As its establishment in early 2000, the Northern Ireland Cancer Trials Centre has significantly enhanced participation in cancer clinical trials in Northern Ireland, such that in the period between April 2013 and March 2014, a total of 1665 patients in Northern Ireland were recruited to cancer clinical trials and related translational studies, a rate that is nearly twice the recruitment target of 850 patients (10% of the incident cancers in NI)

As its establishment in early 2000, the Northern Ireland Cancer Trials Centre has significantly enhanced participation in cancer clinical trials in Northern Ireland, such that in the period between April 2013 and March 2014, a total of 1665 patients in Northern Ireland were recruited to cancer clinical trials and related translational studies, a rate that is nearly twice the recruitment target of 850 patients (10% of the incident cancers in NI). 23 This enhanced cancer clinical trial activity, underpinned by patientfocused discovery research and its translation, led to the subsequent designation of the CCRCB as a CRUK center (one of the first to be established in the United Kingdom) in 2009 and a Department of Health/CRUK Experimental Cancer Medicine Centre (ECMC) in 2007. George Mitchell, captured on a giant 10meter high banner, greet every visitor to the Centre for Cancer Research and Cell Biology (CCRCB) at Queen’s University Belfast (QUB) in Northern Ireland (NI), reflecting the aspiration to match local ambition with global collaboration to achieve better outcomes for patients with cancer. The opening of the CCRCB by Senator Mitchell represented LKB1 an important step in a capacitybuilding initiative that commenced in the mid1990s to address the fragmented and uncoordinated nature of cancer care and research in NI. == THE CHALLENGE: FRAGMENTED CANCER SERVICES AND POOR CANCER OUTCOMES == The publication of the Campbell Report in 19961highlighted significant deficiencies in cancer services in NI. For example , among patients with breast cancer, there was wide variation in treatment provision across the province. Although some patients received quality care from specialist breast cancer teams, audit data indicated that 64% of surgeons in NI had performed <10 breast cancer surgeries per year. 1Similar issues were identified for several ARS-1620 other malignancies, such that NI had the poorest cancer outcomes in the United Kingdom for the majority of cancers. 2However, as well as ARS-1620 highlighting the problems that an uncoordinated cancer care system with a limited and underresourced cancer research activity can pose, the Campbell Report1also provided a blueprint for change, recommending the development and implementation of a populationlevel cancer plan that emphasized the need for a comprehensive and coordinated researchenabled partnership approach to achieve improved outcomes for patients with cancer. Key principles of this strategy included: 1) the consolidation and expansion of cancer services within an overarching cancer center framework; 2) the production of comprehensive incidence and mortality data through a researchactive national cancer registry; 3) the introduction of robust cancer screening services; and 4) the development of an expanded research capacity to enable discovery science to be translated into clinical applications. == RESPONDING TO THE CHALLENGE: EXEMPLARS OF AN INTEGRATED PARTNERSHIPENABLED APPROACH TO IMPROVING CANCER CARE AND RESEARCH == The question remains: were the ambitions of the Campbell Report rewarded with measurable outputs of success? In the clinical setting, the introduction of a provincewide 2view mammography screening program (unlike the singleview approach that was used initially in the rest of the United Kingdom) raised attendance levels at breast screening clinics from just under 30% to nearly 80% and resulted in better detection of small invasive cancers. Breast cancer services were reorganized to ensure patients were seen by specialist teams with dedicated breast cancer surgeons rather than general surgeons with lowvolume activity as had been the case previously. Enhanced screening, in combination with this consolidation of ARS-1620 breast cancer services, yielded a decrease in breast cancer ARS-1620 mortality of 29. 6% by 2006. 3Continuing this upward trend, by 2013, survival in NI for breast cancer was the highest in the United Kingdom (81. 9%) compared with England (79. 3%), Scotland (78. 5%), and Wales (78. 2%). 4 From a public health perspective, the ability to capture NI populationlevel data through the precise development and interrogation of comprehensive populationbased cohorts, particularly in patients with cancers of the gastrointestinal tract, has yielded findings that not only increased our understanding of disease etiology but also delivered populationrelevant, practicechanging clinical interventions. The NI Barrett Esophagus Register5is to our knowledge one of the largest populationbased registries of Barrett esophagus (BE) in the world (> 13, 000), and includes every patient in NI diagnosed between 1993 and 2010. The precise evaluation of this unrivalled resource has revealed that progression from BE to esophageal cancer is lower than was previously suspected, 6thus questioning the costeffectiveness of a BE surveillance program. Research on the NI BE cohort has also revealed that smoking leads to a 2fold increase in the risk of esophageal cancer, 7emphasizing the need for smoking cessation strategies for patients with BE. The availability of populationbased cohorts for colorectal adenoma/colorectal cancer (CRC) has also contributed to research with potentially practicechanging clinical implications. 8Pharmacoepidemiological studies ARS-1620 of general practitioner databases have shown that bisphosphonates (which are increasingly used to treat osteoporosis but are potentially associated with.