Cancer is an increasingly urgent global health issue. By 2030, the global cancer burden is projected to grow by 70 percent, and more than two-thirds of cancer deaths are occurring in low- and middle-income countries. Yet only 2 percent of health funding in these countries is directed toward cancer and other noncommunicable diseases. Many of the highest-burden cancers in these regions are associated with infectious diseases, including HIV, human papillomavirus, and viral hepatitis.
Fred Hutch has a growing cross-divisional Global Oncology program that investigates globally relevant cancers and seeks to understand the varied genetics and biology of common cancers around the world. We aim to develop high-impact, low-cost diagnostic tools, and therapies that can be used in low-resource settings worldwide.
Cervical cancer, which is caused by the human papillomavirus (HPV), is the most common cancer in sub-Saharan Africa and kills more African women than any other cancer. HIV-infected women are five times more likely to develop cervical cancer than women who do not have HIV. Our research on cervical cancer includes a study of Ugandan women with HIV who are found to have precancerous lesions; it compares those whose precancers spontaneously resolve with those who develop cancer. The results of the study could lead to improved prevention and treatment of HPV-associated cancers worldwide.
In sub-Saharan Africa, fewer than half of people diagnosed with breast cancer live beyond five years, compared with almost 90 percent in the United States. We are testing a diagnostic tool that is widely available in Africa to assess its performance in determining a tumor’s hormone receptor status and other characteristics that can guide treatment. We will study the feasibility of a three-drug chemotherapy regimen that can be given orally rather than intravenously. In addition, we are using genetic sequencing to look for mutations that may explain why breast cancer in sub-Saharan Africa tends to strike younger women and be especially aggressive — characteristics also seen in breast cancer in African-American women.
We are studying how adults respond to treatment for Kaposi sarcoma, an infection-related cancer that was relatively rare until the 1980s, when its incidence skyrocketed due to a rapid increase in HIV. It is the most frequently diagnosed cancer in several African countries, including Uganda, and can lead to tumors that appear as lesions on the skin. We are studying treatment-naïve adults with Kaposi sarcoma who are initiating therapy at the UCI, following them for up to one year to evaluate their response to treatment with antiretroviral therapy and chemotherapy. We have perfected a way to gather tumor specimens in Uganda and ship them to Fred Hutch for state-of-the-art analysis, including using high-speed genome sequencing.
— Dr. Edus Warren, Program Head, Global Oncology
Read highlights of Global Oncology’s progress during fiscal year 2022. Learn more about our research progress and scientific achievements, training initiatives, grants and finances, and operations. The report also provides an update on our local response to the COVID-19 pandemic.