As we mark the International Agency for Research on Cancer (IARC) 60th anniversary, this is an opportunity to reflect on our contribution to cancer evidence and action. Global cancer incidence continues to rise, with the largest proportional increases projected in countries that are the least equipped to respond. However, the central challenge is no longer only to produce evidence, but to understand why evidence is translated into policy and practice in some settings more effectively than in others. Drawing on the International Agency for Research on Cancer Impact in Practice series-30 country reports co-produced with national partners across IARC participating states-we examine how shared international cancer science influences policy and practice in national settings. Four recurrent pathways help explain that translation: (1) independent assessment that makes evidence usable under contestation; (2) surveillance that makes burden actionable; (3) sustained technical support that builds durable institutional capacity; and (4) co-governance through which countries can help to shape the science that they later apply. Across countries, IARC evidence is widely available and frequently cited, but citation alone does not ensure use. What determines whether evidence becomes embedded in policy and implementation is an enabling layer of registries, training platforms, expert participation, and governance relationships. This enabling layer is cumulative, slow to build, and most fragile in settings where the dependence on shared infrastructure is greatest. For IARC's next phase, we identify three priorities: (1) securing predictable, multiyear support for the shared scientific functions that participating states collectively rely upon; (2) evaluating the IARC medium-term strategy 2026-30 not only by output, but also by the extent to which evidence is translated into and embedded within national policy and practice; and (3) broadening meaningful participation in IARC's scientific and governance processes, so that a wide range of countries can help to shape the science they rely upon. Without renewed investment in that enabling layer, the risk is not abrupt failure but gradual erosion of the conditions that allow evidence to become action.
Schmutz et al. (Fri,) studied this question.