Cancer is increasingly recognized as a threat to the health of people worldwide. Current estimates are that 70% of new cancer cases will be in low- and middle-income countries by 2020. Drivers of these statistics include increasing life spans due to overall health and reductions in childhood and adult mortality; increasing obesity; higher smoking rates; and, in Africa, increasing rates of cancer associated with the growing number of long-term survivors of HIV. These trends are likely to continue. Cancer mortality rates are also higher in resource-poor economies. The goal of the Program in Global Oncology (PiGO) is to develop a robust research program that allows in- country investigators to develop data-driven approaches to the prevention and treatment of cancers of relevance in their region, as well as to develop a robust research enterprise that leverages the resources and opportunities in these countries to increase our understanding of cancer, especially those that are rare in the developed world and common in the developing world. Research conducted outside the U.S. has elucidated novel cancer risk factors, described unique molecular signatures for common malignancies, and suggested potential new strategies for cancer prevention and treatment. PiGO leverages the resources of our Cancer Center to lead effective research outside the U.S. through four Specific Aims: 1) Leverage data systems, methods and visualization to support global surveillance of cancer; 2) Expand our studies of tumors from HIV- infected and non-HIV-infected individuals to determine how and whether these cancers differ, utilizing the human and physical infrastructure we have developed in Uganda, South Africa and select areas in China; 3) Further develop a robust multidisciplinary research program to discover novel infection-related cancers, with particular emphasis on HIV-infected individuals; and 4) Develop effective in-country guidelines to improve the detection, potential prevention and treatment of common cancers found in resource poor settings. PiGO has 35 members drawn from 3 schools and 18 departments of FHCRC, UW and Children's, and $4.5M in peer-reviewed funding (direct dollars) in fiscal year 2013, of which $2.6M (49%) is from NCI. The program also has $ 21.4M (cancer-relevant portion) from the Bill and Melinda Gates Foundation. Members have published 322 papers, of which 10% are intra-programmatic, 33% are intra-programmatic and 18% are inter- institutional.
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