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The need to build on recent progress

Colombia consolidates the data, managed by

the National Cancer Institute.^46 The coverage

of the registry is about 9%,^47 and according

to Dr Murillo “the information has been used

efficiently to generate estimates for all other

departments of the country”.

Cancer research is measured through

the availability of research policies. While

there are research guidelines and policies

in a number of the countries, most experts

interviewed are not enthusiastic about the

achievements in research. In Uruguay, the

absence of clinical research on cancer is

an important challenge, notes Luis Ubillos,

president of the Society of Medical and

Pediatric Oncology of Uruguay. Bruno Nervi,

president of the Chile sin Cáncer foundation,

highlights the problem of underfunding in

Chile. For Dr Ruales, in Ecuador, “research is

very limited, and it mainly addresses clinical

themes and/or specific cases, but it doesn’t

cover factors, territorial differences or special

characteristics”. He refers to an example of

thyroid cancer exceeding the regional mean,

which has not been sufficiently investigated.

Such concerns are echoed in Chile, where “we

have the highest incidence in gallbladder and

gastric cancers in the world, but there is not

enough research about them,” adds Dr Nervi.

In the ICP review, Bolivia, Chile, Costa Rica

and Ecuador were lacking a research policy

or programme altogether. Lastly, a research

policy can be the foundation for research

activity, but it needs co-ordination for it

to actually translate into activity, notes Dr

Murillo.

Research and technical leadership are usually

driven by national cancer institutes, which play

a key, and often heroic, role in a number of

countries. Experts say that it is important that

they fulfil a role as a national benchmark for

clinical practice and knowledge. Both Dr Mitsui

and Dr Ruales note the absence of an institute

with this function in their countries. Both the

Instituto Nacional del Cáncer in Paraguay

and the Sociedad de Lucha Contra el Cáncer

del Ecuador fulfil mainly a care delivery role.

Despite the apparent lags in research, some

initiatives stand out, led by these institutions.

For example, Argentina’s Instituto Nacional del

Cáncer runs a grant programme for scientific

research in cancer.^48 Similarly, the National

Institute of Neoplastic Diseases (INEN) in Peru

shows an active research programme and

has developed a telehealth cancer support

approach (see box below).^49

Addressing risk factors

The geographical, demographic and cultural

diversity of Latin America is reflected in a

multiplicity of risk factors. These range from

risk of skin cancer due to Ecuador’s location, to

milenary food salting traditions in Peru linked

to gastric cancer, and a worrying obesity

epidemic in Mexico. These add to the common

risk factors brought along with economic

development and rapid urbanisation, such as

sedentary lifestyles, alcohol consumption and

smoking.

(^48) Argentina.gob.ar, “Asistencia financiera a proyectos de investigación”.
(^49) Instituto Nacional de Enfermedades Neoplásicas, Comité de investigación.

For Dr Ruales, in Ecuador, “research

is very limited, and it mainly

addresses clinical themes and/or

specific cases, but it doesn’t cover

factors, territorial differences or

special characteristics”.