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Principal Investigator: Scott Dryden-Peterson
Organization: BRIGHAM AND WOMEN'S HOSPITAL
Fiscal Year: 2024
Award: $367,640
Funding agency: National Cancer Institute
Project Summary / Abstract
Successful HIV treatment programs in Botswana and elsewhere in southern Africa have led to dramatic
reductions in mortality from tuberculosis, cryptococcosis, and other non-cancer AIDS deaths. However, cancer
deaths have not decreased, and cervical cancer now is the leading cause of death for women living with HIV in
the region. Cervical cancer is preventable with early detection and treatment of precancerous lesions but
challenges of limited access to initial screening, poor performance of initial screening technologies, high
prevalence of cervical precancers, and persistent or relapsed dysplasia following therapy impair the impact of
programs for women living with HIV. Working to develop strategies to these challenges, we will establish the
Botswana CASCADE Clinical Trials Site at BHP that will participate in and contribute to the following high-
impact areas of research: 1) Enhancing cervical precancer screening uptake through patient and context
relevant approaches, including HPV self-sampling, non-clinical screening venues, and screening during
antenatal care; 2) Strategies and novel technologies to improve management of positive HPV initial screening
maximize prevention of invasive cancer while minimizing patient risk and consumption of health system
resources; 3) Improving precancer treatment access, treatment completion, and outcomes; and 4) Optimizing
treatment approaches to cervical precancers including comparative trials of ablation techniques, intervals of
repeat evaluation, and vaccines or other immunologic therapies. The Botswana CASCADE Clinical Trials Site
will contribute to conducting high-quality clinical research studies, provide context-relevant input on
developing trial concepts, understand disparity in access by geography, economic factors, and
language/ethnicity, and continue to develop local research capacity through mentoring and training.
Terms: <AACTG><ACTG><AIDS><AIDS Virus><AIDS associated cancer><AIDS clinical trial group><AIDS related cancer><AIDS-Related Malignancy><AIDS-Related Malignant Neoplasm><AIDS-associated malignancies><Ablation><Access to Care><Acquired Immune Deficiency><Acquired Immune Deficiency Syndrome><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome><Acquired Immunodeficiency Syndrome Virus><Africa><African><Area><Bechuanaland><Botswana><COVID-19 Prevention Network><Cancer Treatment><Cancers><Caring><Cause of Death><Cervical><Cervical Cancer><Cervical Cancer Screening><Cervical dysplasia><Cervix Cancer><Cervix Dysplasia><Cessation of life><Clinical Research><Clinical Study><Clinical Trials><Clinical Trials Network><Clinical Trials Unit><CoVPN><Collaborations><Communities><Community Education><Community Health Education><Consumption><Country><Cryptococcosis><Cryptococcus><Data><Death><Devices><Dysplasia><Early Diagnosis><Early treatment><Economic Factors><Economic Income><Economical Factors><Economical Income><Effectiveness><Enrollment><Ethics><Ethnic Origin><Ethnicity><Evaluation><Female Adolescents><Geography><HIV><HIV diagnosis><HIV-Associated Cancer><HIV-associated malignancy><HIV-related malignancy><HIV/AIDS-associated malignancy><HIV/AIDS-related cancer><HPV><HPV Vaccination><HPV positive><HPV(+)><HPV+><Health Services Accessibility><Health system><High Prevalence><Human Immunodeficiency Viruses><Human Papilloma Virus><Human Papilloma Virus Vaccination><Human Papillomavirus><Human Papillomavirus Vaccination><IMPAACT><Immune mediated therapy><Immunologically Directed Therapy><Immunotherapy><Impairment><Improve Access><Income><Infectious Human Wart Virus><International><International Agencies><International Maternal Pediatric Adolescent AIDS Clinical Trials><International Maternal Pediatric Adolescent HIV/AIDS Clinical Trials><Investigators><LAV-HTLV-III><Laboratories><Language><Lesion><Lymphadenopathy-Associated Virus><M tuberculosis infection><M. tb infection><M. tuberculosis infection><M.tb infection><M.tuberculosis infection><MTB infection><Malignant Cervical Neoplasm><Malignant Cervical Tumor><Malignant Neoplasm Therapy><Malignant Neoplasm Treatment><Malignant Neoplasm of the Cervix><Malignant Neoplasms><Malignant Tumor><Malignant Tumor of the Cervix><Malignant Tumor of the Cervix Uteri><Malignant Uterine Cervix Neoplasm><Malignant Uterine Cervix Tumor><Malignant neoplasm of cervix uteri><Mentors><Mycobacterium tuberculosis (MTB) infection><Mycobacterium tuberculosis infection><NIH><National Institutes of Health><Observation research><Observation study><Observational Study><Observational research><Oncology><Oncology Cancer><Outcome><Patient Recruitments><Patient risk><Patients><Performance><Persons><Population><Prevalence><Preventative service><Prevention><Preventive service><Protocol><Protocols documentation><Quality Control><Randomization trial><Relapse><Research><Research Personnel><Research Resources><Researchers><Resources><Sampling><Site><Southern Africa><TB infection><Target Populations><Techniques><Technology><Time><Torula><Torulosis><Training><Treatment Effectiveness><Tuberculosis><United States National Institutes of Health><Universal Coverage><Uterine Cervix Cancer><Vaccines><Viral><Virus-HIV><Woman><Women's mortality><access disparities><access to health services><access to services><access to treatment><accessibility disparities><accessibility to health services><acquired immunodeficiency syndrome clinical trial group><adolescent girl><aged><antenatal care><anti-cancer therapy><antiretroviral therapy><antiretroviral treatment><assess effectiveness><availability of services><breast cancer diagnosis><cancer diagnosis><cancer invasiveness><cancer prevention><cancer therapy><cancer-directed therapy><care access><cervical cancer early detection><cervical screening><clinical research site><clinical site><cohort><community engagement><comparative trial><coronavirus disease 2019 prevention network><data management><data quality><death among females><death among women><death in females><death in women><death rate among women><death rate in women><determine effectiveness><disparities in access><disseminated TB><disseminated tuberculosis><dyscrasia><early detection><early therapy><effectiveness assessment><effectiveness evaluation><engagement with communities><enroll><ethical><evaluate effectiveness><examine effectiveness><experience><female death><female mortality><health service access><health services availability><human papillomavirus +><human papillomavirus positive><immune therapeutic approach><immune therapeutic interventions><immune therapeutic regimens><immune therapeutic strategy><immune therapy><immune-based therapies><immune-based treatments><immuno therapy><improved><incomes><inequality in access><inequity in access><inequity in accessibility><infection due to Mycobacterium tuberculosis><innovate><innovation><innovative><malignancy><mortality><mortality among females><mortality among women><mortality in females><mortality in women><neoplasm/cancer><new technology><novel><novel technologies><participant enrollment><participant recruitment><patient enrollment><patient navigation><pragmatic effectiveness trial><pragmatic trial><precancer><precancer cervical detection><precancerous><premalignant><presence of HPV><presence of human papillomavirus><prevent><preventing><programs><prospective><quality assurance><randomized trial><research study><screening><screening program><screenings><service availability><therapy optimization><treatment access><treatment optimization><treatment program><tuberculosis infection><tuberculous spondyloarthropathy><uptake><wart virus><women's death><women's death rate>