Exploring country priorities and contextual considerations for implementing national cancer control plans (NCCP) among participants of International Cancer Control Partnership (ICCP) ECHO.

1581 Background: Promoting NCCP implementation by low- and middle-income countries (LMICs) is key to addressing inequities in cancer outcomes and the global burden of cancer. We explored contextual factors that may influence implementation of NCCP priorities in LMICs. Methods: Seven countries participated in the 2021 International Cancer Control Partnership ECHO (R) geared toward creating a community of practice to inform NCCP implementation. Using qualitative methods, we conducted focus group discussions (FGDs) with country teams who were asked to identify NCCP priorities and provide contextual considerations around implementing these in the 12-months program. FGDs were audio-recorded, transcribed, double-coded, and underwent thematic analysis. Results: Thirty-three participants from 6 Sub-Saharan African countries and 1 country in Asia took part in 7 FGDs, including 14 physicians, 9 non-governmental organizations, 6 Ministry of Health/NCCP and 4 cancer registry representatives. All seven country teams (100%) prioritized cancer early detection, especially for cervical (71%) and breast (57%) cancer, including by educating primary care clinicians (57%) and general population (43%) about cancer signs and symptoms. Related contextual factors included late-stage diagnosis of cancer (43%) and low knowledge about cancer among primary care clinicians and the general population (29% each), respectively. Finding resources for implementation of NCCP priorities was important given lack of funding (57% each). Harmonizing programs and building partnerships for implementation (57%) was prioritized given perceived fragmentation of efforts and benefit of leveraging limited resources (29% each). Improving access to treatment (43%) was a priority given a lack of oncology specialists (29%) and unaffordable treatment (14%). Improving access to palliative care (43%), including by writing guidelines (29%), was prioritized due to late-stage diagnosis and insufficient access to palliative care (14% each). Improving cancer registry data was essential for NCCP program planning (43% each), while cancer research (43%) was key to answering specific questions related to cancer registry data (14%) and program impact (29%). Additional contextual considerations for making progress on these priorities dicussed by country teams included leveraging existing programs (100%) and learning from other countries and ICCP technical experts (57% each). Conclusions: There were similarities in country NCCP priorities and contextual factors affecting implementation. These results allow for future exploration of how LMIC country teams implement NCCPs and examine the value of communities of practice promoted by ICCP and facilitated by ECHO, towards improving cancer outcomes.