Preventing cervical cancer in older Vietnamese women
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Description
Cervical cancer is a leading cause of cancer mortality in Vietnam with over 80% of deaths among women aged over 45 years. In Western countries, regular cervical screening allows cancers to be detected and treated, but cervical screening in Vietnam is rare and less than 5% of the population have ever been screened. This means that cancers are detected later and are often fatal. Human papillomavirus (HPV) causes cervical cancer and is common in younger people in Vietnam. Research into how best introduce a vaccine to prevent future cervical cancers is currently being undertaken. However, little is being done to help women who are too old to be vaccinated and are now at highest risk of developing cancer. We propose to strengthen existing research partnerships between LSHTM and both the Pasteur Institute and Cancer Registry in Ho Chi Minh City (HCMC) in order to pilot an innovative HPV screening method among older Vietnamese women. Our research in the UK has indicated that the majority of invasive cancers could have been detected by sensitive HPV testing compared to very few by cytology (a smear test). This project will pilot HPV testing in two districts of HCMC in 300 women aged 45-64 years. The women testing positive will be invited for repeat testing after 1 year and those still positive will be invited to undergo a therapeutic biopsy with the aim of greatly reducing their future cancer risk. In addition, 100 former sex workers will be identified and also invited to take part. These women are estimated to be at much higher risk of developing cervical cancer than the general population and therefore are an important target group for HPV screening. This pilot project will allow us to assess the response rate and also the attitudes to screening in those that accept their screening invite compared to those who refuse. The cancer registry in HCMC is well organised but poorly resourced. Analysis of the data is required to understand unexpected changes in cancer rates which are likely to be due to migration in and out of the city. At least 50 cervical cancer patients identified by the registry will be interviewed in this pilot study to between understand their characteristics including whether they have moved from a rural area to HCMC.
Objectives
The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.
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