Sylvester Takes the Lead to Focus Cancer Research on Low Resource Countries

The Global Oncology Initiative encourages researchers at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine to develop innovative and cost-effective ways to control and treat cancer in low resource countries.

From left, researchers Rhoda K. Moise, Soroya Julian McFarlane, and Omar Picado, M.D.

“Global oncology is a new area of research and academic interest. It has developed out of a need to improve the results of cancer control and treatment in low- and middle-income countries (LMIC),” said Gilberto Lopes, M.D., Associate Director for Global Oncology at Sylvester and associate professor of clinical medicine.

Ambitious inaugural proposals from three young researchers serve as prime examples. The $25,000 grants awarded to each principal investigator will help launch projects designed to improve cancer screening, awareness, and ultimately treatment outcomes among populations with unmet needs:

Acceptability of HPV self-sampling tools for cervical cancer prevention in Jamaican women: A theory-based approach to culturally tailored message design

“I’m trying to address certain systematic barriers in terms of access to screening and the uptake of HPV screening in Jamaican women – as well as cultural barriers that prevent women from screening for cervical cancer in Jamaica,” said Soroya Julian McFarlane, a Ph.D. candidate in communication studies.

Unlike HPV vaccination studies that focus on pre-teens and adolescents, McFarlane plans to study adult women. “We have a very high burden of cervical cancer in Jamaica.” The screening rate falls well below the WHO target of 70 percent among women over 30. “Cost is one of the barriers, yes, but it’s also the interaction with the health system. They’re not comfortable getting a Pap test — it’s embarrassing and painful. There are also cultural beliefs about what HPV is.”

McFarlane is testing an HPV self-sampling tool that will allow women to screen in the privacy of their own homes. “I’m looking at whether or not that would be acceptable in the Jamaican context, and whether or not culturally tailored packaging would increase uptake.”

Haitian Cervical Cancer Screening Registry: Developing Cancer Prevention and Clinical Care Infrastructure in a LMIC in the Caribbean

This study also addresses prevention of cervical cancer – this time among Haitian women living in Miami and Haiti. “Since Miami has the biggest enclave of Haitians living in the U.S., that information will be informative to develop qualitative interviews of both patients and providers in Haiti,” said Rhoda K. Moise, a Ph.D. candidate in the Department of Public Health Sciences.

Identifying barriers to cancer prevention, targeting areas for improvement and developing strategies to increase screening in this population are among the goals.

Moise is partnering with the Ministry of Health in Haiti as well as several non-governmental organizations. “It’s a coalition approach. With community-based participatory research, we have a number of partners on the ground … a consortium of groups committed to cervical cancer prevention.”

Cancer Patterns and Trends in Costa Rica

Determining the epidemiology and extent of the current burden of cancer in Costa Rica is the goal of a third Global Oncology Initiative grant.

“Costa Rica is facing a double burden of disease. They have higher rates of lung, breast and colorectal cancers, but also a number of infectious-disease related cancers, like gastric cancer and hepatocellular carcinoma,” said Omar Picado, M.D., of the Jay Weiss Institute for Health Equity at Sylvester.

Picado plans to create a website to update researchers on the incidence, mortality and population risk factors for various forms of cancer in the country. “This tool will provide researchers in Costa Rica and even for the government to create policies for cancer prevention and control.” The ultimate aim is to help researchers and public health officials focus their efforts and resources on the most effective strategies for cancer control and treatment.

‘Extremely Well Situated’ to Identify Solutions

The Global Oncology Initiative aligns with a mission of University of Miami President Julio Frenk to ensure the University serves as a hemispheric academic center. “Miami is the gateway to the Americas,” Lopes said. “We have researchers, students and patients that come from the Caribbean and Latin America. We are extremely well situated.”

Faculty members also want to give back and solve problems in their countries of origin, Lopes said.

The Initiative provides these young researchers the tools and skills they need for promising careers in medical research. “For right now, it’s a pilot grant so we can generate initial data that we can apply to external, peer-reviewed research,” Lopes said. “The results generated in these studies should help them move on and try to get NIH funding and other types of independent grant sources.”

Tags: Dr. Gilberto Lopes, Global Oncology Initiative, Sylvester Comprehensive Cancer Center