Cancer Screening and Early Detection in Low-Income Countries

Men in truck from Ocotal
The men pictured above were arriving for a men-only multi-organ cancer screening day for prostate, testicular, skin, oral, and colon cancer. They also received a referral to La Liga Contra Cancer for a clinical follow-up if appropriate.

With cancer screening, early detection, and lifestyle choices, it is generally agreed that 40-50% of cancers can be prevented. For millions of people living in low- and middle-income countries (LMIC), access to screening and early detection and information about lifestyle choices simply is not available. And, in LMICs cancer is on the rise meaning even more stress on fragile and inadequate health systems ill-equipped to treat cancer on a large scale. Prevention, early detection and lifestyle choices are essential tools to reduce the LMIC cancer burden.

Since 2013, in partnership with La Liga Contra Cancer in Honduras, Dartmouth Cancer Center has been evolving and testing brigade-style integrated multi-organ screening.

Here's the concept:

  • Plan to address targeted disease sites identified by regional oncologists.
  • Work with local leaders to invite hundreds of residents to a large-scale cancer screening event.
  • Organize the event to using branching logic to triage the attendees and identify those most at risk for cancer.
  • Develop tight connections between the local leaders and a partnering cancer center to facilitate referrals for clinical follow-up of individuals at high risk.

In 2018, Dartmouth Cancer Center named Gregory J. Tsongalis, PhD a Quinn Innovation Scholar to accelerate further development of integrated multi-organ cancer screening.

Women with Jornada poster
Linda Kennedy, the Cancer Center’s Associate Director for Strategic Initiatives & Global Oncology is pictured here with leaders of a local rural Honduran Health and Development Committee holding a translation of the scientific poster about the cancer screening study they hosted in their community; the English title is Cancer screening in rural Honduras: maximizing impact with a multi-organ screening approach and citation in Related Publications.

Related publications

Kennedy L, Tsongalis G, Case Study: Introducing PCR Testing for hrHPV in Cancer Screening in the Developing World: Case Studies and Strategies from the Field, editor Madalon Finkel, UPNE (2017).

Kennedy L, Bejarano S, Onega TL, Stenquist DS, Chamberlin MD Opportunistic breast cancer education and screening in rural Honduras, Journal of Global Oncology (2016).

Stenquist DS, Bejarano SA, Kennedy LS, Portillo S, Barrientos A, Burgos SP, Zelaya RE, Averill CE, Liu E, de Abreu FB, Burchard P, Gallagher TL, Goodrich ME, Eliasson MS, Weiss J, Mandujano C, Alford-Teaster JA, Tsongalis GJ, Onega TL, Chamberlin MD, Partnering for success: Expanding breast and cancer screening in rural Honduras one clinic at a time, Poster at 2016 Annual CUGH Global Health Conference, University of California San Francisco, Journal of Global Oncology (2016).

Onega TL, Weiss J, Eliasson MS, Alford-Teaster JA, Goodrich ME, Kennedy LS, Portillo S, Martinez Membreno M, Zelaya RE, Barrientos A, Chamberlin MD, Tsongalis GJ, Stenquist DS, Herrera O, Crespin M, Mandujano C, López Madrid R, Paz F, Steinmetz HB, Eneh PN, Bejarano SA, Cervical cancer screening in rural Honduras: Knowledge, participation and HPV prevalence, 2015 International Cancer Screening Network Meeting, Rotterdam, the Netherlands (2015).

Kennedy LS, LaRochelle EPM, Bejarano SA, Tsongalis GJ, An organized approach to multi-organ screening in rural Honduras, World Cancer Congress / UICC, Kuala Lumpur, Malaysia (2018).

Kennedy LS, Marra K, LaRochelle EPM, Chamberlin MD, Lyons KD, Bejarano SA, Tsongalis GJ, Cancer screening in rural Honduras: maximizing impact with a multi-organ screening approach  AACR Health Disparities Conference, Atlanta GA (2017).