Pilot countries / Pays fondateurs

France is the second most populous (67.4 millions) European country. Breast cancer is the most frequent cancer affecting French women with nearly 60,000 new cases annually and an incidence that has almost doubled between 1990 and 2018. Breast cancer is also the most deadly compared to all other types of cancer affecting French women. In 2012, the first subtle decline in breast cancer mortality rate was reported. This decline is continuing over the years; it has been linked to more proactive screenings and improved cancer management.

Since 2003, France has had three 5-year cancer plans. The 3rd cancer plan (2014-2019) added onto the second cancer plan 2009-2013 with four new priorities: (1) cure more cancer patients, (2) preserve the quality of life of cancer patients, (3) invest in prevention and research and (4) maximize the efficiency of health organizations. The aim of this plan was to preserve the integrity of the patient with cancer and reduce cancer incidence. The most recent strategic plan is for a decade (2021-2030) and under the responsibility of the National Cancer Institute (INCa). It was prepared based on feedback and comments from patients, researchers, health organizations and professionals, and the public community at large. The new plan articulates around fours axes, Prevention (with an emphasis on diet and the environment), Healthcare, Research (two of the goals are to strengthen networks working on primary prevention and improve prevention) and Artificial Intelligence for cancer. Since 2020, the Headquarters of the International Breast Cancer & Nutrition (IBCN) network are located in France following a first decade in the USA.

Ghana is a country in West Africa with a population of 30 million people and the home to Lake Volta, the largest artificial lake in the world by surface area. It is the world’s second largest cocoa producer and one of the world's largest gold producers.

  Considering the absence of a national cancer registry in the country, hospital based data have indicated that cancer is the fourth cause of death, with the five most common cancers affecting the liver, the breast, the cervix, the prostate, and the stomach. Breast cancer is the leading malignancy for women accounting for 15 % of all cancers and its incidence appears to be increasing. 

Cancer care in Ghana has improved substantially in the past 10 years. Solid tumors used to be managed entirely with surgery followed by some form of chemotherapy, or by chemotherapy alone. However, since radiotherapy was introduced to Korle Bu Teaching Hospital in 1997 and to Komfo Anokye Teaching Hospital in 2004, multidisciplinary approaches with some adjuvant treatments and palliative care strategies have enhanced cancer management in the country. Despite these advances, however, most patients with cancer still present at late stages, because of personal factors and deficiencies in the general health-care system. Currently, Ghana faces several challenges to cancer management, including a scarcity of trained professionals and the prohibitive costs of investigations and treatments.

Breast cancer incidence has been on the rise in Lebanon and many middle and low income countries in the region. In Lebanon, breast cancer has a higher prevalence than in most other countries of the region, especially amongst younger women (35-50 years old).  As a result, there is a growing interest in raising awareness about breast cancer causes, early detection and prevention.  There are several research projects ongoing at the American University of Beirut (AUB) that focus on breast cancer. Among other studies, the investigation of blood-based microRNA profiles in the population is seeking to decipher mechanisms of breast cancer progression.  The AUB is actively engaged, through NGOs, in raising awareness of the public, including the younger generation, about cancer, cancer prevention and cancer research. The International Breast Cancer and Nutrition (IBCN) vision aligns with Lebanon’s national directives in combatting the disease through prevention campaigns and supporting capable multidisciplinary research teams.  Besides this, the IBCN network provides Lebanon a unique access to expertise and knowledge sharing forums that include other member countries that would not have been available otherwise.

  Lebanon has several ongoing collaborative research projects and initiated student exchange with member countries. A local organizing committee has been set up for that purpose and other interdisciplinary research teams have assembled and participated in grant writing with IBCN member countries and countries in the region. The intent is to look into lifestyles and cultural dietary habits and understand how they affect the genomic imprints in populations at risk and the incidence of breast cancer. This is the tenth year that Lebanon is part of the IBCN group and much has been done, but more efforts are needed to secure substantial funds so that Lebanon can become an effective participant in this global effort. We are highly committed to the IBCN vision and mission and we are looking forward to the years ahead.

Taiwan is located in East Asia and is home to 23 million people of whom 2.7 million live in the capital Taipei City. Over the past few decades, cancer has been a leading cause of death in adults in Taiwan. Breast cancer is the top cause of cancer incidence and ranks fourth in terms of number of deaths among all types of cancers affecting Taiwanese women. In recent years, breast cancer has become more prevalent in younger women in Taiwan.

  In 2006, the government launched the Taiwan Biobank program to help identify causal factors and mechanisms (e.g., gene-gene interactions, gene-environment factor interactions, etc.) of common diseases, such as cancers, cardiovascular disease and diabetes. This endeavor fits in well with the vision of the International Breast Cancer and Nutrition (IBCN) network. Taiwanese scientists are currently working in partnership with the IBCN to pursue research on the primary prevention of breast cancer.  

The United States is the fourth-largest country by total area and third largest country by population (0.3 billion). It is one of the world’s most ethnically diverse and multicultural nations. 

Breast cancer is the most common cancer among American women. About 1 in 8 women will develop invasive breast cancer over the course of her lifetime. In 1971, the USA passed the National Cancer Act, starting the “War on Cancer”. The overall incidence of breast cancer declined in the early 2000 and has remained stable since 2004; however, the incidence in breast cancer in women under 55 years of age continues to increase each year. In 2007, the world’s first normal breast tissue bank was founded in Indianapolis. In 2010, Sophie Lelièvre and Connie Weaver, two professors from Purdue University (Indiana), launched the International Breast Cancer and Nutrition (IBCN) Project to foster the development of a global community of scientists across disciplines, public health experts and stakeholders dedicated to research on the primary prevention of breast cancer.

Uruguay is the second-smallest nation in South America. It is home to 3.3 million people, of whom 1.8 million live in the capital Montevideo and its metropolitan area.

Cancer is the second leading cause of death in adults after cardiovascular diseases in Uruguay (~ 24 %), with a profile similar to that of developed countries. Uruguay has been working on cancer prevention for long time; it was one of the first nations in the world to sign the Framework Convention on Tobacco Control (FCTC) and to develop tobacco control policies. Breast cancer is the leading cancer in terms of incidence and deaths in Uruguayan women. Health policies in primary prevention of breast cancer in Uruguay focus on promoting a healthy diet and avoiding obesity, and studies related to these topics are encouraged.

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