Characterization of Research Priorities Among LMICS: A Qualitative Content Analysis of Cancer Control Plans

Abstract

Background: The Cancer Resolution approved at the 2017 World Health Assembly highlighted the need to improve the evidence base for cancer prevention and control through research. Research priorities articulated in national cancer control plans can promote effective cancer control, especially in low and middle-income countries (LMIC) that bear a significant cancer burden and where local research is scarce. Understanding how LMICs address research in their cancer control plans may enhance integration of research and control efforts. Aim: We sought to systematically identify and characterize the research priorities in select LMIC cancer control plans. Methods: LMIC plans published in English and in 2016 or later, that met World Bank and Human Development Index criteria and were identified. Key terms were used to identify relevant research-related content. A systematic, inductive approach was used to examine for clusters of concepts or topics, and codes were applied to characterize the research priorities into categories, phases, types, dimensions and aspects. Results: A total of 12 LMIC plans were deemed to be eligible for the analysis. Two overarching categories of research-related content were identified: Establishing a Research Agenda (ERA), where specific types and topics of research were articulated, and Building Research Capacity (BRC), for content describing intention to plan or facilitate research. Six LMICs included a total of 67 ERA priorities involving five types of research. Health Services Research was the most frequently reported type of research (31%). The research topics in the treatment/management phase were most frequently identified (30%). Three of the six countries had the most number of ERA research priorities. A total of 126 BRC priorities were identified across five dimensions. Two BRC dimensions were most frequently proposed: Enhance Cancer Surveillance (44%) and Establish Research Infrastructure (24%), and subsequent aspect codes elucidated a range of activities. Five aspects characterized focal areas in cancer surveillance while two aspects revealed focal areas for research infrastructure. Country-specific variation in ERA and BRC priorities were seen. Priorities were mapped to illustrate the breadth and depth of research priorities in LMICs' plans. Details of the distribution of research by country and by dimensions will be discussed. Conclusion: This first comprehensive examination of research priorities in LMIC cancer plans revealed countries' commitment to incorporate research into their cancer control efforts. The extent of research-related priorities demonstrates promise for transnational research collaborations. Next steps include improved understanding of key factors in achieving successful integration of research and control efforts through cancer control plan implementation.