Low- and middle-income countries are increasingly bearing the brunt of the global burden of cancer. As much as 70% of global cancer deaths occur in these countries, despite having a lower incidence of cancer compared to higher-income countries. With limited health resources allocated to chronic diseases like cancer, low- and middle-income countries are struggling to respond to the challenges cancer places on already stressed national health systems.

To address this global health gap, the Herbert Irving Comprehensive Cancer Center (HICCC) and ICAP at Columbia University have come together to form the ICAP-HICCC Cancer Initiative (IHCI), a platform for training, research, education, and programs focused on cancer prevention and management.

The HICCC, designated as a Comprehensive Cancer Center by the National Cancer Institute since 1979, brings together leading experts across cancer care and basic, clinical, and population-based research to reduce the burden of cancer across the globe. Long a leader in population sciences and public health, the HICCC has extensive ongoing research in more than 15 countries dedicated to understanding and addressing the outsized burden of cancer that low and middle-income countries bear.

The HICCC leads several studies focusing on how HIV infection affects the care of patients who have epithelial cancers, or cancers that arise in the linings of organs such as breast cancer and colorectal cancer, which make up 80-90% of all cancer cases. At the HICCC, the new global initiative will be housed within the dedicated Cancer Population Science program, made up of nearly 50 top cancer researchers under the joint leadership of Dawn Hershman, MD, MS, Regina Santella, PhD, and Mary Beth Terry, PhD, focused on primary prevention, early detection, health outcomes, and the delivery of cancer care to diverse communities.

Dr. Anil K. Rustgi, director of the Herbert Irving Comprehensive Cancer Center (Photo: Barbara Alper)

“We are committed to reducing the burden of cancer on patients and their loved ones not only in our local communities, but in communities across the globe,” says Anil K. Rustgi, MD, director of the HICCC interim executive vice president and dean of the Faculties of Health Sciences and Medicine at Columbia University Irving Medical Center. “In partnership with ICAP, a leader in global public health, our new initiative will build on the expertise of our researchers and the enormous accomplishments of ICAP in creating better and more accessible health services in communities around the world.”

Wafaa El-Sadr, MD, MPH, MPA, founder and global director of ICAP and member of the HICCC.

A major global health organization that has been improving public health in countries around the world for nearly two decades, ICAP works to transform the health of populations through innovation, science, and global collaboration. Based at Columbia Mailman School of Public Health, ICAP has projects in more than 30 countries, working side-by-side with ministries of health and local governmental, non-governmental, academic, and community partners to confront some of the world’s greatest health challenges.

“A rise in cancer incidence is an emerging challenge that many of the countries where we work are ill-prepared to confront,” says Wafaa El-Sadr, MD, MPH, MPA, founder and global director of ICAP. “Through this groundbreaking collaboration with the HICCC, we have the opportunity to bring the lessons of cancer prevention, early detection and effective management to settings where they are urgently needed.”

Working to address major gaps in cancer screening, prevention, and management in low- and middle-income countries, the IHCI will launch programs that draw on the HICCC’s expertise in cancer research and care and ICAP’s expertise in capacity building, laboratory science, implementation science research and training. The IHCI will span between the Columbia campus and key countries where ICAP works, with programs aimed at building global cancer research at Columbia as well as establishing a hub for cancer research, training and programming. The hub will provide opportunities for training and mentorship on cancer prevention and management for health workers, as well as expanding training opportunities at Columbia focusing on oncology and public health. The IHCI will also serve as a global launching point for multidisciplinary research studies on prevention and early detection of cancer.

“With the far-reaching impacts of the COVID-19 pandemic, it is a critical time for this new initiative,” says Dr. Rustgi. “The disruption of health services and delays in screening and other care because of COVID could significantly increase the burden of cancer, particularly in low- and middle-income countries. The time to act is now.”