Notice of Special Interest (NOSI): Dissemination and Implementation Science for Cancer Prevention and Control in Low Resource Environments

Application Due Date
Brief Description

The purpose of this Notice is to inform potential applicants of the interest of the National Cancer Institute (NCI) in supporting implementation research related to cancer prevention and control in low- and middle-income countries (LMICs). This Notice also aligns with the Global Alliance for Chronic Diseases (GACD) 2020 Cancer Call.


Cancer is a leading cause of premature death worldwide. In 2018, an estimated 18.1 million new cancer cases were diagnosed and there were 9.6 million deaths from cancer. Predictions suggest that 30 million people will die from cancer each year by 2030, of whom 75% will be in low- and middle-income countries (LMICs). This increase may be attributed to the aging of societies, the 'epidemiologic transition' in many LMICs, the high prevalence of behaviors that increase the risk of developing cancer, as well as the socioeconomic inequalities that result in delayed diagnosis or care provision and poor-quality care in many LMIC settings.

It is estimated that 30-50% of all cancers are preventable. Specifically, one-third of global cancer deaths are attributable to behavioral risk factors, such as tobacco and alcohol use, low fruit and vegetable intake, obesity, and lack of physical activity. Tobacco use alone accounts for around 22% of the cancer mortality. Around 20-25% of cancer incidence in LMICs is attributable to chronic infections, including human papillomavirus (HPV), hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), Epstein Barr virus (EBV), human T-cell leukemia virus 1 (HTLV1), helicobacter pylori, and other pathogens. Increasingly, in LMICs, exposure of humans to environmental risk factors, such as air pollution, poses an increasing challenge to health. Within high-income countries, similar patterns are seen in populations experiencing health disparities and greater exposure to cancer risk factors.

A key challenge to reducing the global burden of cancer, particularly among people in LMICs and in other populations experiencing disparities, is the poor implementation of cancer prevention and control strategies that are known to work. Implementation of effective, evidence-based interventions has been central to cancer control in many high-income countries (HICs). Yet, in LMICs and other low-resource environments, such interventions are under-used or have limited impact because of implementation challenges that have yet to be identified, researched, and addressed.