan, Rwanda, Armenia, and Uganda, and the protocol is also being expanded to other LMICs with different implementation settings, such as China, Zimbabwe, Indonesia, Eswatini, and Bangladesh.
- HPV vaccine trials in India
EPR is coordinating a multicentre study of 17 000 females vaccinated at age 10–18 years with one, two, or three doses of quadrivalent HPV vaccine. Long-term follow-up shows that a single dose is as protective as two or three doses against persistent HPV16/18 infections as well as CIN2/3 associated with these two genotypes (https://clinicaltrials.gov/ct2/show/NCT00923702). The study outcomes are instrumental in the WHO Strategic Advisory Group of Experts on Immunization (SAGE) recommendation in 2022 to use a single dose of HPV vaccine. EPR also provided technical support to a phase II/III study comparing the safety and immunogenicity of the Serum Institute of India (SIIL) quadrivalent HPV vaccine versus Gardasil in males and females aged 9–14 years (two-dose cohort) and 15–26 years (three-dose cohort).
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- Understanding risk factors in diverse populations with variable gastric cancer risks using standardized multicentre protocols
EPR leads investigations of the epidemiology of H. pylori infection and co-factors for gastric cancer using standardized methods in areas with low and high incidence of gastric cancer (ENIGMA studies). Participating countries with recruitment sites currently include Chile, the Islamic Republic of Iran, New Zealand, Uganda, and Zambia.EPR leads and co-coordinates investigations of blood metabolite signatures for gastric cancer development prospectively using samples taken before diagnosis of gastric cancer, and generating evidence for the role of modifiable risk factors in gastric cancer development (Meta-GC project with EPIC collaborators, and INTL-CC, an international gastric cancer cohort consortium involving five other USA-based cohorts).
- H. pylori screening and treatment to prevent gastric cancer
EPR co-leads large trials to investigate the role of H. pylori treatment and endoscopic surveillance for gastric cancer prevention. Most notably, the HELPER trial is a randomized, double-blind placebo-controlled trial in the Republic of Korea of people aged 40–65 years who underwent endoscopic screening at baseline as part of the National Gastric Cancer Screening Program and were tested for H. pylori infection (NCT02557932). HELPER has recruited more than 12 000 people aged 40–65 years from 12 study centres throughout the country, and 5268 H. pylori-positive participants were randomized to H. pylori eradication therapy or placebo. HELPER celebrated its 10-year anniversary in 2024 while continuing its active follow-up, and results from the interim analysis are foreseen in 2026.
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The GISTAR study aims to determine whether H. pylori eradication combined with endoscopic screening of atrophic gastritis reduces mortality from gastric cancer among people aged 40–64 years in Latvia (NCT02047994). GISTAR has recruited more than 11 000 participants from 11 study centres in Latvia after the successful completion of its pilot study. GISTAR investigates a wide range of epidemiological and clinical questions in an eastern European country where the gastric cancer burden remains high but epidemiological data to develop a preventive strategy are limited. The follow-up results of the study will add to the currently available evidence about whether the strategy of combining population-based H. pylori eradication with pepsinogen testing with endoscopic surveillance of participants in whom precancerous lesions have been detected is acceptable and reduces the gastric cancer burden in high-risk regions in Europe.
Visit webpageEPR is also part of the EUROHELICAN project, which aims to accelerate gastric cancer reduction in Europe through H. pylori eradication. Within EUROHELICAN, a population-based H. pylori screen-and-treat programme is piloted in young adult population in Slovenia, and the long-term effect of H. pylori eradication is evaluated using the GISTAR study. EPR leads a work package to hold an IARC Working Group Meeting by convening an international, interdisciplinary group of experts to provide global guidance on the implementation of population-based H. pylori screen-and-treat strategies for adult populations in various settings for the prevention of gastric cancer.
Visit webpage Read about the Working Group Meeting View the Working Group Report
Research projects related to screening asymptomatic at-risk populations
- Cancer Screening in Five Continents (CanScreen5)
The CanScreen5 project aims to uniformly collect, analyse, and disseminate data on the characteristics and performance of cancer screening programmes globally. A web-based open access platform facilitates data interpretation (https://canscreen5.iarc.fr), and self-paced training modules enable participants to propose measures to improve the quality of cancer screening programmes, to maximize the benefits and minimize the potential harms (https://learning.iarc.fr/edp/resources/pgm-cancer-screening). Capacity-building is supported through regional training sessions with programme managers, in partnership with WHO regional offices. More than 100 countries have participated in the programme to date.
- Strengthening cancer screening data collection to update the European Cancer Information System and improve the quality and coverage of cancer screening programmes in Europe – the CanScreen-ECIS project
The CanScreen-ECIS project (https://canscreen-ecis.iarc.who.int/) aimed to develop and pilot a new cancer screening data management system to be integrated into the European Cancer Information System (ECIS; https://ecis.jrc.ec.europa.eu/). Various work packages have been structured to perform the work and to produce the expected outputs, namely a list of screening indicators, data collection tools (qualitative and quantitative), data collection platform, data analytics tool, and web application for visualization of the results. Key performance indicators for monitoring breast, cervical, colorectal, and lung cancer screening in the EU have been developed by the project (https://canscreen-ecis.iarc.who.int/).
- RISCC (Risk-Based Screening for Cervical Cancer for Europe)
RISCC is a EU-funded consortium aiming to identify optimal risk-based cervical cancer screening protocols. The RISCC consortium is based on data from four large European population-based randomized controlled trials of HPV screening and from the Finnish phase IV cluster-randomized vaccination trial of vaccinating only girls versus both girls and boys. EPR contributes to RISCC through its open-source model for disease progression by assessing health gains and screening-related harms associated with different risk-based programmes (https://www.riscc-h2020.eu/).
- CBIG-SCREEN (Cervical cancer screening in vulnerable women in Europe)
EPR is supporting the implementation of this multicentre research study, which aims to tackle inequality in the cervical cancer screening continuum in Estonia, Portugal, and Romania. These focus countries have been identified to represent different health-care settings within Europe. The interventions aim to increase screening participation among vulnerable women from the current 26% to 45%, and intend to offer support to policy-makers and national programmes to help Europe reach the WHO 2030 target of screening at least 70% of women for cervical cancer.
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- SAVE-CERVIX (Artificial intelligence image recognition in cervical screening in LMICs)
EPR is supporting the development and evaluation of a promising artificial intelligence (AI)-driven technology to recognize cervical precancers and cancers. The technology includes a high-acuity image capturing device (n-AVE) and a meditab to visualize and evaluate cervical images using a built-in AI algorithm. Training of the algorithm using images captured from HPV-positive women is under way in several countries (India, Thailand, Antigua, Zimbabwe), to improve its accuracy and generalizability (https://www.isrctn.com/ISRCTN18333554). EPR is also developing a Cervical Image Bank comprising thousands of cervical images captured from HPV-positive women to support development of AI globally (https://screening.iarc.fr/cervicalimagebank.php). - Zimbabwe randomized controlled trial to evaluate treatment time and use of analgesics for thermal ablation
Thermal ablation is widely practised in LMICs to treat the cervical transformation zone, following a recommendation from WHO. There are a few unresolved issues about the technique. The duration of application of the probe on the cervix varies from 20 seconds to 60 seconds in previous studies, which needs to be standardized. No anaesthesia is used for the procedure, despite the fact that at least some women (< 5%) experience moderate to severe pain during the procedure. EPR is conducting a randomized controlled trial to evaluate treatment time (20 vs 30 seconds per application) and whether pain can be reduced by local application of anaesthetic (local spray of lignocaine vs no anaesthesia) (https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=15741).
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- EASTER study in Zimbabwe (improving cervical screening and management in LMICs through artificial intelligence-based solutions)
The EASTER study, implemented in a screening setting at the University of Harare, Zimbabwe, aims to adapt, apply, and evaluate two emerging technologies: (i) artificial intelligence (AI)-supported spectroscopic detection of high-risk HPV (hrHPV) in urine for cervical cancer screening, and (ii) AI-supported cervical image interpretation for diagnosis and treatment guidance. The pilot phase has been completed, and the study is currently in its field validation phase, in which the new system of HPV detection from urine samples is being evaluated as a screening test to detect cervical intraepithelial neoplasia grade 2 or higher (CIN2+) and compared with a validated HPV detection test, while the AI diagnostic accuracy of the nGyn device to detect CIN2+ lesions is evaluated as a triage test for HPV-positive women. A total of 2100 women are to be recruited in this second project phase (https://clinicaltrials.gov/study/NCT06042543?tab=results).
- Measurement of the impact of introducing HPV vaccination in Zimbabwe
The aim of this project is to measure the impact of introducing HPV vaccination in LMICs. Introducing vaccination is a challenge for LMICs because it is a complex and long process. Therefore, IARC has implemented two large-scale impact studies to support Bhutan and Rwanda, and has now expanded its set of multicentre protocols to Zimbabwe. The results from these studies provide reassurance to LMICs that implementing HPV vaccination is a sound investment and will yield impactful results. The project also helps to optimize resource allocation and can serve as a template for other countries aiming to introduce vaccination.
- HPV Vaccine Effectiveness Coordination Center (CHRONOS)
The aim of the CHRONOS project is to set up a Center of Excellence to measure HPV prevalence and the impact of HPV vaccination in resource-limited settings. The Center of Excellence will be based at IARC and will focus on developing standardized and exportable procedures to assist local partner institutions in selected countries to plan, prepare, conduct, monitor, and analyse findings from HPV cross-sectional prevalence surveys. The Center of Excellence will train and provide support to local personnel to ensure adequate quality standards and will centralize the data to allow for comprehensive, transparent, and standardized analyses. The output of this project will inform cervical cancer control strategies and accelerate progress towards cervical cancer elimination, while building capacity in resource-limited settings. A dedicated website is under construction.
- METHIS (ModElling Tools for HPV Infection-related cancers)
Mathematical modelling approaches are increasingly used to clarify the global and local epidemiology of HPV infection, to project the impact of vaccination, to elucidate the natural history of HPV precancerous lesions, and to assess the impact of cervical cancer screening strategies. The IARC Public Health Decision Science Team (PHDS) is developing an open-source platform called METHIS (ModElling Tools for HPV Infection-related cancers) to model HPV transmission and the progression towards cancer. METHIS is being applied to LMICs, where the cervical cancer burden is disproportionately high and large numbers of young girls and women are still unvaccinated, to assess the potential impact of primary and secondary prevention on cervical cancer and determine the country-specific optimal maximum age for HPV vaccination catch-up. Data from this project will inform local stakeholders in deciding on cervical cancer control strategies and will accelerate progress towards cervical cancer elimination.
- GUIDES (Facilitators and barriers for WHO cervical screening and treatment guidelines)
GUIDES aims to identify barriers and facilitators for the implementation of the WHO cervical cancer screening and treatment guidelines in specific local contexts and propose interventions to maximize the adoption and the fidelity of local implementation of the most up-to-date WHO guidelines. GUIDES will use the Consolidated Framework for Implementation Research (CFIR) to guide the interviewing of decision-makers, scientific societies, and health providers to understand their knowledge, their perceptions, and the acceptability of the implementation of guidelines.
- STRING project
The STRING project is a cross-sectional study nested within the OptiTri cohort, evaluating the clinical utility of urine samples for HPV detection and cervical lesion screening among women living with HIV in Cameroon. The study will compare HPV detection in urine samples versus self-collected vaginal samples and provider-collected cervical samples among 2228 women. It also aims to assess DNA methylation as a triage method for HPV-positive cases. The study is ongoing as part of the larger OptiTri implementation research project.
- Interventions to improve participation in cervical cancer and breast cancer screening in France
The AppDateYou study aims to develop and assess the impact of women’s informed decision-making through conversational artificial intelligence (a chatbot) to increase adherence to cervical cancer screening among non-respondent women. EPR is supporting the development and evaluation of a social network (CANelles) aimed to be used in the breast cancer screening programme in France, as a shared decision-making tool for women and general practitioners.
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The MIRABELLE project is a randomized controlled trial to be implemented in two regions in France, evaluating HPV self-sampling strategies in the general population among 4500 women. The study will compare standard care against direct home delivery with navigation support and an informed choice approach. The project includes cost–effectiveness analysis and qualitative assessment, and it aims to provide evidence-based recommendations for national cervical cancer screening policy by July 2027.
- Colorectal cancer screening projects
EPR supported the implementation of multicentre studies in Morocco and the Islamic Republic of Iran, to evaluate the acceptability, feasibility, organization, implementation, monitoring, and evaluation of colorectal cancer screening in the general population setting by integrating the programme within the existing public health services to inform and guide the eventual scaling up of colorectal cancer screening to cover the entire country (https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=5847).
Visit webpage for Morocco, Visit webpage for the Islamic Republic of Iran
EPR is also leading a randomized controlled trial to evaluate a novel strategy for colorectal cancer screening, specifically testing the direct home delivery of faecal immunochemical test (FIT) kits alongside invitation letters. The KITCOLO project aims to assess whether this new delivery approach can improve the current low participation rate (32%) in France’s national colorectal cancer screening programme and provide evidence to support the French Ministry of Health’s decision-making process.
- Multicentre pilot programmes for lung cancer screening
EPR is supporting this study to evaluate the development and implementation of a pilot programme for low-dose computed tomography (LDCT) lung cancer screening in Belarus (https://www.isrctn.com/ISRCTN16878075) and Uruguay (https://doi.org/10.1186/ISRCTN88299564).
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- APACHES (Anal cancer natural history and screening)
EPR has a particular interest in the natural history and prevention of anal cancer, a cancer type that is rare in the general population but has an elevated incidence in established high-risk groups. APACHES is an ongoing prospective study of 500 HIV-positive men who have sex with men, in six centres in France. APACHES was designed particularly to answer essential questions about the progression and regression of high-grade anal lesions, and will evaluate the utility of several (bio)markers (including epigenetic) for anal cancer prevention (https://clinicaltrials.gov/ct2/show/NCT02287961).
- CervScreen project
In the CervScreen project, researchers from EPR worked in collaboration with the Department of Health and the Health Service Executive of Ireland to address global issues relating to the quality and coverage of cervical screening programmes. The objectives of the three Technical Working Groups were (i) to develop best practices for conducting cancer audits in cervical cancer screening programmes; (ii) to identify good practices and key considerations, including a checklist for improved communication with the public, service providers, and other stakeholders about the benefits, inadequacies, and potential harms of cervical cancer screening; and (iii) to develop best practices and a legal framework that will better safeguard the interests of screening participants, providers, and managers. These outcomes were framed as global best practices for audit of cancers, legal and ethical practices, and communication in cancer screening.
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- Improving cancer care coordination and screening in Latvia and Slovakia – the ICCCS project
Latvia and Slovakia are lagging among the EU Member States regarding their performance indicators related to the cancer care continuum and particularly their cancer screening programmes. The ministries of health of both countries requested support to prepare a strategic plan and a roadmap tailored to the needs and expectations of Latvia and Slovakia regarding improving cancer care coordination, cancer screening, and reduction of cancer mortality in both countries by:- improving population-based cancer registration (Latvia),
- aiming for comprehensive cancer care and research infrastructure/network accreditation (Latvia),
- improving the coverage and quality of breast, cervical, and colorectal cancer screening programmes (Latvia and Slovakia), and
- improving awareness of stakeholders (Slovakia).
- Improving cancer screening in Slovenia – the ICSIS project
This project aims to enhance Slovenia’s cancer early detection programmes by using a health systems framework that emphasizes key components such as leadership and governance, health workforce, service delivery, and information systems, with a strong focus on quality assurance and communication. The project is particularly focused on:- Planning organized lung cancer screening,
- Switching from opportunistic to organized prostate cancer screening, and
- Switching from cytology-based to HPV-based cervical cancer screening.
- SHE-CAN
The SHE-CAN study is guided by the INSPIRE implementation framework to co-design and test HPV-based screening approaches in two states of India with different health system organization, based on understanding the status of screening as currently implemented, readiness and challenges to transition to HPV-based screening, and preferences of key stakeholders.
- PRAISE-U
For prostate cancer, EPR is leading a work package to develop context-appropriate risk-stratified screening protocols for men aged 50–69 years for implementation pilots in five EU regions (Ireland, two sites in Spain, Lithuania, and Poland) through the PRAISE-U project. In addition, EPR led the work to develop key performance indicators to monitor the effectiveness of prostate cancer screening (https://uroweb.org/praise-u).
- ProScreen Slovenia
EPR researchers are extending the learnings of the PRAISE-U project to an additional site in Slovenia through the ProScreen project, where EPR will develop a context-appropriate screening programme based on stakeholder engagement and local capacity.
- HPV-FASTER-Implement
This hybrid efficacy and implementation study will evaluate offering combined HPV vaccination and HPV-based cervical cancer screening to unvaccinated and underscreened vulnerable populations in Europe. The specific strategies will be tailored to the local contexts of the intervention countries (Denmark, France, Romania, Spain, and Sweden). EPR will be involved in assessing the capacity of services to provide cervical cancer screening and HPV vaccination, creating an operational plan for each country, and conducting evaluation using the RE-AIM implementation research framework. EPR will also contribute with a dynamic microsimulation model based on HPV transmission and cervical cancer natural history and costing data collection from the pilots to assess the economic resources required and the benefit–harm ratio of scaling up the pilots.
- INTERVENER
EPR researchers developed a web-based tool, called INTERVENER, matching barriers to the cancer continuum organization to evidence-based interventions to overcome them. This tool will support countries in conducting a systematic assessment of barriers, including their prioritization, and identifying interventions to address them, ultimately facilitating reduction of health inequalities. INTERVENER can support governments, policy-makers, managers, and health-care providers to make better informed decisions to improve their cancer screening programmes. The tool will be made publicly available in the coming months.
- The European Commission Initiative on Cervical Cancer (EC-CvC)
The EC-CvC is the main deliverable of the EUCervscreen_QA project, which receives co-funding from the EU4Health programme (grant agreement no. 101122251) (https://health.ec.europa.eu/non-communicable-diseases/cancer/europes-beating-cancer-plan-eu4health-financed-projects/projects/eucervscreen-qa_en). Led by IARC in collaboration with the European Commission’s Joint Research Centre (JRC), the initiative aims to develop European cervical cancer prevention guidelines (covering primary and secondary prevention), along with an integrated quality assurance (QA) scheme that also includes tertiary prevention of cervical cancer. This is a novel, quality-driven framework to harmonize cervical cancer prevention across Europe, addressing inequities and implementation challenges. All project outputs are delivered through an interactive web-based platform, ensuring broad accessibility and facilitating timely updates (https://cancer-screening-and-care.jrc.ec.europa.eu/en/ec-cvc).
- Zimbabwe cervical precancer treatment failure study (Zceptre)
The Zceptre study is a prospective cohort of 250 women living with HIV aged 18–65 years treated for cervical precancer at the Newlands Clinic in Harare, Zimbabwe. The study aims to assess the risk of disease recurrence and the predictive value of post-treatment tests, ultimately improving monitoring guidelines and outcomes for women living with HIV in low-resource settings. The participants undergo cervical biopsies for histology, HPV genotyping, and DNA methylation testing, with follow-up every 6 months for 24 months. Re-treatment is offered for cervical intraepithelial neoplasia grade 2 or higher (CIN2+) per local guidelines.
- RESET Gulf
EPR and CSU in collaboration with the Gulf Center for Disease Prevention and Control (Gulf CDC) are implementing the RESET Gulf project in the six Gulf Cooperation Council countries with the aim of improving cancer screening and cancer surveillance in the region. For cancer screening, the project is being implemented in two phases. The first phase is based on the IARC Cancer Screening in Five Continents (CanScreen5) project and will focus on capacity-building on implementation, monitoring, evaluation, and quality assurance of cancer screening programmes, by focusing on data management and continuous quality improvement of cancer screening activities. To achieve this, the project will train, set up, and facilitate a network of master trainers in the region. The second phase will focus on the evaluation of the cancer screening programmes in a selected country, assessing the cancer screening process health systems capacity and readiness, monitoring and evaluation framework, quality assurance framework, and communication strategies. Based on the findings, IARC will co-design a strategic plan to support the country in designing and implementing policies based on evidence-based interventions and best practices on cancer control aligned with international standards, to improve the cancer screening programme.
- TOGAS
EPR is an Associate Partner of the TOGAS (Towards Gastric Cancer Screening Implementation in the European Union) project, which aims to provide the missing evidence-based knowledge to be further transferred to design, plan, and implement appropriate gastric cancer prevention across the EU. TOGAS has three specific objectives: (i) assessing the state of play as well as the needs of EU Member States and target populations in gastric cancer prevention, including information on opportunistic screening initiatives organized in public and private settings; (ii) assessing the appropriateness of various gastric cancer screening modalities for use in the EU; and (iii) assuring the sustainability of the results by an effective dissemination strategy and coordination of the methodology with the approaches used within the EU, including with the European guidelines and quality assurance schemes, which EPR has been tasked to lead.
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- The European Commission Initiative on Gastric Cancer (EC-GaC)
EPR is leading the European Commission Initiative on Gastric Cancer (EC-GaC) in collaboration with the Joint Research Centre and will develop the first set of evidence-based European guidelines and quality assurance schemes focusing on primary prevention of gastric cancer, especially population-based H. pylori screen-and-treat programmes, for particular consideration by those EU Member States with the highest gastric cancer incidence and mortality rates, allowing for a stepwise and gradual roll-out. These efforts are expected to continue, to expand the aim to cover secondary prevention of gastric cancer, diagnosis, and treatment, addressing the entire care pathway as in other established guidelines in the next work programmes. This initiative recommended by the EU Council is the first of its kind in the EU context and may be applicable in other regions of the world with a high burden of gastric cancer.
- Mapping cancer inequalities by migration background in Europe (Cancer RADAR)
Cancer RADAR addresses the urgent need to quantify and reduce disparities in cancer among individuals with a migration background in Europe. In recent years, there have been increases in migration to and within Europe, resulting in more-diverse populations whose health needs may differ from those of the general (host) population. In addition, migrants can face significant barriers to accessing appropriate health care. Currently, a unified way of measuring cancer disparities by migration background does not exist, limiting the ability of policy-makers to respond effectively. To close this gap, Cancer RADAR is establishing an infrastructure that combines systematic data collection with advanced analytical methods, offering a harmonized, Europe-wide perspective on the current and future cancer burden and mortality among people with a migration background. As a first step, Cancer RADAR will focus on infection-related cancers (specifically, liver cancer, gastric cancer, and cervical cancer) and screening-preventable cancers, including breast cancer, cervical cancer, colorectal cancer, and lung cancer.
- EUCanScreen (European Joint Action on Implementation of Cancer Screening Programmes)
EUCanScreen, funded by the European Union’s EU4Health programme, aims to ensure sustainable implementation of high-quality screening for breast, cervical, and colorectal cancers, as well as prepare for the implementation of screening programmes for lung, prostate, and gastric cancers as per recommendation by the European Commission. The project brings together 29 countries, including 25 EU Member States, Ukraine, the Republic of Moldova, Norway, and Iceland, to achieve the overarching goal of reducing the cancer burden while achieving equity in cancer across Europe. EPR is leading several initiatives aimed at ensuring the sustainability of cancer screening programmes while also supporting tasks focusing on interval cancers and leadership, among others.
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Research projects related to early diagnosis of common cancer types
- ABCDE India and Uganda (Evaluation of new technologies for breast cancer early diagnosis)
EPR is supporting the implementation of a multi-level, multi-component intervention strategy, including telepathology, a low-cost portable breast ultrasound device, and novel strategies such as molecular and histopathological diagnosis from cell blocks, to reduce delays in access and diagnosis and improve the quality of diagnostic services for patients with breast cancer in India and Uganda. The project evaluated detection of molecular markers (ER/PR/HER2/Ki67) of breast cancer from tissue and cell block samples using a novel mRNA test.
- PUD-INDIA (Portable ultrasound device to triage clinical breast examination-positive women)
The aim of this study is to estimate the diagnostic accuracy of a low-cost, battery-powered portable ultrasound device (PUD) to triage which lumps need further evaluation from those that are clearly benign, and compare it with that of standards of care among clinical breast examination (CBE) screen-positive women. The use of the PUD can save CBE-positive women from unnecessary radiation, can lower costs, and can reduce the workload of radiologists. Non-radiologist clinicians can be trained to use the PUD to evaluate CBE-positive women. Evaluation of ultrasound triage of CBE-positive women is also ongoing in Indonesia, nested in the national breast cancer screening programme.
- Access Cancer Care India (ACCI)
This project aims to assess barriers to access to early detection and treatment services for oral, breast, and cervical cancers among rural populations, review the capacity of the current health services for early detection of oral, breast, and cervical cancers, and co-develop an intervention strategy to improve participation in early detection programmes for oral, breast, and cervical cancers among rural populations in three states in India. Finally, this project will evaluate the intervention strategy to improve access to early diagnosis and screening of oral, breast, and cervical cancers in these three states.
- Development of oncology services – Uzbekistan
EPR is supporting the Ministry of Health of Uzbekistan to strengthen the monitoring and evaluation of breast cancer early detection by providing training to epidemiologists and statisticians on data reporting and quality control. EPR will also provide technical support in piloting colorectal cancer screening in Uzbekistan and will co-design a plan for strengthening/implementing interventions for prevention and early diagnosis of gastric cancer and liver cancer in coordination with WHO and the Ministry of Health of Uzbekistan.
