A Cervical Cancer Prevention Training Facility in Lima, Peru

Dr. Carlos Santos with two of his trainees.

Uterine cervical cancer is the first or second cause of cancer related mortality in many Latin American countries. Affecting women of reproductive age, it represents a serious public health problem. Unfortunately, there is a shortage of personnel qualified to fight against this potentially lethal but preventable disease, especially through secondary prevention (screening for early lesions). In spite of serious efforts to establish nationwide cervical cancer screening programs in many Latin American countries in the last three decades, there has not been a significant reduction in mortality. In exploring the reasons for this it has become clear that there is a great need for the education of health professionals in the management of cervical cancer in order to improve our ability to combat this disease in the region, particularly through secondary prevention.

As a result of discussions between the International Agency for Cancer Research (IARC) and the Instituto Nacional de Enfermedades Neoplasicas, in Lima, Peru (INEN), it was decided to establish a training facility that would serve Spanish speaking Latin American countries, based at INEN, a referral center for the entire country that manages 1200 new cases of cervical neoplasia per year.

The concept of a “Latin American School for Cervical Cancer” was developed in 2004 and implemented later that year, through a collaborative agreement between INEN and IARC. A training curriculum, and educational materials were completed by the end of 2004. Training is being conducted primarily at the Gynecologic Oncology Department of INEN, where classical and alternative primary and secondary prevention modalities are extensively practiced as well as surgical management of early invasive disease. The goal is to “train the trainer”, promoting a “cascade effect” that would result in ever more rapid augmentation of the national capacity for the control of cervical cancer.

Dr. Sobeyda Lopez, from Honduras, learns to use the analytic tools of colposcopy.

At this point, INCTR became an important component of this joint effort, offering not only collaboration but economic support for foreign trainees. INCTR was the link between INEN and the Instituto Oncologico del Oriente Boliviano from Santa Cruz de la Sierra, which is committed to improving its cervical cancer screening program. The first trainee from Bolivia arrived in November 2005. Five Latin American professionals have been trained since then over a period of 16 months, as follows:

- Ingrid Hurtado, MD,
Gynecologic oncologist from
Santa Cruz Cancer Center,
Bolivia; one month

- Miss Etelvina Franco,
secretary from Santa Cruz
Cancer Center, Bolivia,
trained in Cancer Registry
related procedures
and documentation;
one month

- Reynaldo Rocha, MD,
Ob/Gyn from Hospital
Municipal de Yapacani,
Santa Cruz, Bolivia,
in charge of the
Cervical Pathology Unit;
three months

- Lismar Bianco, MD,
Ob/Gyn from Merida,
Venezuela;
three months

- Sobeyda Lopez MD,
Ob/Gyn from “Enma Romero
de Callejas” Cancer Center,
Tegucigalpa, Honduras;
three months

Dr. Reynaldo Rocha, from Bolivia, studying at the Peruvian School.