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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

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