As a global community of cancer care providers in more than 100 countries around the world, ASCO is uniquely positioned to improve cancer patient outcomes worldwide—an opportunity that it has seized since the organization’s inception through numerous innovative programs. Building upon this foundation, ASCO recently launched ASCO International, an ambitious 4-year expansion of new programs, initiatives, and research opportunities to increase awareness, improve practice, and foster innovation in cancer care regardless of socioeconomic status and geographic boundaries to make cancer care a global health priority.
Fueling the flame for the expansion of ASCO’s international impact, Sandra M. Swain, MD, FACP, current ASCO President and Medical Director, Washington Cancer Institute MedStar Washington Hospital Center, has prioritized the goal of “ensuring global health equity” as part of her presidential theme, “Building Bridges to Conquer Cancer.” Noting that cancer survival rates vary significantly among countries with differing financial and infrastructural resources, Dr. Swain says, “Investment in ASCO International will help build bridges between members, organizations, and countries, regardless of geography. The goal is to provide clinicians around the world with the tools, knowledge, and training they need to achieve better care for their patients with cancer.”
ASCO’s Current International Reach
According to David M. Khayat, MD, PhD, of Pitié-Salpêtrière Hospital in Paris, ASCO’s International Affairs Committee Chair, “Although ASCO has a bold vision for improving cancer care worldwide, the organization has already made significant strides toward that goal through its educational offerings and grants and awards programs.” These programs span continents, including many low- and middle-income countries.
ASCO’s Annual Meeting is a key forum for international bridge building, with more than half of attendees coming from outside the United States. Recognizing that it is impossible for many international oncologists to travel to the Annual Meeting, ASCO works with its partner societies to bring highlights of the Annual Meeting to those individuals through “Best of ASCO International.” Faculty include a blend of national and international ASCO members who collaborate to provide scientific highlights and place those highlights into the local practice context. In addition, ASCO works with peer oncology societies to hold joint symposia that showcase oncology themes selected to fit regional needs. The International Affairs Committee reviews proposals for joint symposia on a case-by-case basis.
Education Initiatives
ASCO’s training courses serve as another vehicle to provide oncology skills and knowledge to health-care professionals worldwide. For example, in partnership with the European Society of Medical Oncology, ASCO developed the Global Curriculum, an outline of training topics that includes basic scientific principles, the management and treatment of individual cancers, psychosocial aspects of cancer, patient education, bioethics, legal and economic issues, and specific skills, such as anticancer agent administration. Ten countries have adopted the curriculum.
In addition, ASCO partners with national and regional oncology societies worldwide to provide multidisciplinary cancer management courses in low- and middle-income countries, where cancer patients are frequently treated by nonspecialists. Since 2004, this training has been conducted in 16 countries, with more than 2,500 participants.
Through similar partnerships with oncology societies worldwide, ASCO also offers palliative care courses, using the National Cancer Institute’s Education in Palliative and End-of-Life Care for Oncology curriculum, and advanced cancer courses, which train experienced oncologists in topics ranging from cancer care in the elderly to cancer genetics and cancer prevention.
Mentoring and Knowledge Exchange Programs
Meanwhile, ASCO is committed to mentoring future cancer leaders in developing countries and fostering international networks for research collaboration. To that end, the Conquer Cancer Foundation grants the International Development and Education Award (IDEA), which pairs early-career oncologists in low- and middle-income countries with leading ASCO members in the United States or Canada who serve as scientific mentors. The 205 IDEA alumni from more than 40 countries have created joint research projects with their mentors, obtained fellowships and grants, and joined ASCO’s leadership. The Foundation’s Long-term International Fellowship provides early-career oncologists in low- and middle-income countries with the opportunity to deepen the mentor-mentee relationship through a 1-year fellowship at a mentor’s institution. After completion of the fellowship, award recipients return to their home institutions to share the knowledge they gained.
ASCO’s International Cancer Corps also pairs ASCO volunteers with medical centers in low-resource countries through a partnership with Health Volunteers Oversees, a nonprofit organization committed to improving global health through education. During 1- to 4-week onsite visits, volunteers deliver lectures, provide training, and participate in rounds, fostering relationships of ongoing collaboration.
Initiatives to Advance Cancer Research
In addition to its support of international cancer research through mentoring and knowledge exchange programs, ASCO has worked to increase international participation in Foundation research awards. Between 2010 and 2012, the number of Career Development Award and Young Investigator Award applications from international candidates increased 71%.
Meanwhile, ASCO’s Journal of Clinical Oncology is read by more than 24,000 subscribers worldwide, facilitating the international dissemination of cancer research. An additional 24,000 receive the international editions available in eleven foreign languages, and special editions in English are available in India, Greece, North Africa, and the Middle East.
To help build the research skills of investigators in developing countries, ASCO partners with national and regional oncology societies worldwide to organize clinical trial workshops to disseminate best practices in study design and execution.
International Initiatives on the Horizon
“Despite the active role that ASCO has played in the global oncology community over the years, the looming challenges, particularly in low- and middle-income countries, require an even greater investment of resources to ensure that cancer care is a global health priority,” says Dr. Swain. Currently, experts estimate that a majority of new cases of cancer occur in low- and middle-income countries and that nearly two-thirds of the deaths from cancer occur in these countries. Moreover, if current trends continue, the global cancer burden will double over the next 20 years, with approximately 70% of new cancer cases occurring in low- and middle-income countries.
To address this burden, ASCO has identified priority needs that will guide the expansion of its international programs. Those areas include providing oncology instruction for non-specialists by integrating training into existing primary care structures in low-resource countries; offering innovation grants that would spur cancer control solutions for developing countries; linking members around the world in mentor-mentee pairs; and expanding the International Cancer Corps Program, which will include several new sites over 4 years.
Commenting these plans, Dr. Khayat says, “Through the continued support and participation of ASCO members, ASCO International has great potential to further help cancer professionals provide quality care in our global communities and lessen suffering for people with cancer worldwide.” ■
© 2013. American Society of Clinical Oncology. All rights reserved.
