Making the invisible visible: Oncology nursing efforts of NCI-designated cancer centers in LMICs.

An increasing majority of new cancer cases and mortality occur in low- and middle-income countries (LMICs). Nurses provide most cancer care in LMICs, yet receive limited, if any, oncology education and training. To better understand the efforts taking place to address this need, the Center for Global Health (CGH) at the US National Cancer Institute (NCI) undertook a study of global oncology nursing projects at NCI-designated cancer centers. The 62 comprehensive and clinical NCI-designated cancer centers were surveyed about the nature and scope of their efforts in strengthening oncology nursing internationally. We received responses from 43 of the 62 cancer centers, with 21centers reporting a total of 29 projects. Twenty-three of 29 projects had involvement in an LMIC. The most common types of projects were research studies and short-term intensive trainings, most of which were for discrete tasks. Unsurprisingly, of the projects that had specific foci, most focused on breast or cervical cancer, and palliative care. Of the 22 projects that reported project costs, almost 90% were under $200,000 USD, suggesting that strengthening the global cancer workforce can be done with limited expense. While this study is limited to efforts of NCI-designated cancer centers, the findings reveal limited engagements in education and training of oncology nurses, who provide most of the cancer care in LMICs, but also provide tangible areas for strengthening this workforce and improving oncology care delivery.