This event, co-hosted by Case Western Reserve University and BHI, was the first open-to-the public conference in this exciting new field. The conference brought together researchers, non-profits, industry and LMIC representatives to disseminate innovative and low-cost cancer technologies to a global audiences.

Funding Source: Case Western Reserve/Basic Health International

This randomized, controlled trial tests the effectiveness of a modified handheld, portable thermal ablation device compared to cryotherapy, the standard of care in LMICs for high-grade cervical precancer. Thermal ablation has recently been endorsed by the WHO and has received significant attention because it is simple, low-cost, and doesn't require gas. The modified portable device is handheld, works with a battery, has better visibility and has interchangeable probes that allow for flexible treatment protocols.

Funding Source: National Institute of Health/Gateway for Cancer Research

In collaboration with the ES MOH, BHI's landmark study "CAPE" helped to revolutionize the cervical cancer program of an entire nation. Since then, over 60,000 women have been screened and treated using these new guidelines. With COVID-19 ES' healthcare systems are largely inaccessible. Of the 60K screened, over 5,100 known HPV+ women are without adequate access to healthcare. This can have detrimental consequences for their health and promote severe anxiety and depression. This grant addresses the urgent need by giving these women access to evaluation and treatment by trained colposcopists. If they are found to have high grade cervical precancer, they will be offered enrollment into the ongoing R01 study.

Funding Source: Freedom Philanthropic Trust

New technologies and strategies for the screening/treatment of cervical cancer have emerged. To realize the full potential of these innovations, it is essential to ensure their adoption and effective implementation in regions with high disease burden. Healthcare workers often face challenges including inadequate training, lack of continuing education, isolation, and burnout. An evidence based strategy to improve health system capacity is the use of CoPs. CoPs are groups of individuals working in a common field that interact regularly to contribute expertise, share experiences, and build a common knowledge base. The goal of this project is to establish vCoPs among

Funding Source: National Institute of Health

This randomized controlled trial compares the effectiveness of a portable non-gas cryotherapy device, the Cryopen, against the standard treatment (gas-based cryotherapy) for high-grade cervical precancer. Gas-based cryotherapy is the most widely used treatment for cervical precancer in most areas of the world. However, cryogen gas is costly, requires a renewable resource, and is often difficult to procure, transport and store . A non-gas option, such as the Cryopen, is urgently needed. This trial will also fill gaps in data about effectiveness and side effects of cryotherapy in general.

Funding Source: National Institute of Health/Rising Tide Foundation for Clinical Cancer Research

The objective of this clinical trial is to introduce a low-cost, self-collected tandem test for cervical cancer screening and triage based on HPV genotype in an underscreened population of women living in rural areas in central Mexico. The proposed strategy will reduce the burden of multiple visits by delivering a single sample screening and triage and providing immediate treatment to women at highest risk of developing invasive cancer. Women diagnosed with high-risk HPV will need only 1 clinic visit vs the current standard of care requires 5.

Funding Source: Prevent Cancer Foundation

This project evaluates the implementation of thermal ablation, a safe and effective treatment for cervical precancer, within El Salvador's national cervical cancer prevention program. As one of the first countries to adopt thermal ablation following the World Health Organization's recommendations, El Salvador offers a unique opportunity to study how this innovative treatment can be successfully integrated into a national health system. Through mixed-methods research, cost analyses, and implementation science, the project examines adoption, effectiveness, sustainability, and barriers to implementation. The findings will help strengthen cervical cancer prevention programs in El Salvador and provide evidence to support the expansion of thermal ablation and other evidence-based interventions across low- and middle-income countries.

Funding Source: National Institute of Health

This project evaluates a new, portable treatment (thermal ablation) that can replace the current method (cryotherapy) and increase access for women in hard-to-reach areas.

Funding Source: Prevent Cancer Foundation

This landmark study will compare incidence of cervical cancer and precancer in women who were screened >5years ago using primary HPV testing vs. traditional screening methods.

Funding Source: MD Anderson/POMA Foundation

The goal of this three-phase, multi-year project is the implementation of a national cervical cancer prevention program in Antigua and Barbuda (AB). This proposal covers the first two phases, namely i) providing technical training to medical personnel and decision makers, and ii) rolling out a pilot screening program with 1,500 women. BHI's key collaborators are the MOH in AB and PAHO.

Funding Source: Direct Relief

A recent needs assessment revealed that cervical cancer prevention efforts in Belize were limited by a shortage of specialized medical providers and a pathology infrastructure that could not support population-based screening efforts. The development and training of healthcare personnel and the implementation of decentralized screening services could vastly improve cervical cancer management in Belize and allow for sustainable services throughout the country. Currently, the MOH has only one certified trainer, resulting in limited availability for training sessions. This proposal will deliver a master training course with specific focus on VAT and thermal ablation treatment for physicians and nurses in Belize.

Funding Source: Inter American Development Bank

BHI has partnered with a biotechnology company to design and validate artificial intelligence (AI) technology to diagnose cervical precancer and help triage patients in low-income and resource-poor areas.

Funding Source: National Institute of Health

The handheld IRIS dual-function digital colposcope and thermal ablator is a novel device to address the urgent need for point-of-care triage and treatment options for cervical precancer in LMICs. This project will modify and clinically validate the IRIS device by designing optimized thermal ablation treatment probes and integrating an artificial intelligence algorithm that can triage screen-positive women using digital cervical images. It will allow us to identify and prioritize treatment for women with highest risk for cervical precancer.

Funding Source: National Institute of Health

An important feature to control cervical cancer in LMICs is to shorten the time from HPV self-sampling and immediate treatment for those at the highest risk of developing invasive disease. This is only possible through a low-cost and effective test that is easy to use in the field, combined with triage strategies that channel women to treatment but avoid unnecessary procedures that drain limited resources. A novel HPV genotyping test can identify 13 high-risk HPV types and stratifies them by oncogenic risk into four groups. This test allows for small-batch processing in 1-2 hours at a low cost per sample. No other HPV test has these characteristics, which allow for the development of same-day screen-and-treat strategies that can triage women at the highest risk, reduce loss to follow-up, and decrease overtreatment. This project pilots a same-day screen-and-treat strategy with this novel HPV test and Automated Visual Assessment (AVE), an artificial intelligence triage method based on an assessment of cervical images captured with an ordinary smartphone.

Funding Source: National Institute of Health

This project investigates a low-cost HPV test that has high efficacy in self-collected specimens. With the ease and speed of this new platform, we will be able to provide HPV self-sampling testing AND immediate treatment to women with the highest risk for cervical cancer in one single visit. We expect this will markedly decrease loss to follow-up in general, but particularly in remote and resource-poor areas. Until now there has been no low-cost HPV tests that have the capacity to facilitate a single visit approach in real world low- and middle income (LMIC) settings.

Funding Source: National Institute of Health

This project will offer colposcopy services to women with abnormal cervical cancer screening tests who have not been able to obtain follow-up due to the pandemic, and will compare the performance of new, low-cost, self-collected HPV screening tests against the currently used standard.

Funding Source: Prevent Cancer Foundation

There is widespread evidence that women experience distress, fear, and shame associated with cervical cancer screening, but there is a lack of validated psychometric assessments that measure cervical cancer or HPV-related stigma. There is an urgent need to better understand and measure how HPV stigma is understood and manifested, and to design interventions that can reduce HPV-related stigma and increase uptake of cervical cancer preventive services. The important work adapts an existing psychometric tool to assess HPV stigma. Based on the results, a pilot stigma-reducing intervention with 200 women will be launched in El Salvador. ** This is a supplement to our SCALE project

Funding Source: National Institute of Health

BHI’s flagship programs are large-scale clinical research studies, designed to evaluate innovative cervical cancer prevention strategies in low-resource settings. They are supported by competitive research grants that enable BHI to screen and treat thousands of underserved women in low- and middle-income countries (LMICs), identifying those at high risk for cervical cancer and referring them for life-saving treatments. While grant funding supports the research activities (screening, diagnostics, clinical evaluation and cervical precancer treatment), it does not cover the non-clinical, patient-centered support services required to ensure women complete follow-up care. As a result, nearly 50% of women in many countries are lost to follow-up due to financial hardship, transportation barriers, work and family obligations, and stigma. This gap represents a critical, currently unfunded need across BHI’s research portfolio. The aim of this project is to strengthen follow-up care for patients across BHI’s ongoing research programs by addressing these barriers and ensuring that high risk women identified through these projects can successfully access and complete treatment.

Funding Source: Hillsdale Foundation

This study will optimize and evaluate a cervical screen-triage-treat approach in support of the WHO cervical cancer control goals, aimed at resource limited settings in the COVID-19 era. The research study will be conducted among up to 100,000 women in the age range of 30 to 49 years in approximately 10 different settings/countries. BHI was selected as a collaborator, and plans on contributing up to 30,000 of the 100K women from our projects, such as SCALE, PROGRESS and POINT CARE.

Funding Source: National Institute of Health

In collaboration with the NIH, BHI is validating various low-cost, rapid methods to test for COVID-19, including one that does not require RNA extraction, a barrier in many LMICs. The infrastructure for this testing will then be used to scale-up HPV testing once the global pandemic is under control. Our public health expertise gives us the flexibility to address this urgent crisis and provide implementation consultation to large-scale organizations and governments.

Funding Source: National Institute of Health

The goal of the project is to improve data coverage and quality of the Demographic Cancer Registry (RCP) of the San Salvador Department in El Salvador