A call to action in South Texas

Since its introduction in the 1940s, the Pap test has been successfully detecting abnormal cells in the cervix that, if left untreated, could lead to cancer. In fact, that success has led to a 70% drop in cervical cancer rates in the United States.

But in Texas’ four southern-most counties lining the Texas-Mexico border, the cervical cancer death rate is 30% higher than the rest of the state. Lack of resources is the culprit, says Kathleen Schmeler, M.D., associate professor in Gynecologic Oncology and Reproductive Medicine.

“Seventy percent of the population in the region is uninsured, and the number of public hospitals serving the uninsured is zero,” says Schmeler. “Residents there are at a huge disadvantage.”

It’s especially tragic when women in these underserved Rio Grande Valley counties are diagnosed with incurable cervical cancer, Schmeler says, because the disease is almost always 100% preventable when detected early with a simple Pap test or another test developed in 2011 that detects the presence of the human papillomavirus (HPV) — the cause of almost all cervical cancer cases.

“But due to lack of insurance and health care facilities for the poor,” Schmeler says, “only five percent of women in South Texas avail themselves to these simple and lifesaving screening tests.”

To bridge this gap, the Cancer Prevention Research Institute of Texas (CPRIT), which provides state funding for cancer research, prevention and product development programs, has awarded MD Anderson a grant in excess of $1.4 million to increase cervical cancer screenings and preventive treatments for women living along the border. Efforts will target Cameron, Hidalgo, Willacy and Starr counties, which have 40% fewer physicians and half as many nurse practitioners as the rest of Texas.

With this latest round of funding, Houston doctors will teach Rio Grande Valley clinicians how to perform three medical procedures commonly employed when a patient’s Pap or HPV tests are abnormal: colposcopy (examination of the cervix with a special magnifying device), cervical biopsies (removal of a small sample of tissue from the cervix for further examination), and LEEP (loop electrosurgical excision procedure), which uses a thin, low-voltage electrified wire loop to cut out precancerous tissue.

The CPRIT grant also funds two programs that will bring additional health care workers and services to the region. One of those programs, Project ECHO (Extension for Community Healthcare Outcomes), enlists the services of Su Clinica Familiar — a Federally Qualified Health Clinic serving the poorest segment of the Rio Grande Valley population. In addition, the University of Texas School of Public Health’s Brownsville campus operates a mobile health van for the medically underserved along the border, and the University of Texas Medical Branch in Galveston sends a doctor to its McAllen outreach clinic one day a month to perform LEEP procedures.

“There are very few providers in the lower Valley who perform these procedures in medically underserved patients,” says Ellen Baker, M.D., Project ECHO director.

Read more about MD Anderson’s efforts to prevent cervical cancer.