Methodology

IARC has established a two-level hierarchical mechanism to harmonize strategies, methods, and work processes to promote cancer prevention globally under the World Code Against Cancer Framework while developing region-specific Regional Codes Against Cancer. The World Code Against Cancer Framework benefits a broad audience of citizens, health professionals, advocates, and policy-makers.

Each Regional Code Against Cancer is a region-specific tool for cancer prevention that comprises the priorities for primary and secondary prevention of a given region, formulated as evidence-based recommendations to empower individuals to act to reduce their risk of cancer, while informing policy formulation and programmes.

The updated methodology has a robust step-by-step decision-making algorithm to be applied to review the scientific evidence, assess communication aspects, and formulate recommendations for the general public and population-level recommendations for policy-makers. The figure below shows a summary of the four sequential criteria that compose the step-by-step decision-making algorithm.

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Structure of the Regional Codes Against Cancer

Each Regional Code Against Cancer will provide the following outcomes:

  • Clear communication of the latest evidence for the general public;
  • A good framework to inform programmes and policy formulation;
  • A strong evidence base and methodology, supported by IARC, to maintain the coherence of a World Code Against Cancer Framework;
  • A basis to enable stakeholders to unite cancer prevention with consistent messages and to promote collaborative networks of regional experts.

 

Methodology - World Cancer Code

These outcomes are delivered under three levels of information:

Level 1: Two sets of region-specific recommendations, one set targeted to individuals and the community, complemented by the second set of population-level recommendations, aiming to structurally influence the systems that shape individual choices and improve the environmental conditions to which all citizens are involuntarily exposed;

Level 2: Knowledge translation outputs for different target groups (e.g. capacity-building materials for health promoters, policy briefs for policy-makers) on the topics covered by the recommendations (i.e. expanding on key aspects of primary and secondary prevention of cancer, definitions, clarifications, special target groups, international guidelines, etc.). These serve to provide additional information and explanations about each of the recommendations to foster proper dissemination across the region. The types of outputs will be project-dependent and will be decided at the outset of the project.

Level 3: Publication of the scientific justification in peer-reviewed articles, explaining the recommendations and related content for the online training, and the respective evidence base.

The content of all three levels will be developed by several working groups of independent experts from the region, focusing on:

  • Lifestyle determinants: tobacco, weight, diet, alcohol and non-alcoholic beverages, physical activity, and hormonal factors (including related prevention policies);
  • Environmental and occupational determinants: contaminants in the air, water, soil, and food; radiation; and occupations (including related prevention policies);
  • Infections: hepatitis, human papillomavirus (HPV), human immunodeficiency virus (HIV), Helicobacter pylori, etc. (including related prevention policies or health system strategies);
  • Medical interventions: screening and pharmaceutical drugs (including related prevention policies or health system strategies);
  • Communication and health literacy: health promotion and behavioural change, education, and communication and dissemination in relation to cancer prevention campaigns;
  • Literature review: systematic reviews needed to update the evidence.