INCTR UPDATE
58 CANCER CONTROL 2021
Mission, organization and
achievements
T
he International Network for Cancer Treatment and
Research (INCTR) is an international nongovernmental
organization (NG0) that was established to address a
neglected global health problem - the ever increasing burden
of cancer in developing countries. The founder members of
INCTR included the former Institut Pasteur in Brussels and the
International Union Against Cancer, now known as the Union
for International Cancer Control (UICC). The National Cancer
Institute in the United States provided financial and technical
support and the organization began its activities in 2000.
INCTR's headquarters are located in Brussels and it has offices
and branches throughout the world. INCTR became an NGO in
Official Relations with the World Health Organization (WHO) in
January 2010.
The need for INCTR: Cancer in developing countries
Approximately 85% of the world's people live in low- or middleincome countries (LMICs). In 2012, Globocan estimated that
there were approximately 14.1 million new cases of cancer and
8.2 million deaths from cancer in the world, with 65% of deaths
occurring in LMIC. The number of cancer cases continues to rise
across the world, but much faster in LMICs because development
brings decreased mortality and with their higher fertility rates,
this rapidly translates into population growth and increased
numbers of patients with common diseases. The birth rate
subsequently declines, although population growth continues
since people live longer. Eventually birth and death rates
stabilize at a much lower level of both than was the case prior
to development. These demographic changes are accompanied
by the adoption of unhealthy lifestyles practiced in high-income
countries, particularly smoking, and increasingly, overeating and
a sedentary lifestyle.
Resources of all kinds for treating cancer are limited in
LMICs, such that patients who develop cancer frequently lack
access to a facility capable of making an accurate diagnosis and
providing appropriate therapy. There is a lack of drugs, a paucity
of radiation therapy facilities and very few cancer specialists or
other health care workers who are needed to effectively care for
cancer patients. Diagnosis may be so delayed that there is little
that can be done even if the patient does finally reach a facility
competent to care for them. Terminal care is not widely available,
and regulations and attitudes are still largely directed towards
preventing the misuse of opioids rather than relieving the pain of dying patients, such that most patients die without symptomatic
relief or little or no mental or spiritual comfort. It is estimated, for
example, that less than 1% of patients who need palliative care in
India receive it.
INCTR is unique in that it focuses only on the developing
world. It also works directly with its collaborators, sometimes
visiting them many times in order to achieve its goal of helping
to build sustainable capacity in LMICs in order to assist these
countries in cancer prevention, early diagnosis, treatment and
palliative care. It is not an advocacy organization, and all clinical
projects are coordinated by a health professional. Its output is
information collected in the field, lives saved by cancer prevention
or treatment, and improved quality of palliative care.
Who INCTR works with
INCTR utilizes healthcare professionals familiar with the
problems of developing countries to enable it to achieve its goals.
See Box 1.
INCTR develops local capacity within LMICs by training
healthcare professionals to establish "centres of excellence" in
the delivery of feasible, affordable and effective care, including
palliative care, that is considered "best practice" so that they, in
turn, can train others within their country or region.
INCTR works through its branches in implementing various
programmes and projects conducted in collaboration with partner
institutions in developing countries and monitored by field visits.
INCTR integrates research into its programmes by documenting
and evaluating actual data (rather than projected economic or
health benefits, for example). Such research may include a wide
range of projects, from cancer education for the general public
to developing treatment outcomes, including palliative care.
This, in turn, enables healthcare professionals working in LMICs
INCTR'S GOALS - MAKING A DIFFERENCE
J To reduce the incidence of cancer in resource-limited
countries through public and professional education about
the causes of cancer and how to use this information in
cancer prevention
J To detect cancer early through public and professional
education about the early signs of cancer and what to do if
they appear
J To diagnose cancer accurately through pathology training
and, where important and feasible, imaging techniques