Cancer in Puerto Rico: disease burden, public policy, research and training.
Article Type: Perspectiva general de la enfermedad/trastorno
Subject: Cancer (Historia)
Cancer (Investigacion cientifica)
Cancer (Analisis de casos)
Authors: Ortiz, Ana Patricia
Cruz-Correa, Marcia
Pub Date: 09/01/2010
Publication: Name: Puerto Rico Health Sciences Journal Publisher: Universidad de Puerto Rico, Recinto de Ciencias Medicas Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2010 Universidad de Puerto Rico, Recinto de Ciencias Medicas ISSN: 0738-0658
Issue: Date: Sept, 2010 Source Volume: 29 Source Issue: 3
Geographic: Geographic Name: Puerto Rico
Accession Number: 234999032
Full Text: Cancer is a public health problem in both industrialized and developing countries and remains as one of the leading causes of morbidity and mortality worldwide. With the decrease in infectious disease mortality observed before the mid-20th century and the significant increase in life expectancy that have occurred in Puerto Rico, the incidence and mortality rates of cancer have increased during the past century in our population. Cancer has become the second leading cause of death in the island, after cardiovascular disease, and is the leading cause of death among men between the ages of 50 and 69 years and among women between the ages of 30 and 69 years. The epidemiology of cancer (study of the frequency, distribution and determinants of malignancies in a specific population) in Puerto Rico has distinctive patterns. For example, disparities in cancer occurrence between Puerto Rico and the United States exist, which highlight the need for conducting research that aims to elucidate the social, cultural, environmental, and biological factors that contribute to these disparities. Moreover, these disparities underscore the importance of developing a systematic and integrated approach to cancer prevention and control tailored to the specific public health and cultural needs of our population. This is in alignment with the US Department of Health and Human Services' national health objective of eliminating cancer disparities in the United States, an area that continues to be of key interest in the development of the Healthy People 2020 objectives, as disparities in cancer incidence, mortality and survival in the United States continue to exist.

In August 2004, the Law #230, approved by the Government of Puerto Rico in a three party resolution, created the University of Puerto Rico Comprehensive Cancer Center (UPRCCC), a public corporation affiliated to the University of Puerto Rico. This law established that this Center will be the organism responsible for executing the public policy related to the prevention, education, and research, as well as the clinical and treatment services related to cancer in Puerto Rico. The dual mission of the UPRCCC is: (1) To deliver the best research-driven cancer care through programs that integrate patient care, research, prevention, and education, and (2) To eradicate cancer in Puerto Rico using a multidisciplinary approach of basic, clinical, and population research. Thus, the UPRCCC is fundamental for the development of cancer control, research, and training efforts in Puerto Rico. More recently, in 2008, with funding from the Centers for Disease Control and Prevention, Puerto Rico published its first official Cancer Control Plan, a structured guide with measurable outcomes aimed at reducing the cancer burden in our population.

All of the previously mentioned initiatives will continue to be key to the progress in cancer control and research in Puerto Rico and thus, to the quality of the preventive and treatment services that we will offer to our patients. The increase in the cancer burden in Puerto Rico has been accompanied by a substantial increase in the volume of published research and federal funds to academic institutions in Puerto Rico for cancer research. Despite this advancement, areas that need our continued support and development in the years to come include:

1) continued surveillance of cancer occurrence in Puerto Rico through the Puerto Rico Central Cancer Registry, 2) development of transdisciplinary and translational cancer research that encompass all areas of the cancer control continuum (prevention, early detection, diagnosis, treatment, survivorship), 3) outreach efforts that bring scientific knowledge to the development of targeted cancer control strategies for the community, 4) development of sound cancer-related public policy, and 5) continued training of the next generation of cancer researchers and health professionals. Our ability to collaborate in multidisciplinary local and international teams will be essential to our success.

The forthcoming issue of the Puerto Rico Health Sciences Journal provides an informative summary of various research studies that are currently being conducted in Puerto Rico. The 17 articles in this issue describe diverse research areas in the cancer field including disease burden, disease prevention, correlates of cancer occurrence, diagnostic technologies and clinical management. In addition, an overview of cancer training efforts in the island is discussed. Our future as a healthy nation will require a concerted effort between government, academia and industry that lead the research, training, and public policy efforts that will ultimately result in improved cancer prevention and control outcomes for the people of Puerto Rico. We hope you find in this edition of the journal a well-rounded overview of cancer research in Puerto Rico.

Ana Patricia Ortiz PhD, MPH *[dagger] & Marcia Cruz-Correa MD, PhD* [dagger]Guest Editors, *University of Puerto Rico Comprehensive Cancer Center; [dagger]Department of Biostatistics and Epidemiology, Graduate School of Public Health & [double dagger] Department of Medicine & Biochemistry, School of Medicine, Medical Sciences Campus, University of Puerto Rico.
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