In conversation with the first Indian Oncologist directly elected as, President of the Union for International Cancer Control (UICC, Geneva), Dr Anil D’Cruz
The Union International for cancer control (UICC) is the largest and most influential cancer organization globally that works closely with WHO and other global cancer and economic bodies and has a membership of 1200 organizations from over 172 countries. Dr Anil D’Cruz, Director, Oncology Services, Apollo Cancer Centres, Mumbai, is the first Indian Oncologist to lead this global body. As a well-recognised global leader, clinician, researcher and teacher in Head and Neck Oncology, Dr D’Cruz brings with him over 30 years of experience in the field of cancer care. Dr D’Cruz has held leadership positions and is on the board of numerous professional organizations, universities, research organisations and cancer institutions across the country and abroad. His landmark contribution on the management was neck nodes in oral cancer was awarded the prestigious plenary at the American Society of Clinical Oncology in 2015. Here he talks about his role at UICC and his vision for UICC in the coming year.
Could you tell us about the global burden of cancer and how it has changed after the COVID-19 pandemic?
The global and country-specific burden of cancer is monitored and data released in the public domain by the IARC (International Agency for Research on Cancer-WHO) as globocan data and is available as a free download on the internet. IARC releases updated figures every couple of years, the last being in mid-December.
The new estimated global cancer burden had risen to 19.3 million cases and 10 million cancer deaths. IARC estimates that globally one in five people will develop cancer during their lifetime and one in eight men and one in eleven women will die of this deadly disease.
Breast cancer, accounting for one in four cases is the commonest cancer in women globally while lung and prostate cancers are the commonest in males and together constitute a third of all male cancers.
Latest Indian data from National Cancer Registry Programme projected the number of cancer cases in India to be 1.3 million for the year 2020, with breast, lung, mouth, cervix and tongue being the five leading sites. Distressingly two-thirds of cancer in our country present at a locally advanced stage.
Since the COVID pandemic is barely a year old, it is not expected to have an appreciable change on the burden of cancer in such a short period, however, there are indications that given the impairment of regular health services, stoppage of screening programmes as well as shut down of transportation in many countries, there would be an expected stage shift towards cancer being detected late globally.
What is UICC’s role in the fight against cancer?
Union International for cancer control (UICC) is the largest and oldest international cancer-fighting NGO, founded in Geneva in 1933, with over 1200 member organisations across 172 countries. Its mission is to unite and support the cancer community, to reduce the global burden of cancer, promote greater equity and ensure that cancer control remains a priority on the global health and developmental agenda. UICC partners with over 50 organisations, associations, companies and foundations that are committed to the fight against cancer. It enjoys consultative status with the united nations economic and social council (ECOSOC) and has an official relationship with WHO, IARC, International atomic energy agency and united nation’s office on drugs and crime (UNODC). The activities of UICC are in three main domains namely advocacy (tobacco control, cervical cancer elimination), convening (world cancer congress and world cancer summit) and capacity building (Fellowship grants, CEO training programmes, master courses)
You are the first Indian to be elected President of the UICC, this is a great impetus to India’s efforts in the fight against cancer, how do you see this new role?
It is an honour to be the first Indian to be elected as the president of this great organisation. It gives me a chance to work on the mission of UICC both nationally as well as on the international stage. Many organisations within our country have been doing excellent work in the area of cancer control and I see myself strengthening their activities as well as facilitating their interaction with global organisations. Also, I would make efforts to influence leaders and policymakers to strengthen our fight against cancer.
What is your vision for your presidency at UICC?
The pandemic has impacted and shifted the focus from cancer control. However, to me, cancer must remain a top priority on the global health agenda and for countries at the national level. We at UICC will continue to lead to ensure that our advocacy messages and those of the cancer community are heard worldwide. We will work closely with our membership and further strengthen our collaboration with our strategic network organisations namely IARC, IAEA, city cancer challenge foundation, NCD Alliance, McCabe Center of Law and Cancer as well as our partners in the private sector. My dream is to engage more global health leaders from academia from across major institutions. Supporting the WHO global strategy to eliminate cervical Cancer is another of my priorities.
Also, we will support countries to ensure that they set up a robust national cancer control plans. Countering the growing challenges of the E-cigarettes and the continuous sustained fight against the use of tobacco will be other areas of priority for me in the next two years.
Convening leaders in cancer, which is one of our fortes, will be another core priority area as we adapt to the pandemic. We have already affected a shift from traditional face to face meeting to setting up virtual fellowships, workshops and webinars. Hopefully, we look at transitioning to a hybrid model of meetings in the near future.
What are the challenges you perceive in connecting global voices in cancer advocacy? How do we bring all voices together?
The biggest challenge as I see today is the uncertainties and restrictions brought about by the pandemic. Rightfully, the focus did shift to issues related to COVID 19. The financial impact of the pandemic has also affected many organisations within our community. In a survey of our members, 120 of whom responded, 3 per cent will cease operation as a result of the pandemic; 40 per cent have seen drops in income between 25 – 75 per cent, and 20 per cent have seen drop up-to 25 per cent. We do not know how long this impact will last and what 2021 has in store for us. However, our cancer community has been very resilient and are bouncing back towards pre-covid status. We plan to bring our cancer community together strongly starting with the world cancer day on February 4 when we will make sure the voice of cancer is heard loud and clear with the theme “I am and I will”. In addition, we will hold the world cancer leaders summit in October 2021 at Boston with the theme ‘Driving innovation to advance cancer control equitably’. We are designing new ways to engage members virtually in a quest to bring all voices together.
Our efforts in cancer care are concentrated in pockets around the world, how do we increase the impact of the effort to reach even the marginalised in remote locations?
Equity in healthcare is a concern world over, including in some of the most developed countries. Addressing this issue is difficult as the reasons are multi-factorial and in addition to do with socioeconomic causes which are linked to the development of the country or region. For me, I believe the best way to overcome these issues is the diagonal approach to healthcare. This includes strengthening both the primary healthcare of a region (will help in prevention, screening and early detection) as well as strengthening the centre of excellence and manpower (improving outcomes).
What would be the best ways to attract the attention of global leaders towards cancer care efforts?
As mentioned earlier, convening the world leaders and having them exchange ideas at the highest level would help attract their attention to the growing incidence of cancer as well as what needs to be done to help in its control. Also, encouraging and helping them to develop cancer control plans in their own countries would help prioritise cancer care efforts.