Abstract
During the 21st century, ongoing epidemics of cancer and other non‐communicable diseases can be anticipated with a high degree of certainty. The 20th century saw the rise of pandemics of non‐communicable diseases, matching the burden of morbidity and mortality that had come with wellrecognized epidemics of infectious disease. These pandemics, including lung cancer and other cancers, coronary artery disease and atherosclerosis, and chronic obstructive pulmonary disease, were driven by causal factors with global reach: cigarettes and high‐fat and high‐calorie diets, for example. Beginning in the mid‐20th century, epidemiological studies provided evidence that identified major causes of these epidemics and led to the start of disease control programs that are still in progress. Experience gained in addressing these epidemics led to evidence‐based strategies at levels ranging from interventions with individuals to programs with global reach. Now, rates of these same chronic diseases are rapidly increasing in low‐ and middle‐income countries where they were previously uncommon. Some of the increase reflects the spread of already well characterized risk factors, including smoking, high‐fat and high calorie diets, and obesity.
This presentation focuses on research approaches to non‐communicable diseases that will provide insights into factors driving the rising occurrence of these diseases around the world, while also offering evidence that can be quickly used to guide the development of control strategies. The presentation will cover historical patterns of disease occurrence, the global factors driving these epidemics, and the policy approaches to their control. Emphasis will be given to epidemiological study designs that can provide the evidence base needed for planning control programs, including multi‐country studies which come with multiple design and implementation challenges. Examples will be drawn from the multi‐country studies carried out by the International Agency for Research on Cancer (IARC), similar studies on the risks of tobacco smoking and air pollution, and pooling projects on cancer and cardiovascular disease.
Beyond the conduct of research, capacity building may be needed to develop capability to carry out multi‐country protocols. Diverse models for capacity building have been applied; now distance‐based approaches can facilitate the reach of academic institutions for training researchers. Networks of researchers can also be established as the internet now has true worldwide reach. Implementation of control programs remains a major barrier to disease control; unfortunately, the generation of research evidence does not necessarily lead to sound, evidence‐based policies.
Citation Information: Cancer Prev Res 2010;3(1 Suppl):ED05-02.
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