Starting date: 2023
Work Programme
The International Agency for Research on Cancer (IARC) and the World Health Organization (WHO) have complementary functions and mandates to advance cancer control globally. WHO launched the Global Breast Cancer Initiative (GBCI) on 8 March 2021, aiming to reduce breast cancer mortality by 2.5% per year. To achieve this goal, three pillars and specific targets were established:
- Pillar 1: Health promotion for early detection
Target: Achieve diagnosis of at least 60% of invasive cancers at stage I or II
- Pillar 2: Timely diagnosis
Target: Evaluation, imaging, tissue sampling, and pathology completed within 60 days
- Pillar 3: Comprehensive breast cancer management
Target: At least 80% of patients with breast cancer undergo a full course of multimodality treatment and successfully return home
The IARC GBCI Team was established with the objective of improving sharing of information and knowledge that relates to the GBCI, and improving dialogue and coordination with the WHO Cancer Team.
The overall objective of the IARC GBCI Team is to share information, knowledge, and updates on the latest developments regarding the ongoing relevant IARC projects, including sharing with WHO, and facilitating dialogue and coordination between the GBCI partners. The current activities, aligned by theme or GBCI Pillar, include:
Development and dissemination of supporting data and tools
- Estimated breast cancer burden via the IARC Global Cancer Observatory, which provides information on incidence, mortality, and prevalence for 185 countries or territories
- Breast cancer mortality trends by age in 70 middle- and high-income countries (via the Cancer Over Time subsite of the Global Cancer Observatory)
- Reported cancer incidence from high-quality cancer registries around the world via the periodic publication Cancer Incidence in Five Continents
- Support to cancer registries in less-developed settings via the Global Initiative for Cancer Registry Development (GICR)
- Breast cancer incidence and survival by stage and age in 70 low- and middle-income countries (SURVCAN-4)
- Breast cancer prevalence according to phase of care (PrevPhase-1)
- Estimated intergenerational impact of premature deaths from breast cancer in terms of maternal orphans
- Cancer Screening in Five Continents (CanScreen5)
- The World Code Against Cancer Framework and related educational materials for health promoters and frontline health-care professionals
- The IARC Learning portal (e.g. self-paced learning programme on Improving the Quality of Cancer Screening)
- Digital atlas on clinical breast examination (CBE), diagnostic mammography and breast ultrasound, and breast pathology (Atlas of Breast Cancer Early Detection)
- Country-specific breast cancer profiles via the GBCI framework (e.g. Namibia)
- Data collection for the GBCI Pillar key performance indicators (KPIs)
Activities related to GBCI Pillar 1: Health promotion for early detection
- Development of standards, recommendations, and studies regarding breast cancer incidence by stage at diagnosis at the population level
- The World Code Against Cancer Framework and related educational materials for health promoters and frontline health-care professionals
- Digital atlas on clinical breast examination (CBE), diagnostic mammography and breast ultrasound, and breast pathology (Atlas of Breast Cancer Early Detection)
- Studies of the patient’s journey to diagnosis, health system barriers to early detection, and breast cancer awareness levels in hospital-based studies in low- and middle-income countries, including across sub-Saharan Africa (ABC-DO: Namibia, Nigeria, South Africa, Uganda, and Zambia) and in eastern Europe and Asia (DEDICA multicountry study: Belarus, Georgia, Kazakhstan, Nepal, the Republic of Moldova, Romania, the Russian Federation, and Uzbekistan)
- Evaluation of clinical breast examination (CBE) in a randomized trial (https://doi.org/10.1002/cncr.34526)
- Implementation of a new multilevel strategy to improve access to the early detection and downstream care continuum for vulnerable rural populations in India (Access Cancer Control India; ACCI)
- Launch of the 1st edition of the Latin America and the Caribbean Code Against Cancer: https://cancer-code-lac.iarc.who.int/en/ and pr342_E
Activities related to GBCI Pillar 2: Timely diagnosis
- IARC multicentre study to evaluate novel technologies to improve breast cancer early diagnosis in limited-resource settings, in India and Uganda
- Digital atlas on clinical breast examination (CBE), diagnostic mammography and breast ultrasound, and breast pathology (Atlas of Breast Cancer Early Detection)
Activities related to GBCI Pillar 3: Comprehensive breast cancer management
- Patterns-of-care studies for breast cancer in Morocco, in Nepal, across eastern Europe and Asia (DEDICA multicountry study: Belarus, Georgia, Kazakhstan, Nepal, the Republic of Moldova, Romania, the Russian Federation, and Uzbekistan), and across sub-Saharan Africa (ABC-DO); interventions to improve treatment completion
Team Composition
Team Leaders: Dr Nadya Dimitrova, Early Detection, Prevention, and Infections Branch (EPR) and Dr Marion Piñeros, Cancer Surveillance Branch (CSU), IARC
Emails: DimitrovaN@iarc.who.int; PinerosM@iarc.who.int
Team members:
Dr Partha Basu (Branch Head, EPR)
Dr Freddie Bray (Branch Head, CSU)
Dr Pauline Boucheron (Postdoctoral Scientist, ENV)
Dr Andre Carvalho (Scientist, EPR)
Dr Carolina Espina (Scientist, ENV)
Dr Milena Foerster (Scientist, ENV)
Dr Valerie McCormack (Deputy Branch Head, ENV)
Dr Isabel Mosquera (Scientist, EPR)
Dr Farida Selmouni (Scientist, EPR)
Dr Eileen Morgan (Scientist, CSU)
Dr Anita Gadgil (Senior Visiting Scientist, EPR)
Ms Hanna Fink (Doctoral Student, CSU)
Dr Tingting Mo (Postdoctoral Scientist, ENV)
Key publications
- Arnold M, Morgan E, Rumgay H, Mafra A, Singh D, Laversanne M, et al. (2022). Current and future burden of breast cancer: Global statistics for 2020 and 2040. Breast. 66:15–23. https://doi.org/10.1016/j.breast.2022.08.010 PMID:36084384
- Piñeros M, Parkin DM, Ward K, Chokunonga E, Ervik M, Farrugia H, et al. (2019). Essential TNM: a registry tool to reduce gaps in cancer staging information. Lancet Oncol. 20(2):e103–11. https://doi.org/10.1016/S1470-2045(18)30897-0 PMID:30712797
- Zhang L, Mosquera I, Lucas E, Rol ML, Carvalho AL, Basu P; CanScreen5 collaborators (2023). CanScreen5, a global repository for breast, cervical and colorectal cancer screening programs. Nat Med. 29(5):1135–45. https://doi.org/10.1038/s41591-023-02315-6 PMID:37106168
- Benitez Fuentes JD, Morgan E, de Luna Aguilar A, Mafra A, Shah R, Giusti F, et al. (2024). Global stage distribution of breast cancer at diagnosis: a systematic review and meta-analysis. JAMA Oncol. 10(1):71–8. https://doi.org/10.1001/jamaoncol.2023.4837 PMID:37943547
- Piñeros M, Ginsburg O, Bendahhou K, Eser S, Shelpai WA, Fouad H, et al.; Staging Survey Group (2022). Staging practices and breast cancer stage among population-based registries in the MENA region. Cancer Epidemiol. 81:102250. https://doi.org/10.1016/j.canep.2022.102250 PMID:36115143
- Mosquera I, Todd A, Balaj M, Zhang L, Benitez Majano S, Mensah K, et al. (2023). Components and effectiveness of patient navigation programmes to increase participation to breast, cervical and colorectal cancer screening: a systematic review. Cancer Med. 12(13):14584–14611. https://doi.org/10.1002/cam4.6050 PMID:37245225
- McKenzie F, Zietsman A, Galukande M, Anele A, Adisa C, Parham G, et al. (2018). Breast cancer awareness in the sub-Saharan African ABC-DO cohort: African Breast Cancer-Disparities in Outcomes study. Cancer Causes Control. 29(8):721–30. https://doi.org/10.1007/s10552-018-1047-7 PMID:29980984
- Baena A, Paolino M, Villarreal-Garza C, Torres G, Delgado L, Ruiz R, et al. (2023). Latin America and the Caribbean Code Against Cancer 1st Edition: medical interventions including hormone replacement therapy and cancer screening. Cancer Epidemiol. 86(Suppl 1):102446. https://doi.org/10.1016/j.canep.2023.102446 PMID:37852728
- Selmouni F, Bendahhou K, Sauvaget C, Abahssain H, Lucas E, Muwonge R, et al. (2024). Impact of clinical breast examination-based screening program on care pathway, stage at diagnosis, nature of treatment, and overall survival among breast cancer patients in Morocco. Cancer. 130(19):3353–3363. https://doi.org/10.1002/cncr.35419 PMID:38837217
- Morgan E, O’Neill C, Shah R, Langselius O, Su Y, Frick C, et al. (2024) Metastatic recurrence in women diagnosed with non-metastatic breast cancer: a systematic review and meta-analysis. Breast Cancer Res. 26:171. https://doi.org/10.1186/s13058-024-01881-y
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