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Global review finds wide gaps in finance, research and equity in national cancer control plans
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Summary
A global review led by the International Cancer Control Partnership found that while many national cancer control plans include prevention and screening strategies, large gaps remain in financing, clinical trials, radiation oncology, health equity goals and meaningful involvement of people with lived cancer experience.
A global review of national cancer control plans (NCCPs) presented during a National Cancer Institute Center for Global Health seminar found that most countries include prevention and screening strategies but many lack actionable plans for financing, research funding and equity.
"Plans help increase financial, political and social support," Susanna Tittenbruen, global resource manager at the Union for International Cancer Control (UICC), said during the Feb. 2023 webinar hosted by the NCI Center for Global Health. The presenters represented the International Cancer Control Partnership (ICCP), the multi‑partner collaborative formed by NCI and UICC to coordinate technical assistance and knowledge sharing.
The review used an updated questionnaire applied by three independent reviewers per plan and covered documents in multiple languages. Presenters said the dataset contains more than 100 country plans (the presentation cited plans from 128 countries in the ICCP portal) and that descriptive analyses examined region, income level, human development index and rural population percentage to identify patterns.
Key findings presented by Yannick Romero, senior knowledge and advocacy manager at UICC, included: - Research and clinical trials: 81% of NCCPs referenced cancer research broadly; 45% included strategies related to clinical trials; and 42% addressed funding for research activities. - Prevention and screening: presenters reported high inclusion of actionable strategies for breast and cervical screening modalities across NCCPs. - Treatment gaps: roughly half of plans lacked explicit, actionable strategies for radiation oncology. - Financing and implementation: presenters said financing strategies improved since 2018 (an increase described in the presentation as rising from about 7% to 27% in the prevalence of financing strategies), yet more than 70% of countries still lack actionable financing strategies in their NCCPs. - Equity and stakeholder involvement: only about 14% of plans had explicit health equity goals, roughly 18% addressed universal health coverage, and involvement of people with lived experience of cancer was low (presenters cited about 17–18%). The Ministry of Finance was listed as involved in development in about 8% of plans.
Romero and colleagues also described geographic disparities: ICCP data showed a concentration of comprehensive NCCPs in the WHO European region and in high‑income countries, while low‑ and middle‑income settings were less likely to include clinical‑trial strategies and research‑funding components.
Presenters said the ICCP uses the dataset to support technical assistance. Susanna described ICCP ECHO, an NCI‑led telementoring program for implementation support, and Romero said the ICCP portal is being upgraded to an interactive map that will display country scores and indices to help planners prioritize gaps in their national context. The presenters said more than 22 requests for substudies on the dataset were made within months of publication.
During a Q&A, participants raised implementation challenges, political changes and monitoring needs. In response to questions about moving from ambitious plans to execution, presenters recommended an "implementation matrix" that specifies objectives, timelines, key performance indicators and assigned responsibilities to improve the likelihood that a plan is implemented rather than remaining a voluminous document.
Next steps described in the presentation include launching the upgraded ICCP portal (presenters said a May release and a Geneva convening of cancer planners in May were planned) and sharing forthcoming WHO monitoring and evaluation tools via the ICCP portal. Presenters encouraged collaboration and use of the ICCP dataset for substudies and technical support requests.
The presentation and dataset were described by organizers as available through the ICCP portal and the NCI Center for Global Health website. The seminar recording and resources will be posted at cancer.gov/globalhealth, the host said.
