NEWS

Global Player in Cancer Research: IARC Celebrates Its 40th Anniversary

Sabine Steimle

In 1965, France, Germany, the United States, Italy, and the United Kingdom spearheaded an effort to create the International Agency for Research on Cancer (IARC), which formally came into existence by a resolution of the 18th World Health Assembly. "Only little was known about cancer and its causes in those days, and with the creation of the IARC, the World Health Organization officially recognized cancer as a public health issue," said Andreas Ullrich, M.D., officer for cancer control at the WHO headquarters in Geneva, Switzerland.

The agency celebrated its 40th anniversary in May. Now, 300 researchers and administrative personnel are on staff to carry out IARC's mission of coordinating and conducting research on the causes of cancer and the mechanisms of carcinogenesis, and developing scientific strategies for cancer control.

"One of the agency's main tasks is to provide the World Health Organization and its member states with scientific evidence that enables the development of effective cancer control programs and public health strategies to fight this disease," said Peter Boyle, Ph.D., director of IARC.



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Peter Boyle

 
Boyle, who was elected to his position in 2003, reshaped the agency's scientific structure by creating five research clusters: biostatistics and epidemiology, epidemiology and biology, molecular carcinogenesis, genetics and epidemiology, and pathogenesis and prevention.

In the international cancer community, IARC is arguably best known for its monographs on the evaluation of carcinogenic risks in humans. Within this program, a series of consensus classifications of carcinogenicity are developed and published by top-ranking international cancer experts from diverse scientific backgrounds.

Since the program's inception in 1971, the carcinogenic hazards of 900 agents have been evaluated, including chemicals, occupational exposures, pharmaceutical treatments, lifestyle factors, and physical and biological agents. Some of the monographs have affected national and international health policies: "The results of IARC's monograph meeting on Tobacco Smoke and Involuntary Smoking, published in 2004, for instance, paved the way for legislation in Ireland [that] banned smoking in bars, restaurants, and public places to protect the health of workers in these industries," said Kurt Straif, M.D., Ph.D., a senior scientist with IARC's monograph program. The monograph's conclusions confirmed the cancer-causing effect of active smoking and added more sites to the list of cancers that smoking causes.

The message of the tobacco monograph also hastened the coming into force of the first-ever World Health Organization Framework Convention on Tobacco Control (FCTC), which went into effect in February of this year (see related story, p. 1404). The contracting parties of the FCTC are bound by the treaty's provisions to develop public health strategies to reduce the demand for tobacco and to protect people from exposure to secondhand smoke.

In the field of descriptive epidemiology, IARC is considered a global player: "It is the only institution that collects, evaluates, and makes available data on incidence, mortality, and prevalence of 27 different cancer types in every country in the world," said Paola Pisani, Ph.D., acting head of the agency's Descriptive Epidemiology group.

In the early days of IARC, few population-based cancer registries existed. Today the agency evaluates data from 600 registries worldwide, most of which are supplied by members of the International Association of Cancer Registries (IACR), a nongovernmental organization that has official relations with the World Health Organization and is administrated by IARC.

Pisani explained that in the coming years the number of cancer registries will continue to increase. "As a result of rising cancer rates in medium- and low-resource countries, the need for registries as an essential public health resource will make itself felt in these countries as well," she said. To support cancer registries worldwide, IARC has developed computer software for population-based registries. The software provides consistency checks for duplicate records to ensure high-quality data. Another major concern of Pisani's group is disseminating the results through the publication Cancer Incidence in Five Continents, which is updated every 5 years. "We plan to speed this up and supply fresh data every 2.5 years by using the most recent data available," Pisani said.

Since its creation, IARC has put a strong focus on the training and education of young researchers. "In the mid-1960s, international fellowship programs for cancer researchers did not exist. IARC was among the first institutions to provide such an opportunity," said Paolo Boffetta, M.D., Ph.D., coordinator of the Genetics and Epidemiology Cluster and in charge of IARC's fellowship and training programs. The agency started off by sending researchers to cancer centers around the world on fellowships. Once IARC was big enough, more in-house post-doc training programs were established, Boffetta said.

Rajesh Dikshit, Ph.D., a visiting scientist in IARC's Gene–Environment Epidemiology group, said that he has learned the importance of collaboration and how to develop sound designs for research studies during his fellowship. Dikshit, who will soon return to his previous post as epidemiologist at the cancer registry of Ghandi Medical College in Bhopal, India, already began a multicenter breast cancer study in his home country in collaboration with IARC to find out more about the rapid increase of breast cancer, which has become the most frequent cancer in Indian women.

IARC's membership today comprises 16 countries, among them the founding states plus Australia, Belgium, Canada, Denmark, Finland, Japan, Norway, the Netherlands, Sweden, Switzerland, and Spain. Although IARC is part of the WHO, it operates independently, because it is financed directly by its participating states that also approve its program of work. Core funding for the next 2 years will be US $40 million, and the agency may reasonably expect about half this amount additional in successful applications for competitive grant funding.

For the next few years, Boyle plans to put a much broader focus on medium- and low-resource countries: "Cancer has stopped being a disease restricted to industrialized countries. Today the majority of the world's cancer burden is in low- and medium-resource countries," he said. "Therefore, IARC needs to provide more support to these countries through its new and designated fellowship program and its ongoing research collaborations."



             
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