Enhanced communication of IARC Monograph findings to better achieve public health outcomes.

Abstract

IARC Monographs are globally-recognized assessments of carcinogenicity published by International Agency for Research on Cancer and directed to national authorities as a contribution to public health. Currently, though not constraining the scope of studies examined, Monographs are declared to involve only hazard identification: a scenario which then dictates that overall evaluations involve a single sentence referencing only the likelihood of carcinogenicity. Consequently, for notable evaluations, commentators explain what particular Monographs encompass, sometimes indicating which national authority might act. However, upon examination, IARC Monographs cannot be recognized as only hazard identification because they include assessment of specified circumstances of exposure, document levels of exposure to particular agents and identify organ site(s) for tumours. Comparisons with assessments of carcinogenicity made by US National Toxicology Program and by World Cancer Research Fund indicate that Monographs represent a singular methodology, not precisely aligned with hazard identification or risk assessment. Hence, all key findings relevant to public health in particular Monographs may be prominently and accessibly communicated. Where currently documented, these findings specifically include situation(s) resulting in highest exposure and known or likely tumour site(s). Correspondingly-less reliance on commentators, and greater insight by the wider community, may be further achieved by WHO, in consultation with IARC, describing the type of national authority relevant to particular evaluations, this information being complementary to relevant Monographs. No changes in the scope, structure or content of Monographs are necessitated by such proposals. Examples of key findings, and the relevant national authority, are provided in respect of several notable Monographs.