WHO Invites ASCP to Participate in Global Cervical Cancer Care Program

Cervical cancer affects over half a million women around the globe each year, killing approximately 250,000 annually.¹ Most of these women are not diagnosed early enough, and nine out of 10 who die from cervical cancer live in low-income countries. Botswana, for example, has one of the highest incidence rates of HIV infection and cervical cancer in the world. 

Tragically, these deaths could be prevented. Cervical cancer is highly treatable, if it is detected early and managed effectively. 

Mohan S Narasimhamurthy, MBBS, faculty member and Assistant Program Director in the Pathology Department at the School of Medicine of the University of Botswana, is actively working to help improve pathology services in his country. “Effective antiretroviral treatment has resulted in increased life span for HIV positive women leading to higher incidence of cervical cancer,” he says. “Botswana has developed a comprehensive cervical cancer program. As this program evolves, robust histopathology services will play an integral role in the successful management of women with pre-invasive and invasive cervical cancer.”

In January, Dr. Narasimhamurthy attended a meeting of the World Health Organization (WHO), which convened healthcare experts, including pathologists from ASCP, to join its new initiative to eliminate cervical cancer globally. He, along with ASCP Chief Medical Officer Dan A. Milner, Jr., MD, MSc(Epi), FASCP, were invited to participate in an informal WHO group consultation on current cancer programs and diagnostics because of the new WHO cervical cancer program and WHO pediatric cancer program.

“It was truly a great experience to interact with so many experts in their respective fields of specialty from across the globe,” Dr. Narasimhamurthy says.

Dr. Milner also met with WHO Technical Officer Andre Ilbawi, MD, a cancer surgeon by training whose work at the WHO includes supporting the WHO global action plan for the prevention and control of non-communicable diseases and development of a work plan on childhood cancers, as well as programs aimed at improving health systems particularly as they relate to cancer care.

WHO’s recognition of the importance of pathologists and laboratory professionals in the cancer continuum of care stems from the core concept that diagnostics are the primary pathway to oncology care around the world.

During the meeting, WHO representatives presented data from surveys on current diagnostic and treatment data, rates of cancer in various sectors, and access to care across difference country economic levels. This was followed by presentations from Mr. Narasimhamurthy and experts from Brazil, India, Indonesia, Malawi, and Zambia on the challenges of treatment for invasive cancer, including pathology, surgery, palliative care, and radiation therapy.

“Listening and interacting with them made me realize the challenges faced by every developing country in fighting the burden of cervical cancer,” Dr. Narasimhamurthy said. “It has given me insight into the importance of interdisciplinary approaches to health. This knowledge is essential to manage the existing system while developing innovative ways to maintain sustainable diagnostic services and collaborating with other institutions across the globe to scale up pathology services.”

During the WHO meeting, working sub-groups tackled discussions about essential medicines and equipment, monitoring and evaluation, palliative care, and care pathways/organization of services. The various groups came away with action items, such as collecting evidence in each area (including publications and case studies) to support the program, review of existing and in development documents regarding policies for cancer, and recommendations about baseline and advance services.

For Dr. Milner, the big take-away from the meeting was the inclusion of pathologists in the discussion. “All too often, clinicians tackle a problem and try to develop a solution which, at the end, they realize they must return to pathology for assistance—sometimes with unfeasible plans,” he said. “WHO’s inclusion of pathologists and laboratory professionals in the initial meetings and ongoing discussions around cancer treatment for invasive cervical cancer will mean that the full plan at the end is sound across the spectrum.”

References

1. WHO Director-General calls for all countries to take action to help end the suffering caused by cervical cancer. www.who.int/reproductivehealth/call-to-action-elimination-cervical-cancer/en/. Accessed Feb. 25, 2019.

Read the February/March 2019 Update for the ASCP Center for Global Health here.