Abstract: Cancer is the first or second leading cause of premature death in 134 of 183 countries, and it is estimated that global incidence of cancer will increase by 50% from 2018 to 2040. The number of cases is projected to double in countries with low Human Development Index; these countries have the least resources and infrastructure to adequately care for cancer patients. Disparities exist within countries; in the US, racial and ethnic minorities and other medically underserved populations share a disproportionate burden for many types of cancer. Most cancers can be cured if detected early and treated effectively. To reduce premature death, the World Health Organization recommends implementing early cancer detection and prevention programs at the primary care level. Yet, existing tests for early cancer detection are too complex and/or expensive to implement in primary care settings, particularly in medically underserved areas. We will establish the Center for Innovation and Translation of Point-of-Care Technologies for Equitable Cancer Care (CITEC) to identify high- priority clinical needs for POC cancer technologies; to accelerate development of effective, affordable technologies to meet these needs; to evaluate and improve the clinical and public health impact of POC technologies in diverse settings; and to train developers and users to create and disseminate more equitable POC technologies. CITEC will prioritize development of POC tests to detect cancers that arise in epithelial surfaces. Initially, we will focus on sites accessible for early detection because this is where POC technologies can have the most immediate impact. Targeted organ sites include the uterine cervix, gastro-intestinal tract (esophagus, stomach, colon, rectum, anus), and oral cavity; cancers in these sites account for 26% of global cases and 29% of global cancer deaths. CITEC builds on the highly productive 15-year collaboration between Rice University, The University of Texas MD Anderson Cancer Center, Baylor College of Medicine, and The University of Texas Health Science Center at Houston to develop and translate novel POC technologies to improve cancer care in both low- and high-resource settings. Joining with collaborators in Brazil at The University of Sao Paulo and Barretos Cancer Hospital and partners in Mozambique at The Universidade Eduardo Mondlane and Ministry of Health, we will create a collaborative center to support technology development and engage and support a global community of investigators dedicated to creating and scaling POC technologies for equitable cancer screening and diagnosis to facilitate early treatment. CITEC will support development of POC technologies to promote high priority topics of NIH cancer research, including precision approaches to prevention, screening and early detection, reducing disparities in cancer outcomes, and building a diverse workforce able to translate POC technologies from research and development to equitable implementation. CITEC will have a major impact on equitable prevention, diagnosis and early treatment of cancer in the US and worldwide, and will work with the POCTRN network to build a strong team of global partners to strengthen and sustain POC technology development.

Narrative: Early detection of cancer and pre-cancerous lesions improves outcomes and reduces the cost and pain associated with treatment. Better tools are needed to improve early detection of cancer at the point-of-care, especially in medically underserved communities. The Center for Innovation and Translation of Point-of-Care Technologies for Equitable Cancer Care (CITEC) will accelerate the development and adoption of new technologies that can be used to improve the early detection of cancer in low-resource settings in the US and globally.