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LACOG fights cancer with real-world data

Only one in five low- and middle-income countries has the data necessary to drive cancer policy. The Latin American Cooperative Oncology Group strives to change that, applying SAS® Analytics to data from thousands of the region’s cancer patients to improve care and inform better health policy that saves lives

LACOG Director, Dr. Gustavo Werutsky, discusses how the clinical research cooperative is applying SAS analytics to real-world data to improve the care and treatment of Latin American cancer patients. 

According to the National Cancer Institute of Brazil, physicians will diagnose about 1.2 million new cancer cases in Brazil over the next two years. At the same time, Brazil has seen a startling rise in cancer mortality. The disease claimed the lives of more than 220,000 Brazilians in 2015, a 31 percent increase in cancer deaths since 2000.

Like other organizations around the world, the Latin American Cooperative Oncology Group (LACOG) in Porto Alegre, Brazil, recognizes the tremendous potential of applying analytics to data to advance the fight against this deadly foe. Embracing the growing Data for Good movement, LACOG is using SAS® Analytics Pro to explore data from thousands of cancer patients and develop clinical and epidemiological studies, not just in Brazil but across Latin America.

A first in Latin American cancer research

Founded in 2008, LACOG is a nonprofit research group, the first multinational cooperative group in Latin America exclusively dedicated to clinical and translational research in cancer. The network of 250 Brazilian and Latin American medical researchers – oncologists, radiotherapists and other specialists among them – conducts studies at more than 150 hospitals in 15 countries.

With the use of SAS, LACOG generates scientifically based real-world data that spans the entire patient journey, from diagnosis through treatment to mortality or survival beyond treatment. Since 2015, LACOG has generated data profiles representing nearly 4,000 patients, helping identify known roadblocks to optimal care, such as poor access to treatment, medication and preventive care. Such insights enable clinicians to better serve patients, facilitate the development of new techniques and technologies to improve cancer care, and even affect public policy.

While Latin American countries have a lower cancer incidence than in the United States and Europe, cancer mortality is markedly higher. Latin America has a 59 percent cancer mortality-to-incidence ratio (MIR) versus 43 percent in the European Union and 35 percent in the United States. Lower MIRs reflect better support of cancer screening and treatment in developed countries.

“Often, in the treatment of various types of cancer, data from developed countries are applied to local patients,” said Gustavo Werutsky, MD, General Director of LACOG and an oncologist at Pontifical Catholic University of Rio Grande do Sul. “Our work makes it possible to analyze data directly related to Brazil and the countries of Latin America, bringing research much closer to our reality.”

Identifying disparities in diagnosis and access to treatment

LACOG divides the data collection process into two stages. First, hospitals and institutions upload all cancer cases into an online platform provided by LACOG. Then, LACOG’s technical team segments and analyzes the data – sociodemographic and clinical data, age, treatment protocols, survival rates and more – to fuel specific research studies.

"All studies adhere to Brazilian law and therefore undergo the required documentation protocols, such as approval by a local and national Ethics Committee and obtaining the appropriate patient consents," explained Werutsky.

With SAS’ support, LACOG has already increased the volume of new studies by 100 percent compared to before the organization adopted SAS Analytics Pro in 2015. The decentralization of the analyses, which are now done in the office itself, has also led to greater agility.

Among its recent research, LACOG presented the EVITA cohort study at the American Society of Clinical Oncology’s (ASCO) annual meeting in Chicago, June 1-5. The study examined 800 new cases of cervical cancer – the third most common type in Brazil – diagnosed at several institutions. The study demonstrated that low income and educational levels, as well as patients' lack of interest in getting the recommended clinical screening to identify this type of disease, directly correlated to advanced-stage diagnoses. Advanced age, race (non-white) and the use of the public health system were also found to be contributing factors.

"Awareness campaigns for early detection and prevention, targeting the poor, should be government priorities," said Werutsky of the study’s findings.

On the horizon in 2018, LACOG is pursuing two major epidemiological studies on breast and lung cancer in Latin America. Involving 5,300 patients, these will be the most comprehensive studies conducted in the region to date, providing critical insights on diagnosis and treatment as well as the survival rates of patients with both diseases. The studies will analyze delays in diagnosis, lack of access to optimal therapies and survival rates in comparison to developed countries.

“Breast cancer is the most prevalent cancer diagnosis among women in Brazil, while lung cancer is the second most common cancer diagnosis among men,” said Werutsky. “Certainly the results of these studies will have significant social impacts and add valuable knowledge that contributes to advances in care and future public policy aimed at controlling disparities in care. We expect that both the government authorities and public at large will recognize these treatment and outcome disparities as serious problems and demand they be corrected so that more lives can be saved."

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