Just Imagine the Impact

Session: The WHO Global Initiative for Cervical Cancer Prevention and Control

Speakers:

Edward Trimble, MD, National Cancer Institute, Senior Adviser for Global HPV and Cervical Cancer Research and Control

Warner Huh, MD, University of Alabama at Birmingham, Professor

Xiaohua Wu, MD, PhD, Fudan University Shanghai Cancer Center, Professor

Diane Yamada, MD, University of Chicago, Professor

Laverne Mensah, MD, National Institutes of Health

Robert Coleman, MD, McKesson/US Oncology Research, Chief Scientific Officer

Leaders and mentors help establish gynecologic oncology training programs around the world to meet the 90/70/90 challenge

Bright and early (by America’s clock) on Saturday morning, SGO members virtually took a seat beside International Gynecologic Cancer Society (IGCS) members and explained the current shared vision to build a world without cervical cancer. Liberally sprinkled throughout the 75-minute session were invitations to join the fight to eradicate cervical cancer by volunteering for virtual tumor boards, mentoring international fellows, and participating in teaching visits a few times annually after international travel safely resumes.

Audacious self-marketing? Nope. The virtual meeting screen’s comments bar was popping with questions like, “How can I get involved?” and “Where do I sign up?”

Driving all this interest is the 90-70-90 challenge, which the World Health Organization (WHO) set forth in 2020—with a finish date of 2030.

  • 90 percent of girls fully vaccinated by age 15.
  • 70 percent of women screened with an HPV test age 35 and again at 45 years of age.
  • 90% of women identified with cervical disease receive treatment for precancerous lesions or invasive cancer.

All of these control targets align with the ultimate goal to achieve a 30 percent reduction in mortality from cervical cancer by 2030.

Since initiating the 2030 target, 192 countries around the world have endorsed the resolution. And a key part of realizing this strategic plan involves improving access to and quality of medical treatment for women found to have invasive cervical cancer.

SGO members, working beside members of the IGCS, Asian Society of Gynecologic Oncology (ASGO), and European Society of Gynaecological Oncology (ESGO), helped develop a model curriculum for gynecologic oncology training programs. Based on the model, 12 gynecologic oncology training programs around the world have so far been established. “With sufficient volunteer help from members of SGO and other professional societies, we can grow the number of global training programs from 12 to 50+ by 2025,” said Ted Trimble, MD, MPH, Director of the National Cancer Institute’s Center for Global Health. “These training programs need volunteer mentors across all disciplines involved in the care of women and invasive cancer, including anatomic pathology, imaging, gynecologic oncology, medical oncology, radiation oncology, palliative care, and oncology nursing.”

To help leaders and mentors fine tune broader goals, IGCS conducted a survey that included international, science-based data as well as input from fellows and mentors participating in the global training programs. Here’s a quick look at the IGCS dashboard results.

Common global challenges surrounding cervical cancer care include:

  • Healthcare access, involving transportation and financial obligations
  • Necessary specialists, including gynecologic oncologist, pathologists, radiation oncologist and medical oncologists
  • Radiology and radiation oncology machines
  • Palliative/hospice care and medications
  • Chemotherapy medications

“In some sites under universal healthcare, treatment for cervical cancer patients was not covered, which seriously affected healthcare access,” said Laverne Mensah, MD, obstetrics & gynecology specialist, National Institutes of Health. As she explained further the IGCS dashboard results, Dr. Mensah added, “There are some sites where the machines were present but not functional or had a significant amount of downtime.”

The doctor also brought up several solutions that the dashboard helped pin down.

  • Increase training for gynecologic pathologist.
  • Increase availability for tele-pathology.
  • Decrease systemic factors that delay surgery
    • Increase operating room time
    • Increase availability of blood for transfusion
    • Increase availability of anesthetic agents and/or anesthesia staff

While the dashboard indicates room for improvement, the team of international mentors, local mentors, and fellows-in-training are inching closer to the 90-70-90 target. Perhaps Rene Pareja Franco, MD, gynecologist and international mentor in Columbia, said it best: “This program is unique—because it provides the opportunity to give high level education to people in countries where those resources don’t exist.”