Early Detection of Cancers in Low Resource Countries
Early Detection of Cancers in Low Resource Countries
The purpose of this study is to implement a community-based combined program for early
 detection of breast, cervical, ovarian and endometrial cancer in low-resource countries
 delivered through a free standing or a mobile Well Woman Clinic. The goals of this program
 are to downstage cancers and improve mortality rates using low-cost early detection methods.
 These programs will be implemented in regions where early cancer detection strategies are not
 in place and cancers present at advanced stages with resultant high mortality. Currently,
 there are three target project sites: Cambodia (June 2011), India (June 2011), and Brazil
 (March 2011). Memorandums of Understanding have been secured with local health organizations
 in each region to establish clinic operations. Each clinic would serve an approximate target
 population of 100,000 amongst whom about 12,000 eligible women (4-5,000 annually) will be
 invited to be screened for breast and cervical cancer over a three-year time span.
We will study the use of sonographic screening in addition to Clinical Breast Examination in
 low resource settings where screening programs are not currently in place and establishing a
 population based mammographic screening would be expensive, resource intensive, and difficult
 if not impossible to implement. The effectiveness of the screening and diagnostic methodology
 used for early detection of breast, cervical, ovarian and endometrial cancers in low resource
 settings will be studied. The program would involve screening of asymptomatic women for
 Breast and Cervical cancer and diagnostic assessment of symptomatic women for Ovarian and
 Endometrial cancer. Women in the age group of 30-59 yrs will be screened once every three
 years utilizing the following methods: Breast - clinical breast examination [CBE] and
 Sonography, followed by Fine needle aspiration biopsy (FNAB) of screen positive cases;
 Cervical - Human Papilloma Virus DNA testing followed by Cryotherapy of screen positive cases
 (Single visit, screen and treat approach); Ovarian - Transvaginal sonogram and clinical
 evaluation; Endometrial - Transvaginal sonographic assessment of the endometrial stripe.
Inclusion Criteria:

 -  Breast Cancer: women age 35-64

 -  Cervical Cancer: women age 30-59

 -  Ovarian Cancer: symptomatic post menopausal women age 50-64

 -  Endometrial Cancer: symptomatic post menopausal women age 50-64

 Exclusion Criteria:

 -  women under the age of 30