A call to action in South Texas
Since its introduction in the 1940s, the Pap test has been successfully detecting abnormal cells in the cervix that, if left untreated, could lead to cancer. In fact, that success has led to a 70% drop in cervical cancer rates in the United States.
But in Texas’ four southern-most counties lining the Texas-Mexico border, the cervical cancer death rate is 30% higher than the rest of the state. Lack of resources is the culprit, says Kathleen Schmeler, M.D., associate professor in Gynecologic Oncology and Reproductive Medicine.
“Seventy percent of the population in the region is uninsured, and the number of public hospitals serving the uninsured is zero,” says Schmeler. “Residents there are at a huge disadvantage.”
It’s especially tragic when women in these underserved Rio Grande Valley counties are diagnosed with incurable cervical cancer, Schmeler says, because the disease is almost always 100% preventable when detected early with a simple Pap test or another test developed in 2011 that detects the presence of the human papillomavirus (HPV) — the cause of almost all cervical cancer cases.
MD Anderson intensifies efforts to prevent cervical cancer
in the Rio Grande Valley
The second program is Project ECHO (Extension for Community Healthcare Outcomes), which uses a Skype-like video conferencing program to link
MD Anderson faculty in Houston with Rio Grande Valley clinicians. Houston doctors connect on screen and in real time with Valley providers to discuss patient cases and teach medical techniques.
With this latest round of funding, Houston doctors will teach Rio Grande Valley clinicians how to perform three medical procedures commonly employed when a patient’s Pap or HPV tests are abnormal: colposcopy (examination of the cervix with a special magnifying device), cervical biopsies (removal of a small sample of tissue from the cervix for further examination), and LEEP (loop electrosurgical excision procedure), which uses a thin, low-voltage electrified wire loop to cut out precancerous tissue.
“There are very few providers in the lower Valley who perform these procedures in medically underserved patients,” says Ellen Baker, M.D., Project ECHO director.
The Project ECHO initiative will also enlist the services of Su Clinica Familiar — a Federally Qualified Health Clinic serving the poorest segment of the Rio Grande Valley population; the University of Texas School of Public Health’s Brownsville campus, which operates a mobile health van for the medically underserved along the border; and the University of Texas Medical Branch in Galveston, which sends a doctor to its McAllen outreach clinic one day a month to perform LEEP procedures.
Project ECHO was originally developed in 2003 at the University of New Mexico to help rural practitioners care for patients with Hepatitis C. Since then, the program has expanded to help caregivers treat multiple diseases at numerous sites throughout the U.S. and around the world. Cultivando La Salud was developed in 2004 at the University of Texas School of Public Health, and has aided Hispanic female farmworkers in communities along the Texas-Mexico border and in California’s Central Valley.