Mapping cancer research across Central and Eastern Europe, the Russian Federation and Central Asia: Implications for future national cancer control planning

Pancreatic cancer challenge in 52 Asian countries: age-centric insights and the role of modifiable risk factors (1990-2019)

Background

Pancreatic cancer is renowned for its elevated incidence and mortality rates on a global scale. The disease burden of pancreatic cancer is anticipated to increase, particularly in Asia, due to its vast and rapidly aging population.

Methods

Data from the Global Burden of Disease 2019 were analyzed for pancreatic cancer burden across 52 countries in Asia, including the incidence, mortality, and disability-adjusted life years (DALY) for pancreatic cancer, with a focus on risk factors such as high body mass index (BMI), elevated fasting plasma glucose, and smoking. We applied the Estimated Annual Percentage Change, the Age-Period-Cohort model, and decomposition analysis to evaluate incidence trends and effects.

Results

From 1990 to 2019, both incidence and mortality rates of pancreatic cancer in Asia significantly increased, with an average annual standardized incidence rate change of 1.73%. Males consistently exhibited higher rates than females, with smoking as a key risk factor. Central Asia reported the highest rates, and South Asia the lowest. The incidence rose with age, peaking in those aged 70~74. The disease burden increased in all age groups, particularly in populations aged 55 and above, representing 84.41% of total cases in 2019, up from 79.01% in 1990. Pancreatic cancer ranked the fifth in incidence among six major gastrointestinal tumors but presented a significant growth rate of mortality and DALY.

Conclusion

With the growing, aging population in Asia, the pancreatic cancer burden is projected to escalate, bringing a significant public health challenge. Hence, comprehensive public health strategies emphasizing early detection, risk modification, and optimized treatment of pancreatic cancer are imperative.

Comparative Analysis of Central Asian Publication Activity Using SCImago Journal & Country Rank Data in 1996-2021

BACKGROUND

Central Asian countries (CACs) are less visible in the global scientific environment, despite their solid scientific nature. The current article aimed to assess the publication productivity of CACs since 1996 using SCImago Journal & Country Rank (SJR).

METHODS

This is a descriptive study. The SJR portal was used to retrieve the data. The Country Rankings section was viewed, and the Asiatic Region option was chosen. The most active countries and CACs' number of documents, number of citable documents, citations, self-citations, citations per document, and H index data were obtained. The number of documents from CACs was recorded annually to determine the ten-year trend (2012 to 2021). Scientific categories in which CACs were prolific were defined.

RESULTS

Between 1996 and 2021, 18,336,647 documents with Asian region origins were produced. The most active countries in the Asiatic Region were China (1st), Japan (2nd), India (3rd), South Korea (4th), and Taiwan (5th). According to the number of documents, Kazakhstan ranked 15th, Uzbekistan 19th, Kyrgyzstan 24th, Tajikistan 27th, and Turkmenistan 31st among the Asiatic Region countries. The total number of documents originating from CACS, which was 1,616 in 2012, increased to 9,780 in 2021 with an upward trend (6.05 fold increase).

CONCLUSION

Despite a rising number of articles, CACs are not at the forefront of scientific productivity in the Asiatic Region. Kazakhstan is the leading country in scientific productivity among CACs. Nonetheless, the increasing quantity of articles from CACs over the last ten years suggests that these countries have the infrastructure and human resources to enhance scientific research and production.

European Groundshot-addressing Europe's cancer research challenges: a Lancet Oncology Commission

Cancer research is a crucial pillar for countries to deliver more affordable, higher quality, and more equitable cancer care. Patients treated in research-active hospitals have better outcomes than patients who are not treated in these settings. However, cancer in Europe is at a crossroads. Cancer was already a leading cause of premature death before the COVID-19 pandemic, and the disastrous effects of the pandemic on early diagnosis and treatment will probably set back cancer outcomes in Europe by almost a decade. Recognising the pivotal importance of research not just to mitigate the pandemic today, but to build better European cancer services and systems for patients tomorrow, the Lancet Oncology European Groundshot Commission on cancer research brings together a wide range of experts, together with detailed new data on cancer research activity across Europe during the past 12 years. We have deployed this knowledge to help inform Europe's Beating Cancer Plan and the EU Cancer Mission, and to set out an evidence-driven, patient-centred cancer research roadmap for Europe. The high-resolution cancer research data we have generated show current activities, captured through different metrics, including by region, disease burden, research domain, and effect on outcomes. We have also included granular data on research collaboration, gender of researchers, and research funding. The inclusion of granular data has facilitated the identification of areas that are perhaps overemphasised in current cancer research in Europe, while also highlighting domains that are underserved. Our detailed data emphasise the need for more information-driven and data-driven cancer research strategies and planning going forward. A particular focus must be on central and eastern Europe, because our findings emphasise the widening gap in cancer research activity, and capacity and outcomes, compared with the rest of Europe. Citizens and patients, no matter where they are, must benefit from advances in cancer research. This Commission also highlights that the narrow focus on discovery science and biopharmaceutical research in Europe needs to be widened to include such areas as prevention and early diagnosis; treatment modalities such as radiotherapy and surgery; and a larger concentration on developing a research and innovation strategy for the 20 million Europeans living beyond a cancer diagnosis. Our data highlight the important role of comprehensive cancer centres in driving the European cancer research agenda. Crucial to a functioning cancer research strategy and its translation into patient benefit is the need for a greater emphasis on health policy and systems research, including implementation science, so that the innovative technological outputs from cancer research have a clear pathway to delivery. This European cancer research Commission has identified 12 key recommendations within a call to action to reimagine cancer research and its implementation in Europe. We hope this call to action will help to achieve our ambitious 70:35 target: 70% average 10-year survival for all European cancer patients by 2035.

How does academia respond to the burden of infectious and parasitic disease?

Background

Academic research is one of the main avenues through which humans can fight the threat of infectious diseases. However, there have been concerns regarding whether the academic system has provided sufficient efforts to fight infectious diseases we potentially face. Answering these questions could contribute to evidence-based recommendations for setting research priorities and third-mission policies.

Methods

With a focus on one of the most common categories of communicable diseases, infectious and parasitic diseases (IPDs), we searched Web of Science for articles and reviews relevant to IPDs published during the period 2000–2019 and retrieved WHO data on disease burden in corresponding years. The academic response patterns were explored by IPD subcategory and by human development level (an index established by the United Nations). We conduct the analysis in particular to gain insight into the dynamic relationship between disease burden and research effort on IPDs, scientific efforts contributed by countries with different development levels, and the variation trends in international joint efforts.

Results

The greatest burden of IPDs is clustered in the developing regions of Africa, but has received academic response from both developed and developing countries. Highly developed countries dominate the ranks of academic research in this area, yet there is also a clear increase in research efforts from the countries most affected, despite their low human development scale. In fact, the overall analysis reveals an improved capability for addressing local problems from African regions. In terms of international collaboration, highly developed countries such as the United States and United Kingdom have commonly collaborated with needy regions, whereas prolific but developing nations, like China, have not.

Conclusions

From a global perspective, academia has positively responded to health needs caused by IPDs. Although the relevant research output contribution is primarily from the highly developed countries, concentrated and specialized efforts from the undeveloped regions to ease their local burden can be clearly observed. Our findings also indicate a tendency to focus more on local health needs for both developed and undeveloped regions. The insights revealed in this study should benefit a more informed and systemic plan of research priorities.

Quantifying geographical accessibility to cancer clinical trials in different income landscapes

Background

Clinical trials are increasingly perceived as a therapeutic opportunity for cancer patients. Favoring their concentration in few high-expertise academic centers maximizes quality of data collection but poses an issue of access equality. Analytical tools to quantify trial accessibility are needed to rationalize resources.

Materials and methods

We constructed a distance-based accessibility index (dAI) using publicly available data on demographics, cancer incidence and trials. Multiple strategies were applied to mitigate or quantify clear sources of bias: reporting biases by text mining multiple registries; reliability of simple geographical distance by comparison with high-quality travel cost data for Italy; index inflation due to highly heterogeneous cancer incidence by log-transformation. We studied inequalities by Gini index and time trend significance by Mann–Kendall test. We simulated different resource allocation models in representative countries and identified locations where new studies would maximally improve the national index.

Results

The dAI approximated well a more realistic but not widely applicable travel cost-based index. Accessibility was unevenly distributed across and within countries (Gini index ∼0.75), with maximal inequalities in high- and upper-middle-income countries (China, United States, Russian Federation). Over time, accessibility increased but less than the total number of trials, most evidently in upper-middle-income countries. Simulations in representative countries (Italy and Serbia) identified ideal locations able to maximally raise the national index.

Conclusions

Access to clinical trials is highly uneven across and within countries and is not mitigated by simple increase in the number of trials; a rational algorithmic approach can be used to mitigate inequalities.

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Accessibility to cancer clinical trials grew less than total number of trials over time in upper-middle-income countries.

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Accessibility is unevenly distributed, with maximal inequalities in high- and upper-middle-income countries.

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Simulation of resource allocation can identify ideal locations able to raise the national accessibility index.

Mapping and Visualization of Cancer Research in Indonesia: A Scientometric Analysis

Introduction

The incidence of cancer and its prevalence are increasing in Indonesia. It is crucial to ensure national cancer policies are evidence-based and promote research. While cancer research is being conducted across Indonesia, the extent and focus of research activities are not known, with no existing synthesis of the cancer research landscape. We seek to address this gap by characterising trends in the extent and types of cancer research conducted in Indonesia.

Methods

Scientometric study using descriptive analyses to determine annual growth patterns in publications across all cancer research literature from Indonesia. We developed a classification system for both research type and study design which was applied to all included publications. A visualisation software tool (VOSviewer) was used to explore the geographical distribution of research activity. The Wilcoxon rank-sum test was used to determine the influence of international collaboration on the impact factor of journals in which articles were published.

Results

We retrieved 1773 cancer-related articles published by Indonesia-affiliated authors from 1961 to 2020, with notable year-on-year increases in the annual total number of published articles since 2015. Most articles (84.0%) were published by authors affiliated with institutions on Java Island. The most commonly published article type was basic research and discovery science (28.8%), using a one-group analytical study design (28.8%). International collaboration was significantly correlated with a higher h-index of the journal in which research was published (P < .0001, r = .317).

Conclusion

An increase in the number and range of topics explored in cancer-related publications over time was identified. The summary of the current corpus of cancer-related research for Indonesia can be used to direct the development of the national cancer control plan alongside informing the national cancer research strategy. Our novel and feasible scientometric approach can be used to direct future national and regional mapping of cancer research.

Peer Reviewers in Central Asia: Publons Based Analysis

BACKGROUND

The five Central Asian republics comprise of Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. Their research and publication activities are gradually improving but there is limited data on how good their peer reviewing practices are.

METHODS

We have use the Publons database to extract information on the reviewers registered including the number of verified review, Publons award winners, and top universities in the domain of peer reviewing. This has been analysed overall and country wise.

RESULTS

Of 15,764 researchers registered on Publons, only 370 (11.7%) have verified records of peer-reviewing. There are 8 Publons award winners. There is great heterogeneity in the number of active reviewers across the five countries. Kazakhstan and Uzbekistan account for more than 90% of verified reviewers. Only Kazakhstan has more than 100 active reviewers and 6 Publons award recipients. Amongst the top 20 reviewers from Central Asia, half of them are from the Nazarbayev University, Nur-Sultan, Kazakhstan. Three countries have less than 10 universities registered on Publons.

CONCLUSION

Central Asia has a good number of peer reviewers on Publons though only a minority of researchers are involved in peer reviewing. However, the heterogeneity between the nations can be best dealt with by promoting awareness and international networking including e-learning and mentoring programs.

Advancing Breast Cancer Advocacy in Eastern Europe and Central Asia: Findings From Women's Empowerment Cancer Advocacy Network (WE CAN) Summits

PURPOSE

Breast cancer civil society organizations have emerged in Eastern Europe and Central Asia to raise awareness about cancer as a survivable disease and provide patient support. We explored the experiences and priorities of these organizations with the goal of making recommendations to advance cancer advocacy and improve cancer care.

METHODS

We conducted in-depth interviews and focus group discussions with representatives of civil society organizations attending the 7th Women's Empowerment Cancer Advocacy Network Summit in Romania in 2015. Interviews were audiorecorded, transcribed, coded, and analyzed for key themes. Findings were discussed at the 8th Women's Empowerment Cancer Advocacy Network Summit in Ukraine in 2017 to ensure accuracy.

RESULTS

We conducted nine in-depth interviews and three focus group discussions with a total of 36 participants. Survivor- and oncologist-led organizations played an important role in filling existing gaps in public health care systems through awareness raising, patient support, and advocacy to improve early detection and access to treatment. Barriers to these efforts included persistent stigma, mistrust of patients toward the public health care system, limited access to evidence-based guidelines, difficulty adapting existing best practices to their setting, and insufficient involvement of policymakers. Key facilitators of advocacy efforts included effective local and international partnerships with physicians, like-minded organizations, and policymakers to facilitate access to educational resources, improve breast cancer early detection and care, and catalyze meaningful policy change.

CONCLUSION

Our findings highlight the value of providing opportunities for advocates to connect and share experiences. To advance cancer advocacy and improve cancer care, the following needs were identified: dissemination of resource-adapted information for improving outcomes; needs assessments; improved program-monitoring practices; and fostering and promotion of collaboration between advocates, medical professionals, and local governments.

Research on lung cancer and its funding, 2004-2018

Although smoking is declining in high-income countries, the relative burden from its most well-known consequence, lung cancer, continues to increase, especially in low-income countries. We examined the amount, types, geographical origins and funding of research on lung cancer as revealed by papers in the Web of Science over the 15 years, 2004–2018. The annual number of lung cancer research papers increased over the study period from 2,157 to 8,202, but as a percentage of all biomedical research in Western Europe and North America they only accounted for one-eighth of the percentage of the disease burden. Lung cancer increased its share of cancer research from 4.4% to 6.5%, mainly because of the greatly expanded output from China in 2014–2018 which published almost one-third of the world’s total on a fractional count basis. For almost all other countries, their lung cancer presence in cancer research has declined over the 15 years. However, only 15% of the Chinese papers were co-authored internationally and its research was focussed on treatment rather than prevention. Support for lung cancer research is primarily from the government rather than charity. There is therefore an urgent need to increase support for lung cancer research, and for more international collaboration, especially in low-income countries where the disease burden is growing rapidly, and in neglected domains, such as screening and palliative care.

Cancer research in the 57 Organisation of Islamic Cooperation (OIC) countries, 2008-17

Background and objectives

The 57 countries of the Organisation of Islamic Cooperation (OIC) are experiencing rapid increases in their burden of cancer. The First Ladies Against Cancer meeting at the 2016 OIC meeting in Istanbul committed to the importance of cancer control and the need for more evidence to support national cancer control planning (NCCP). Strong research systems are a crucial aspect of NCCP, but few data exist to support policy-makers across this political grouping

Methodology

We identified all cancer research papers from OIC countries in the Web of Science from 2008 to 2017 with a filter based on journal names and title words, with high precision and recall. We analysed the country outputs, the cancer sites investigated, the types of research, sources of funding and the citations to the papers.

Results

There were 49,712 cancer research papers over this period. The leading countries in terms of output were Turkey, Iran, Egypt and Malaysia, but the most cited papers were from Qatar, Indonesia and Saudi Arabia. International collaboration was low, except in Qatar and the United Arab Emirates. The site-specific cancers accounting for most research were breast and blood, correlating with their disease burden in the OIC countries, but lung, cervical and oesophageal cancers were relatively under-researched. Most funding from within the OIC countries was from their own university sector.

Conclusion

Cancer is seriously under-researched in most of the OIC countries. This will undermine the ability of these countries and OIC as a whole to deliver on better cancer control for their populations. New policies, OIC leadership and funding are urgently needed to address this situation.

Towards a cancer mission in Horizon Europe: recommendations

A comprehensive translational cancer research approach focused on personalized and precision medicine, and covering the entire cancer research-care-prevention continuum has the potential to achieve in 2030 a 10-year cancer-specific survival for 75% of patients diagnosed in European Union (EU) member states with a well-developed healthcare system. Concerted actions across this continuum that spans from basic and preclinical research through clinical and prevention research to outcomes research, along with the establishment of interconnected high-quality infrastructures for translational research, clinical and prevention trials and outcomes research, will ensure that science-driven and social innovations benefit patients and individuals at risk across the EU. European infrastructures involving comprehensive cancer centres (CCCs) and CCC-like entities will provide researchers with access to the required critical mass of patients, biological materials and technological resources and can bridge research with healthcare systems. Here, we prioritize research areas to ensure a balanced research portfolio and provide recommendations for achieving key targets. Meeting these targets will require harmonization of EU and national priorities and policies, improved research coordination at the national, regional and EU level and increasingly efficient and flexible funding mechanisms. Long-term support by the EU and commitment of Member States to specialized schemes are also needed for the establishment and sustainability of trans-border infrastructures and networks. In addition to effectively engaging policymakers, all relevant stakeholders within the entire continuum should consensually inform policy through evidence-based advice.

Global burden of breast cancer and attributable risk factors in 195 countries and territories, from 1990 to 2017: results from the Global Burden of Disease Study 2017

BACKGROUND

Statistical data on the incidence, mortality, and burden of breast cancer and the relevant risk factors are valuable for policy-making. We aimed to estimate breast cancer incidence, deaths, and disability-adjusted life years (DALYs) by country, gender, age group, and social-demographic status between 1990 and 2017.

METHODS

We extracted breast cancer data from the 2017 Global Burden of Disease (GBD) study from 1990 through 2017 in 195 countries and territories. Data about the number of breast cancer incident cases, deaths, DALYs, and the age-standardized rates were collected. We also estimated the risk factors attributable to breast cancer deaths and DALYs using the comparative risk assessment framework of the GBD study.

RESULTS

In 2017, the global incidence of breast cancer increased to 1,960,681 cases. The high social-development index (SDI) quintile included the highest number of breast cancer death cases. Between 2007 and 2017, the ASDR of breast cancer declined globally, especially in high SDI and high middle SDI countries. The related DALYs were 17,708,600 in 2017 with high middle SDI quintile as the highest contributor. Of the deaths and DALYs, alcohol use was the greatest contributor in most GBD regions and other contributors included high body mass index (BMI) and high fasting plasma glucose.

CONCLUSION

The increasing global breast cancer burden is mainly observed in lower SDI countries; in higher SDI countries, the breast cancer burden tends to be relieving. Therefore, steps against attributable risk factors should be taken to reduce breast cancer burden in lower SDI countries.