Cervical Cancer in Honduras
The Central American country of Honduras has a population of 9 million people and ranks as the second poorest country in the hemisphere, after Haiti. The cancer burden is high with few oncologists and almost no preventative screening. Cervical cancer is the most common cancer of any kind, and only 10% of women of screening age have Pap tests in any year. The result is that more than 50% of women diagnosed with cervical cancer die of their disease. Dr. Suyapa Bejarano from Honduras gave this presentation at NCCC Grand Rounds.
Preventing HPV in Teens
Norris Cotton Cancer Center's research in cervical cancer prevention and screening began in 2011 in the small mountain community of El Rosario, Yoro, Honduras. In partnership with local leaders and ACTS Honduras, a leadership program for teens called La Fuerza para el Futuro or The Force for the Future and coordinated by NCCC Associate Director for Community Affairs Linda Kennedy, M Ed, began to focus on preventing cervical cancer by teaching teens about how to prevent HPV and other sexually transmitted infections. Forty teens participated each year in a week-long program to increase their knowledge and help them to become health promoters in their own communities. They produced handwritten educational brochures and distributed them around the region, wrote and performed skits in remote mountaintop villages, and worked to make condoms available to teens.
Screening Women for HPV
In 2013, NCCC partnered with La Liga Contra el Cancer, a cancer hospital in the city of San Pedro Sula, Honduras to test the concept of a taking the trappings of a temporary cervical cancer screening clinic to a rural area. Would women participate? What barriers might prevent participation? Could we mitigate those barriers? And importantly, are the high risk HPV types in rural Honduras the same ones we see in the U.S.? Principal investigators Gregory Tsongalis, PhD, Tracy Onega, PhD, MA, MS, Mary Chamberlin, MD, and Suyapa Bejarano, MD, joined Kennedy and collaborated to develop a program of research questions.
Results of Screening for High Risk HPV Using Molecular Pathology
Our two-day education and screening clinic called La Gran Jornada screened 472 women from 31 villages for breast and cervical cancer. The poster summarizing our findings in high risk HPV and breast cancer has been shown at the 2014 Dana Farber Global Health Symposium and the 2014 International Cancer Congress in Melbourne, Australia. Women with disease were treated at no cost by Dr. Bejarano at La Liga Contra el Cancer.
Improving HPV Screening
In 2015, Scott Williams, PhD and Kathleen Lyons, ScD joined the NCCC Honduras group to operationalize a new PCR-based HPV screening methodology in a large factory setting.