Developing sustainable interdisciplinary partnershipsto address cancer prevention, survivorship and end of life care in Colombia

A Lancet Oncology commission recommended that cancer control (in Latin America (LA)) needs not only the integration of prevention, screening, and high-quality diagnosis and treatment but also the full range of other services, including rehabilitation, survivorship, and palliative care1. With approximately 75% of cancer deaths occurring in LMICs by 20302 there is a need to better address cancer prevention. In Colombia, cancer is the third cause of mortality3 and between 2007-2011, there were approximately 62,818 new cancer cases per year4. With 50% of cancers caused by smoking and infection1, attention should be directed at lifestyle modification interventions (including HPV vaccine hesitancy, a global health threat5 and something that has become a significant issue in Colombia in recent years6,7,8). Comprehensive cancer care should include monitoring for recurrence, interventions to manage the long term/late effects, and coordination between specialists and primary care to ensure ongoing needs are met9. Traditionally known as survivorship research, but recently renamed `living with and beyond cancer (LWBC), this broad topic covers patients from diagnosis through treatment and survival, or palliative and end of life care (PEOLC). This interdisciplinary programme includes symptom prevention and management, late effects/long-term consequences of treatment, including social and economic consequences, health economics and health service research (e.g. new models of cancer follow-up) and arts-based approaches aimed at improving quality of life. Integration of LWBC services into standard of care needs an evidence base to inform best practices and optimal delivery models. The effect of and interplay between these factors are magnified in LMICs because access to health services, infrastructure, and resources are limited. LWBC/PEOLC challenges are driving innovations in cancer care delivery and research in developed countries such as the UK. These could be adapted (taking into consideration local context and priorities) through our proposed international interdisciplinary collaboration and shared learning. This partnership could enhance research and delivery of care for cancer patients throughout Colombia and potentially other countries in LA9. We are proposing to host a Colombian-based workshop to bring together inter-disciplinary academics, clinicians, consumers, NGOs, policy makers, service planners and insurers to develop a two pronged cancer research strategy: one focused on cancer prevention and the other on LWBC/PEOLC that are relevant and will have impact for Colombia. We will ensure we have the necessary mix of disciplines to cover the broad research strategy: oncologists, family physicians, nurses and AHPs, exercise physiologists, psychologists, and artists.