Working together to eliminate cervical cancer

Feature Stories | 04 Mar 2024

Photo: Dr. Karen Yeates (third from left) with members of her research team at a recent screening event held in Tanzania for World Cancer Day.

Dr. Karen Yeates likes to take on big challenges. Eradicating cervical cancer is just one goal she, along with her research colleagues in Canada and in Africa, are working to make a reality. A professor in the Department of Medicine, Dr. Yeates has several innovative projects underway to help prevent cervical cancer, provide comprehensive care, and significantly reduce the burden of cervical cancer globally.

Working in collaboration with the Ministry of Health and other partners in Tanzania, Dr. Yeates is leading a study assessing recruitment strategies to improve uptake and retention of women who are undergoing cervical cancer screening, especially those who may need subsequent treatment or follow-up due to their high-risk status (e.g., living with HIV or prior cervical lesions). So far, the program has screened and treated over 30,000 women and the team has embarked on a groundbreaking project aimed at tackling the root causes of cervical cancer: Human Papillomavirus (HPV) infection.

“We are using cutting-edge, near-point-of-care testing for high-risk HPV DNA, including self-sampling among women in their communities and in cervical cancer screening clinics,” says Dr. Yeates. “We are thrilled to have the research program underway, thanks to the support from Grand Challenges Africa, Global Affairs Canada, The Bill and Melinda Gates Foundation, and USAID.”

The project, named NECST: supporting the National Expansion of HPV-based Cervical Cancer Screening in Tanzania, is part of an ongoing collaboration with the National Institutes of Health (NIH) and National Cancer Institute (NCI) in the U.S. and is the mechanism to implement and scale up the Tanzanian effort that is part of a global consortium to eliminate cervical cancer worldwide. Using the new screening methods and self-sampling along with high-quality visual evaluation of the cervix and same-day treatment, the team is well on its way to enroll 5,000 women in the project by September 2024. “Our wrap-around research projects also study the most effective strategies for reducing loss to follow-up among the highest-risk women who have undergone screening,” says Dr. Yeates.

Using mobile phone applications in cancer screening

Dr. Karen Yeates

Beyond Tanzania, the team has developed the WEMA mobile app, a revolutionary tool for health providers conducting cervical cancer screenings and for tracking women undergoing screening. The app is currently available in Ontario, Tanzania, and Rwanda with a trial underway in the Republic of Congo. The app’s success has also allowed the team to expand its use in other locations and apply it to other health contexts. “We plan to use a version of our WEMA app in an upcoming project for cervical cancer screening and breast cancer screening and early detection in Kenya,” says Dr. Yeates.

The Kenyan project is supported through an NIH grant and is in collaboration with research partners at Emory University in Atlanta. It also includes an implementation science research training program for young physician-scientists and nurses at the University of Nairobi and Kenyatta National Hospital. They will be trained to deliver evidence-based strategies that will improve uptake of cervical and breast cancer screening and early detection among their patients, also using the WEMA app.

This past November, the team launched a new project in Rwanda using the WEMA app to help improve early detection of cervical cancer. Supported by the Together Foundation, BioVentres for Global Health, Nyamata District Hospital, and Rwanda Biomedical Centre (RBC), the team will study how to improve health care providers’ identification of cervical lesions requiring biopsy or treatment of pre-cancerous lesions of the cervix in order to prevent future cervical cancer. The project will also assess how patients use the WEMA app and with this knowledge, help RBC scale the use of the app across other Rwandan districts with cervical cancer screening services.

In addition, 49 health care providers in Rwanda received refresher training on visual inspection with acetic acid (VIA) and thermal ablation, a procedure to help treat pre-cancerous cervical lesions. Dr. Yeates emphasizes, "Our goal is not just to introduce new technologies but to ensure that they are effectively integrated into existing health care systems, benefitting both health care providers and the women they serve."

Working together to eliminate cervical cancer

Using mobile phone applications in cancer screening

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