Low-income women at risk for cervical cancer will be eligible for follow-up care with the help of a new grant awarded to a researcher at the Arizona Cancer Center.
Dr. Jesse Nodora, a scholar of the Cancer Health Disparities Institute and an assistant professor in family and community medicine, said the five-year, $687,000 grant will be used for a randomized clinical trial study slated to begin in July of this year. The American Cancer Society provided the funds for the American Cancer Society Mentored Research Scholar Grant.
“”The mission of the institute is basically to address these kinds of health disparities in underserved populations,”” he said. “”My research largely revolves around that.””
The study is meant to train young investigators in the clinical area and will look at the effectiveness of patient navigation, Nodora said.
A patient navigator is one who educates patients about what cervical cancer is and how the diagnosis and screening process works, he said. They also address health literacy to help women understand the results of their pap smear tests. In short, they are there to support the women.
The patients are bound to have fears and concerns, Nodora said.
Nodora said he hopes to find whether the navigation method works effectively, which would prompt community health centers to adapt to this type of program. The study will look at how long it takes women to get their definitive cancer diagnosis under the navigation method.
“”They’ll have certain beliefs about what all this means, and the navigator is there to kind of talk that through with them and help them out,”” he said.
Nodora said the grant will allow him to work on a smaller study and train in the area of clinical research. There will be about 106 women involved, half of which will be randomly assigned to a patient navigator and the other half will receive usual care.
A woman who has a positive pap test could potentially have a pre-cancerous lesion or cancer, he said. Poor, underserved women, which constitute 60 percent of women with cervical cancer, tend to delay getting tested for human papillomavirus, often because they do not have access to screenings, Nodora said.
HPV, which is the primary cause of cervical cancer, is usually transmitted through sexual contact, “”so as soon as you start having sex, you’re basically at risk for cervical cancer,”” Nodora said.
“”The whole idea behind the pap and all screening in cancer is to try to catch the growth early so that it can be removed,”” he said.
The primary prevention for cervical cancer is the HPV vaccine, he said. It is intended for females who have not yet had sexual intercourse because they have not been exposed to the virus, and therefore can be protected from it. If a woman is sexually active and has not had the vaccination, they have an increased risk.
The secondary prevention is to get an HPV exam to determine whether or not someone has the virus, Nodora said. If tested positive for HPV, the next step is to find out if it is persistent and in need of treatment.
The rates of cervical cancer are low, Nodora said. There may be two or three women out of 100 that have the cancer. Not all women with positive pap tests will have cervical cancer, he said.
“”The patient navigation is all about helping those women get in for their exam to figure out whether their pap test, if (a) positive pap test, is in fact pre-cancer or cancer,”” he said.
Most women are infected with HPV at some point in their lives, but it isn’t really a concern, he said. Nodora compared it to having a cold because the immune system eventually gets rid of the virus. If the virus lingers, however, it will cause abnormal cell growth, called dysplasia.
“”That is basically a pre-cancerous lesion,”” Nodora said. “”The beauty of cervical cancer, if there is such a thing, is that it’s probably preventable.””
