African Cancer Institute Focuses on Early Detection

Improving screening and early detection of cervical cancer leads the list of priorities for the recently launched African Cancer Institute (ACI). Located at Stellenbosch University in Stellenbosch, South Africa, the new institute will receive funding from the university and from the Cancer Association of South Africa.

ACI will collaborate with The University of Texas MD Anderson Cancer Center in Houston to focus on advancing the prevention, diagnosis, and management of cancer in Africa. “This partnership is of mutual benefit,” says Vikash Sewram, PhD, newly appointed director of the ACI. “Our students and staff can learn from some of the greatest minds in cancer research and, at the same time, we can provide a platform for research in Africa that will assist our colleagues at MD Anderson.”

The new institute's first initiative, led by Kathleen Schmeler, MD, associate professor of gynecologic oncology and reproductive medicine at MD Anderson, will evaluate the use of high-resolution microendoscopy (HRME) in the diagnosis of cervical dysplasia and the prevention of cervical cancer in African women. The technology, developed by Rebecca Richards-Kortum, PhD, and her team at Rice University in Houston, is already being tested in Botswana, Latin America, and China, says Oliver Bogler, PhD, MD Anderson's senior vice president of academic affairs and professor of neurosurgery research.

“The technology supports a low-cost device suitable for resource-constrained settings to screen mucosal surfaces for nuclear atypia in real time,” says Bogler. “We've been working with Rice University on a cell phone–based system in Brazil and China, and now this would be the first significant trial in Africa.”

In the ACI trial of the HRME system, an image will be transmitted through a fiber-optic probe and then through additional optics to the cell-phone camera. In a pilot study in China, researchers reported that HRME helped rule out cervical lesions deemed suspicious after visual inspection or human papillomavirus testing, thus preventing costly and unnecessary treatment.

Investigators also will focus on three other high-priority areas:

• Esophageal cancer: Researchers will use endoscopic screening technologies on asymptomatic individuals in South Africa's Eastern Cape Province to identify those with mild, moderate, and severe dysplasia or esophageal cancer. The goal is to define the nature and magnitude of lifestyle-related and environmental risk factors associated with mild, moderate, and severe dysplasia and its progression to esophageal cancer in the region.

• Palliative care: ACI will participate in an international study aimed at better understanding the decisioncontrol preferences of advanced cancer patients. “There is significant need for palliative care in Africa,” says Bogler. “Much of Africa's population is rural and, by the time patients present, the cancer is late-stage.”

• Melanoma: Collaborations will leverage MD Anderson's expertise in melanoma to create a standardized approach to diagnosis and evidencebased management, establish the first South African biorepository for well-annotated melanoma biospecimens, and develop a pilot study to collect data on knowledge, attitudes, and practices related to melanoma awareness and prevention.

“Focus needs to be placed on development of point-of-care technologies for early detection,” says Sewram. “Detecting cancer early is likely to ensure that the prognosis is better.”

For more news on cancer research, visit Cancer Discovery online at http://CDnews.aacrjournals.org.