JABSOM Researchers Bring New Cervical Cancer Screenings to USAPI

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The Pacific Against Cervical Cancer (PACe) Project was developed and planned In response to the high rates of cervical cancer mortality and morbidity in the United States Affiliated Pacific Islands (USAPI) comprised of Guam, American Samoa, Commonwealth of the Northern Marianas, Republic of Palau, Republic of the Marshall Islands, and Federated States of Micronesia. The Marshall Islands cervical cancer incidence is one of the highest globally, over 8 times higher than in the United States. In Guam, the largest of the USAPI jurisdictions, cervical cancer is the fifth leading site for new cancer cases and the fifth leading cause of death among females. Guam’s cervical cancer incidence and mortality exceed that of the US overall, and the burden is highest among Chamorros and Micronesians. And this is occurring in the context that cervical cancer is totally preventable, and no woman should die from cervical cancer—we know the science and have the technology to prevent all cervical cancer. 

In conjunction with the Cancer Council of the Pacific Islands, Pacific Island Health Officers Association, the Centers for Disease Control and Prevention’s (CDC) Division of Cancer Prevention and Control invested 4 million dollars, and the Department of Interior invested $500,000 to establish a sustainable infrastructure to enable evidence-based cervical cancer screening and follow-up in both Guam and Yap State, Federated States of Micronesia to begin. Dr. Neal Palafox is the PACe Principal Investigator and Implementation Lead, the Department of Family Medicine and Community Health’s (DFMCH) Pacific Cancer Programs provides the PACe Administrative Support, and critical partners from across the globe form the core implementation teams: 

  • Community Engagement and Education Core: University of Alabama at Birmingham
  • Epidemiology and Data Core: CDC
  • Cervical cancer Medical Modelling and Micro-costing Core: Cancer Council New South Wales 
  • Medical Protocols and Laboratory Core: JhpiegoDr. Komal Soin from the DFMCH, and Dr. Ann Chang from the Department of OB/GYN served as a Colposcopy Trainer. Notably, Dr. Lee Buenconsejo-Lum was at the forefront of much of the cervical cancer prevention work in the USAPI that led to PACe Project.  

The impact of the USAPI intervention strategies has been delineated, cervical cancer country elimination policies have been developed, health care capacity and linkages in cervical cancer screening, vaccination, management and treatment have been accelerated, and the gaps in each of the systems have been identified. Most importantly, the newest evidence-based technologies using risk-based screening and management with hrHPV DNA testing have been staged up. The models and knowledge that have been generated from the PACe Project has created the models and strategies for the targeted cervical cancer elimination Pacific relevant interventions. Several of the interventions are being researched and developed. The goal of this project is to take the first step toward the World Health Organization’s cervical cancer elimination goals.