December 16, 2022

The National Cancer Institute (NCI) has awarded a team of UNC researchers a five-year, $3 million grant to help develop studies to assess approaches to scalable, cost-effective screening and treatment strategies to prevent invasive cervical cancer among women living with HIV in low- and middle-income countries and in underserved communities in the United States.

Dr. Jennifer Smith

Dr. Jennifer Smith

Dr. Lameck Chinula

Dr. Lameck Chinula

Dr. Michael Hudgens

Dr. Michael Hudgens

The co-principal investigators are Jennifer S. Smith, PhD, professor of epidemiology at the UNC Gillings School of Global Health and UNC Lineberger Comprehensive Cancer Center member, Lameck Chinula, MD, assistant professor of obstetrics and gynecology (OB-GYN) at UNC School of Medicine’s Division of Global Women’s Health, director of UNC OB-GYN Services in Malawi and UNC Lineberger member, and Michael Hudgens, PhD, professor and associate chair of biostatistics at the Gillings School and the director of the Biostatistics Core of the UNC Center for AIDS Research.

Cervical cancer on a global scale

Cervical cancer is the fourth most common cancer among women globally, with an estimated 604,000 new cases diagnosed every year. Though highly preventable and curable when detected early and managed appropriately, cervical cancer causes more than 340,000 deaths worldwide. Nearly nine in 10 new cases and deaths occur in low- and middle-income countries, and women living with HIV are six times more likely to develop cervical cancer.

Grant support to fuel cervical cancer research

The grant will support the establishment of the UNC CASCADE Network Research Base, which will provide the NCI’s newly established HIV/Cervical Cancer Prevention ‘CASCADE’ Clinical Trials Network with scientific and statistical leadership for developing network clinical trials concepts and protocols, overseeing their conduct, and analyzing and publishing their results. The research base also will ensure regulatory compliance and develop training opportunities for emerging investigators.

The UNC team includes clinicians, epidemiologists, biostatisticians and training experts with extensive experience in developing approaches to prevent invasive cervical cancer and HIV in low- and middle-income countries and domestically. The team also has expertise in implementation science, screening with automated visual evaluation, and assessing the cost-effectiveness of screening approaches.

Smith said the commitment by UNC Lineberger, UNC Center for AIDS Research and UNC Gillings to provide a level of matching funding, together with the well-documented success of UNC Project-Malawi and the UNC Institute for Global Health and Infectious Diseases in the fields of global oncology and health, enabled UNC to submit a highly competitive grant application.

“While we were writing this grant, UNC leadership generously committed resources in recognition of the importance of this work in preventing cervical cancer globally,” Chinula said. “It is important to understand that this is research that will evaluate scalable strategies for the rapid adoption of scientifically proven effective cervical cancer preventive tools, and directly benefit the communities most affected globally.”

Applying insights globally, locally

Smith said while much of the first phase of this research will take place in sub-Saharan Africa, the scientific insights that the studies will generate, have potential to improve the screening, prevention and treatment of cervical cancer in North Carolina. “With Gillings and Lineberger, global is local, and local is global. The lessons learned through this research, such as the implementation of screening approaches that we will develop with HPV self-collection, can certainly inform our work in North Carolina. We will continue to learn as we continue to work back and forth between N.C. and Africa.”

Co-investigators on this project include: Vivian Go, PhD, professor of health behavior; Chemtai I. Mungo, MD, MPH, assistant professor of obstetrics and gynecology; Siobhan M. O’Connor, MD, associate professor of pathology; Lisa Rahangdale, MD, MPH, professor of obstetrics and gynecology; Friday Saidi, MMED, adjunct assistant professor of obstetrics and gynecology; Bonnie Shook-Sa, DrPH, assistant professor of biostatistics; Lisa P. Spees, PhD, assistant professor of health policy and management; and Jennifer H. Tang, MD, MSCR, associate professor in the Department of Obstetrics and Gynecology’s Division of Global Women’s Health.

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