NEWS AND UPDATES
November 2013 Training Workshop
Michele Baldwin's Mother, Ruth Frazier, at TEDxABQWomen
GIAHC Forms New Partnerships
Vinegar Screening Could Impact Death Rates Significantly
GIAHC article appears in the Nargis Dutt Memorial Foundation Magazine
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News & Updates

NEWS AND UPDATES 

November 2013 Training Workshop

A three day clinical workshop on “Low-Tech Screen and Treat Methods for Cervical Cancer” was organized by the Rural Unit for Health and Social Affairs (RUHSA) . Twenty-four healthcare providers from various hospitals in Tamil Nadu, Karnataka and Andra Pradesh were trained at this session. Read more here.

January 21st, 2014

Michele Baldwin's Mother, Ruth Frazier, at TEDxABQWomen

Ruth Frazier has spent much of her life working as a community organizer in New Mexico and around the world. When her daughter, Michele Baldwin, received a final prognosis of 3 to 6 months to live after battling late stage cervical cancer, Ruth's experience and passion allowed her to support her daughter in a final adventure: a 700-mile paddle board expedition down the Ganga River in India to raise awareness of cervical cancer, preventative screening, and the HPV vaccine. Through Michele's message, Ruth believes we can make cervical cancer a thing of the past.

Ruth spoke at the sold-out TEDxABQ Women event in Albuquerque on December 5, 2013. In the spirit of ideas worth spreading, TEDx is a program of local, self-organized events that bring people together to share a TED-like experience. At a TEDx event, TEDTalks video and live speakers combine to spark deep discussion and connection in a small group. 


 

January 15th, 2014

GIAHC Forms New Partnerships

GIAHC forges partnership with Cornell Medical School, New York, Christian Medical College, Vellore, India, and University of Sydney, Australia in order to promote cervical cancer education, training and screening programs. More information coming soon.

November 21st, 2013

Vinegar Screening Could Impact Death Rates Significantly

A study in India shows that vinegar screening could cut the death rates from cervical cancer by nearly 30 percent. Read more

June 30th, 2013

GIAHC article appears in the Nargis Dutt Memorial Foundation Magazine

Click here to view the full article about GIAHC in Nargis Dutt Memorial Foundation Magazine.

 

October 30th, 2012

Michele Baldwin's Starry Ganga Expedition Honored at 2012 SUP Magazine Awards

Michele Baldwin’s 700-mile pilgrimage down the Ganges river in India to received honors as Top Expedition at the 2012 SUP Awards. SUP magazine created the SUP Awards as standup paddling’s top honor, recognizing the absolute best that this sport has to offer. 

Michele's mother, Ruth Frazier, was on hand to accept the award. Frazier noted that Michele’s ultimate goal "was not just to be a person doing this, but to raise awareness." Michele's Starry Ganga journey has indeed succeeded in raising awareness about cervical cancer and raising funds for GIAHC and its efforts in India as well.

To learn more about Michele and the Starry Ganga expedition, click here.


October 2nd, 2012

GIAHC presents its cervical cancer-screening model at various international meetings in fall 2012

GIAHC's cervical cancer screening model will be presented at the 2012 UICC World Cancer Congress (27 – 30 August 2012 at the Palais des Congrès, in Montréal, Canada), entitled “ PREVENTING CERVICAL CANCER IN RURAL INDIA: BUILDING MODEL WITH COMMUNITY HEALTH WORKERS."

The GIAHC will also present at the 14th Biennial Meeting of the International Gynecologic Cancer Society (IGCS 2012) in Vancouver, Canada on "Implementation of Cervical Cancer Screening Program Using Visual Inspection with Acetic Acid/Lugol's Iodine in Kutch District, India: A Community Initiative."

August 27th, 2012

GIAHC’s Tanjore Site Expands its Program

Dr. Rhoda Nussbaum and Dr. John Adams of PINCC (Prevention International, No Cervical Cancer) visit ICTPH, GIAHC’s Tanjore site. Training and program expansion continues at ICTPH. Read more.

March 30th, 2012

Michele Baldwin 1966-2012

Michele Baldwin

Tell me, what is it you plan to do
with your one wild and precious life?
~Mary Oliver from "The Summer Day"

Michele Baldwin, who in November became the first woman to paddleboard 700 miles on the Ganga River in India, died in the early morning of February 5th, 2012.

Michele was diagnosed with cervical cancer in 2009. This past summer she learned that the cancer had come back in an aggressive, untreatable form. Faced with an early twilight to her life - but refusing to let cancer dictate how she'd live in the time that remained- she decided to create the Starry Ganga Expedition: Michele Baldwin’s Living Memorial. On this amazing pilgrimage Michele stood astride a snub-nosed version of a surfboard and for several weeks did a "Stand Up Paddle" down the Ganga (also known as the Ganges River).

“It was August of 2011 when, two months after being told there was no longer any treatment available for my cervical cancer, I came up with the idea of paddleboarding the Ganga. It came to me like a little secret whispered in my ear. It’s an original synthesis of Pilgrimage, athletic challenge, and opportunity to raise awareness about the cancer I have which kills 250,000 women a year worldwide. So it’s not so much as a want but something I feel I must do.”

The video log of her expedition explodes with energy, color, and stunning backdrops. Here is an adventure featuring a noble soul mingling with a cast of thousands, shot against torch-lit rivers in an ancient land. Follow the quest at YouTube and on the expedition’s website. We hope you will take a moment to visit and reflect on Michele’s legacy.

Her trek through India was not only to satisfy the urgings of her spirit, but to also spread the message that cervical cancer is preventable through Pap/HPV tests and vaccines while raising funds for the Global Initiative Against HPV and Cervical Cancer. In reporting the triumphant completion of the exhausting trip, her mother Ruth Frazier wrote “While she may be in the final journey of her life (Michele terms it ‘actively dying’) she still spreads the message: “End this disease. Get tested. Get a Pap today if you haven't."

Michele_paddling

"Finally I want to inspire others to be fearless. Do your own dreams, reach further than you thought possible, help more than you imagine you are able."

February 6th, 2012

India’s news media extensively covers the Starry Ganga expedition and Dr. Shobha Krishnan’s work with the Global Initiative Against HPV and Cervical Cancer

The Times of India
On a mission: A woman, a river and a cause

Hindustan Times
Charting a New Course to Cervical Cancer Prevention

Indian Express
Rafting trainer paddles through the Ganges for cancer awareness

More news:

 

December 7th, 2011

Dr. Shobha Krishnan’s interview with The Hindu, India’s national newspaper

Message on the Ganga

Bindu Shajan Perappadan

Forty-five-year-old Michele Baldwin was diagnosed with terminal cervical cancer last year. Using this as an opportunity to raise public awareness about the disease, she is now paddling down the Ganga to educate the women about cervical cancer.

“My expedition — The Starry Ganga Expedition — is a journey of faith where I believe that a small change can make a big difference,” said Ms. Baldwin. With her at every step of the journey is her mother, who follows her along the shore.

The expedition, which started from Rishikesh two months ago, is being supported by a non-profit organisation, Global Initiative against HPV and Cervical Cancer.

“Ms. Baldwin's journey is an inspiring one because she knows she has terminal cancer and instead of being depressed about it she has taken it as an opportunity or challenge even to help ‘save' other women. She has chosen to make women aware that fighting cervical cancer is possible,'' said Shobha Krishnan of Global Initiative against HPV and Cervical Cancer.

“In between her journey, Ms. Baldwin camps at the river banks and speaks to women in the area about cervical cancer, her fight with the disease and how simple tests can help in early detection and possible cure of the cancer. Several thousand women in India die due to cervical cancer, which is one of the few cancers that can be detected early on and cured. There is a severe lack of awareness about cervical cancer in the country,” added Dr. Krishnan.

“She was diagnosed with cervical cancer but moved her residence before the hospital reports could reach her, and later because of delays in medical health check-ups the cancer went undetected till it reached a stage where it cannot be cured. She says being on the Ganga gives her peace and she that she has always been fascinated by the river which means so much to the Indians. In her words, the experience on the river has been inspiration till now,'' said Dr. Krishnan.

Read online at The Hindu.

November 21st, 2011

The Tribune (India) interviews Dr. Shobha Krishnan on the HPV vaccine

Allow trials for a vaccine to prevent cervical cancer

SHOBHA S. KRISHNAN, staff physician at Columbia University's Barnard College Health Services in the US, shot to fame recently with her path-breaking publication on the Human Papilloma Virus (HPV), one of the most widespread sexually transmitted infections in the world. In the US, it affects 6 million new cases each year while in India it leads to one female death every minute on account of cervical cancer.

In her book titled, "HPV Vaccine Controversy: Sex, Cancer, God and Politics", Krishnan makes a compelling case for countries to use the available HPV vaccines recommended for girls and boys before they turn sexually active. With India having suspended the trials of the two available vaccines - one developed by Merck and the other by GSK - in the wake of ethical and safety concerns, Krishnan, also founder of the Global Initiative against HPV and Cervical Cancer (GIAHC), strongly defends use of the vaccines, which, she claims, can save the lives of 80,000 Indian women every year.

Why is HPV such a huge cause of concern worldwide, more so in developing countries like India?

HPV is among the most widespread sexually transmitted viruses both men and women can have. At least 50 percent of all sexually active people will be infected with the HPV in their lifetimes. While 90 per cent infections resolve on their own, others persist and can be life threatening if not detected and managed.

What is the controversy around the HPV vaccine all about if its safety and efficacy has been tested and documented ?

The controversy really is about ideology versus scientific development. Critics of the vaccine believe that administering children with an HPV vaccine might lead to enhanced sexual activity among youths and undermine family values. They also say it might create a false sense of security among children that they have been protected against a dreaded STI once they have been vaccinated.

But the fact is we actually have enough evidence to support the safety and effectiveness of HPV vaccines and recommend them for children. This vaccine will potentially reduce the occurrence of the second leading cause of cancer in women around the world. Canada and Australia have included this vaccine for use.

In India, trial of HPV vaccines donated by GSK and Merck and funded by the Gates Foundation was suspended last year after seven tribal girls in Andhra Pradesh and Gujarat died during the trials. Are safety concerns around the vaccines not real?

Merck's HPV vaccine Gardasil has been out for five years and 35 million doses of the vaccine have been administered. The Centre for Diseases Control (CDC)which recommended the vaccine in the first place, has been monitoring any adverse effects which show up six weeks after the vaccine has been administered. To date, we have found no link between the vaccine and adverse effects though some side effects like swellings have been reported.

What is the CDC's argument behind recommending vaccines for children even when controversies continue to surround their use?

HPV is a silent disease and may cause no external symptoms. But 70 pc cervical cancers are caused by HPV 16 and 18 while 90 per cent of anogenital warts (an STI) are caused by HPV 6 and 11. All these strains can be prevented by the quadrivalent HPV vaccine. In my book, I have presented evidence of the vaccine being a cost-effective intervention.

Let us remember, cervical cancer is the only cancer that's preventable with safe, inexpensive methods. Safety systems can be built into the programme of vaccine use.

You said most HPV infections get resolved automatically. Why do others like HPV 16 and 18 stay? What are the risk factors?

Tobacco use is a major risk factor. People who have HPV and who smoke are at 2.5 times higher risk of getting cervical cancer than those who have HPV and don't smoke. Smoking releases carcinogens that weaken immunity.

In a country like India where 70 pc of the people live in villages, what is the easiest way to detect cervical cancer?

A Pap Smear Test is a must and it is a very simple test that can be easily administered in any location. The Government must build the capacity by roping in NGOs interested in strengthening the screening network for cervical cancer. 

Read online at The Tribune.

November 13th, 2011

Michele Baldwin and Dr. Shobha Krishnan meet in India during the Starry Ganga expedition

November 6th, 2011

Michel Baldwin and Dr. Krishnan's meeting in Chicago

At the Chicago Public Radio Studios WBEZ, an affiliate of NPR.

The show aired on October 27.

Click here to listen to the interview.

Michele Baldwin and Dr. Krishnan at the Chicago Public Radio Studios WBEZ

At the  Chicago Public Radio Studios WBEZ

Michele Baldwin and Dr. Krishnan at the Chicago Public Radio Studios WBEZ

October 31st, 2011

IUSTI meeting in New Delhi, India, Nov 2-5., Dr. Shobha Krishnan to speak

IUSTI meeting in New Delhi, India, Nov 2-5. 
Dr. Shobha Krishnan to speak
http://delhi.iusti2011.org/home

October 17th, 2011

Starry Ganga expedition to raise cervical cancer awareness


Click here to read more about Michele Baldwin and the Starry Ganga Expedition.

Starry Ganga Expedition

Starry Ganga Expedition

 

October 17th, 2011

Dr. Krishnan addresses the HPV controversy in the news

Read Dr. Krishnan's entry below published on the ABC-CLIO publisher's blog site about the HPV controversy that has been in recent news.

The HPV Vaccine Controversy

Ever since the FDA approved the HPV vaccine in 2006, its introduction has been embroiled in a medical, social, cultural, and political controversy. This controversy has once again been rekindled in the recent Republican Primary debates between Texas governor, Rick Perry and Congresswoman, Michelle Bachmann from Minnesota, where she emphatically stated that Merck's HPV vaccine, Gardasil, causes mental retardation.

As a as a physician, a parent, and the author of the award-winning book The HPV Vaccine Controversy: Sex, Cancer, God and Politics (Praeger, 2008), I feel compelled to comment on this issue:

A report presented by four different sources to the Advisory Committee on Immunization Practices (ACIP), an independent panel of experts that advises the CDC, on vaccine policies, found no signals to link Gardasil directly to any of the serious adverse effects that have been publicized in the media.

In order to clarify this and help consumers make the best-informed decision before vaccinating, it is helpful to understand the difference between a side effect (caused directly by the vaccine), and an adverse effect (which usually occurs within six weeks after the administration of a vaccine but may or may not be related to the vaccine).

1. The two most common side effects reported are pain at the site of injection, followed by swelling and redness. These are temporary symptoms and resolve within a few days, as is the case with most other vaccines.
2. The number of adverse effects that link the HPV vaccines to the nervous system disorder are around 1-2/100,000 cases - about the same that occur in the general population as a sheer coincidence or chance, and have the same statistical occurrence as the population at large that has not been vaccinated.

It is obvious that the more number of shots administered, (as of June 22, 2011, 35 million doses of Gardasil had been distributed), the more likely the chance for these rare and unexpected events to occur. It should be noted that there is no report from the CDC of Gardasil resulting in mental retardation.

The HPV vaccine has established a decent track record at five years post-licensure. Based upon these current findings, the FDA strongly recommends vaccinating the target population: 9-26 year-old females and males. The CDC will continue to be vigilant and monitor safety data on an ongoing basis. Nevertheless, it is helpful to remind ourselves that regardless of how well studies are conducted, gray zones of risk exist. The history of medicine has shown us that such unfortunate events do occur for unknown reasons, and research is underway to study if genetics and environmental factors have a role to play in such rare and serious events.

One should always balance the greater good with these potentially minimal risks when evaluating the advantages offered by new and emerging medicines. 'Scare mongering' for personal political gain does not bode well for the education and welfare of the citizens at large. In the case of the HPV vaccine, it would be a shame if negative attention created by a few rare effects hampers the efforts to reach millions of women and men who risk losing their lives to HPV related diseases including cancers, particularly cervical cancer, both in our country and around the world.


http://abcclio.blogspot.com/

October 10th, 2011

Dr. Krishnan’s interview with the Washington Post

See the article here

The Washington Post
May 2, 2011

Laura Ungar

In her early 20s, Tamika Felder skipped seeing her gynecologist and getting
Pap smears for a few years because she couldn’t afford health insurance.

She was working part time in a job that paid only about $6 an hour, and “it
was either go to the doctor’s or pay the rent,” she recalled. But her health
was good, and Felder figured she’d be fine.

Except she wasn’t.

In 2001, at age 25, Felder learned that she had cervical cancer. She needed
a hysterectomy, chemotherapy and radiation. And she was left unable to bear
children.

“I didn’t want to lose my womb. I didn’t want to lose my fertility. But I
was tossed into this world of cancer,” said Felder, now 35 and a television
producer living in Upper Marlboro. “It changes you in such a profound way.
You have to rebuild your whole life.”

Each year, about 12,000 U.S. women receive diagnoses of cervical cancer and
4,000 women die of the disease. Yet doctors view cervical cancer as a
disease that can easily be prevented and treated. Precancerous lesions and
early cancer are easily detected through Pap smears; lesions can be removed
in a minimally invasive procedure before they turn into cancer. And since
2006 there has been a vaccine against human papillomavirus, or HPV, the
sexually transmitted virus that causes most cases of cervical cancer.

But Felder’s case is a good example of why this disease remains a threat.
Too often, doctors and public-health experts say, women who don’t get
regular screenings — because they don’t have health insurance or for other
reasons — discover the problem when the disease has already progressed.

“In most cases, women who get cervical cancer in this country are those who
did not get a Pap smear,” said Robert Hilgers, a gynecologic oncologist in
Kentucky, one of the states with the highest incidence of cervical cancer.
(The District also has a relatively high rate.) “I have been here — in all
aspects of this disease — having cared for over 1,000 women with cancer of
the cervix, and don’t want to see another woman die of this disease.”

Hilgers and other doctors say cervical cancer is highly correlated with
poverty and a lack of health insurance. The Centers for Disease Control and
Prevention cites disproportionate levels of cervical cancer among the
uninsured and underinsured.

For instance, in the Appalachian region of Kentucky, where the poverty rate
was 24.5 percent in 2005-2009 — compared with the national rate of 13.5
percent — women get cervical cancer at a rate that is one-third higher than
the national rate, and they die at a rate that is 37 percent higher,
according to statistics from the Kentucky cancer registry and the National
Cancer Institute.

Hilgers and others say they believe income disparity, and the resulting
disparity in access to health insurance and health care, contribute to an
elevated death rate from cervical cancer in African American women.
According to statistics from the National Cancer Institute, African American
women died of cervical cancer at a rate of 4.4 per 100,000 vs. 2.2 per
100,000 for white women.

“Socioeconomic factors that people live under affect their health,” said
Hilgers, founder of the Kentucky Cervical Cancer Coalition.

Shobha Krishnan, a gynecologist in New York who is the president of the
Global Initiative Against HPV and Cervical Cancer, says one way to reduce
cervical cancer rates would be to bring help, screening and education to
vulnerable women instead of waiting for them to seek it out. “There are
uninsured and underinsured who lack access to care. There are people living
in rural areas without access to care. . . . If we can adapt what we do in
the developing world [where health-care workers visit homes to provide
information and treatment] we might make more progress. Four thousand deaths
is 4,000 too many."

Pap smears

Cervical cancer used to be a much bigger scourge in America. Before Pap
screening began in the 1940s, about 26,000 women died each year of the
disease. But the American Cancer Society promoted the screening, and rates
fell steadily as physicians began to routinely perform it. The test involves
a quick, painless scraping off of cells from the cervix, which are then
examined in a lab for abnormalities.

Not only did fewer women die when the test became widely used, but fewer got
the disease because doctors found and then could deal with the changing
cells before they turned into cancer. In 1973, the incidence rate was 14.2
per 100,000; by 2003-2007 it had fallen to 8.1 per 100,000.

The American College of Obstetricians and Gynecologists recommends that
women get their first screening at age 21 and that most women younger than
30 get screened every two years. After age 30, if a woman has had three
negative tests in a row she should be screened only every three years. And
many doctors believe that by age 65 to 70, most women can stop getting Pap
smears altogether if they have a history of normal ones. (Some doctors
disagree with this and say checkups are still needed in this age group.)

Almost all cervical cancer is caused by HPV, according to the CDC. Roughly
half of all sexually active people get HPV at some point in their lives, but
the body’s immune system clears the virus in most people. For those who do
develop cancer, it’s typically slow-growing and easily detectable by Pap
smears before it becomes extremely dangerous.

According to the CDC, in 2008 about 83 percent of American women 18 and
older with insurance had gotten a Pap smear within the previous three years;
for uninsured women, the figure was 67 percent. The Agency for Healthcare
Research and Quality says that about half of women with newly diagnosed
cervical cancer had not received a Pap test in the previous five years.

A. Bennett Jenson, a University of Louisville physician who has researched
cervical cancer for decades and helped invent the HPV vaccine, said even
though the disease spreads slowly, he believes it’s important to get yearly
Pap smears. The tests have a 30 percent false-negative rate, he said, so
frequent tests increase the likelihood that any abnormality will be
detected. He said young women should also protect themselves by getting
vaccinated against HPV before becoming sexually active.

He also suggested that women get a separate test for HPV along with their
Pap smear; a positive HPV tests means a woman has the virus on her cervix
and should be monitored more closely by her doctor. The American Cancer
Society says this option is best for women 30 or older, since HPV is so
common among younger women and the body usually fights it off.

Pap smears are generally covered by health insurance, and many plans also
cover the HPV tests and vaccine. But those without insurance face high costs
— about $360 for the vaccine (plus administrative costs, which can raise
that figure to $400 or more), about $20-$40 for a Pap smear (plus the charge
for the office visit) and $80 to more than $100 for an HPV test.

However, there are programs that can help women struggling with the costs,
including the CDC’s National Breast and Cervical Cancer Early Detection
Program, which screens low-income women who are uninsured or underinsured.

Still, some people fall through the cracks. And sometimes, just a few years
without screening can spell trouble.

At great risk

Tamika Felder got Pap smears regularly when she was attending college and
was still covered by her mother’s health insurance. But when she outgrew
that insurance, Felder skipped screenings for three years. She wasn’t too
worried when she began having bad menstrual cramps and lower back pain.
After landing a full-time job with insurance, she went in for a checkup and
got a Pap smear. She could hardly believe the cancer diagnosis and sought
several other opinions.

“I was thinking I was in some bad movie,” she said.

Felder said three things would have made a difference for her: being better
educated about cervical cancer and its causes, having insurance and not
acting as if she were invincible health-wise.

Hilgers said these factors affect many patients. But experts say changing
attitudes, getting health messages out to everyone, and improving access to
health care are some of the thorniest challenges in medicine.

Krishnan, the New York gynecologist, said she hopes for improvements because
the new health-care law should mean fewer uninsured women. “We hope that . .
 . providing coverage for millions more will reduce the number of cervical
cancer cases in this country,” she said.

Hilgers said bringing down the numbers will take a while. “I think we’ve hit
a wall in terms of making progress in Pap smears,” he said. “Now, we have to
wait for the impact of the [HPV] vaccine. . . . If you immunize today,
you’re not going to get a reportable outcome for 10 to 20 years.”

Felder, meanwhile, is doing her part. In 2005, she started a nonprofit
group, Tamika & Friends, which seeks to draw attention to cervical cancer
and its link to HPV. On May 14 it is sponsoring an awareness walk at RFK
Stadium.

“I don’t know if we’ll ever eliminate it completely. But I think we can
lower it,” Felder said. “This is a preventable cancer.”

Ungar is the medical writer for the Courier-Journal in Louisville.

http://www.plannedparenthoodnj.org/news/articles/20110502_cervicalcancer

September 29th, 2011

Fighting Cervical Cancer With Vinegar and Ingenuity

The New York Times

By Donald G. McNeil Jr.

Thailand is a leader in adopting the cryotherapy technique.

Translation: The nurse just told me I do not have cervical cancer, and even the little white spot I had treated three years ago is still gone.

What allowed the nurse to render that reassuring diagnosis was a remarkably simple, brief and inexpensive procedure, one with the potential to do for poor countries what the Pap smear did for rich ones: end cervical cancer’s reign as the No. 1 cancer killer of women. The magic ingredient? Household vinegar.

Every year, more than 250,000 women die of cervical cancer, nearly 85 percent of them in poor and middle-income countries. Decades ago, it killed more American women than any other cancer; now it lags far behind cancers of the lung, breast, colon and skin.

Nurses using the new procedure, developed by experts at the Johns Hopkins medical school in the 1990s and endorsed last year by the World Health Organization, brush vinegar on a woman’s cervix. It makes precancerous spots turn white. They can then be immediately frozen off with a metal probe cooled by a tank of carbon dioxide, available from any Coca-Cola bottling plant.

The procedure is one of a wide array of inexpensive but effective medical advances being tested in developing countries. New cheap diagnostic and surgical techniques, insecticides, drug regimens and prostheses are already beginning to save lives.

With a Pap smear, a doctor takes a scraping from the cervix, which is then sent to a laboratory to be scanned by a pathologist. Many poor countries lack high-quality labs, and the results can take weeks to arrive.

Women who return to distant areas where they live or work are often hard to reach, a problem if it turns out they have precancerous lesions.

Miss Maikaew, 37, could have been one of them. She is a restaurant cashier on faraway Ko Chang, a resort island. She was home in Poyai, a rice-farming village, for a brief visit and was screened at her mother’s urging.

The same thing had happened three years ago, and she did have a white spot then. (They resemble warts, and are caused by the human papillomavirus.) It was frozen off with cryotherapy, which had hurt a little, but was bearable, she said.

Since she has been screened twice in her 30s, her risk of developing cervical cancer has dropped by 65 percent, according to studies by the Alliance for Cervical Cancer Prevention, a coalition of international health organizations funded by the Bill & Melinda Gates Foundation.

The procedure, known as VIA/cryo for visualization of the cervix with acetic acid (vinegar) and treatment with cryotherapy, can be done by a nurse, and only one visit is needed to detect and kill an incipient cancer.

Thailand has gone further than any other nation in adopting it. More than 20 countries, including Ghana and Zimbabwe, have done pilot projects. But in Thailand, VIA/cryo is now routine in 29 of 75 provinces, and 500,000 of the 8 million women, ages 30 to 44, in the target population have been screened at least once.

Dr. Bandit Chumworathayi, a gynecologist at Khon Kaen University who helped run the first Thai study of VIA/cryo, explains that vinegar highlights the tumors because they have more DNA, and thus more protein and less water, than other tissue.

It reveals pre-tumors with more accuracy than a typical Pap smear. But it also has more false positives — spots that turn pale but are not malignant. As a result, some women get unnecessary cryotherapy.

But freezing is about 90 percent effective, and the main side effect is a burning sensation that fades in a day or two.

By contrast, biopsies, the old method, can cause bleeding.

“Some doctors resist” the cryotherapy approach, said Dr. Wachara Eamratsameekool, a gynecologist at rural Roi Et Hospital who helped pioneer the procedure. “They call it ‘poor care for poor people.’ This is a misunderstanding. It’s the most effective use of our resources.”

At a workshop, nurse trainees pored over flash cards showing cervixes with diagnosable problems. They did gynecological exams on lifelike mannequins with plastic cervixes. They performed cryotherapy on sliced frankfurters pinned deep inside plastic pipes. Then, after lunch, they broke into small groups and went by minibus to nearby rural clinics to practice on real women.

Because cervical cancer takes decades to develop, it is too early to prove that Thailand has lowered its cancer rate. In fact, Roi Et Province, where mass screening first began, has a rate higher than normal, but doctors attribute that to the extra testing. But of the 6,000 women recruited 11 years ago for the first trial, not a single one has developed full-blown cancer.

VIA/cryo was pioneered in the 1990s simultaneously by Dr. Paul D. Blumenthal, an American gynecologist working in Africa, and Dr. Rengaswamy Sankaranarayanan in India.

Dr. Blumenthal said he and colleagues at the Johns Hopkins medical school had debated ways to make cervical lesions easier to see, and concluded that whitening them with acetic acid would be effective. Freezing off lesions is routine in gynecology and dermatology; the challenge was making it cheap and easy. Liquid nitrogen is hard to get, but carbon dioxide is readily available.

Thailand seems made for the vinegar technique. It has more than 100,000 nurses and a network of rural clinics largely run by them.

Also, while poor rural villagers in many countries go to shamans or herbalists before they see doctors, poor Thais do not. Thailand has a 95 percent literacy rate, and doctors are trusted. The king is the son of a doctor and a nurse; his father trained at Harvard. One of the royal princesses has a doctorate in chemistry and an interest in cancer research.

But the real secret, Dr. Wachara said, is this: “Thailand has Lady Kobchitt.”

Dr. Kobchitt Limpaphayon to her colleagues at Bangkok’s Chulalongkorn University medical school and “Kobbie” to her classmates long ago at New York’s Albany Medical College, she is the gynecologist to the Thai royal family. “Kobbie is a force of nature,” said Dr. Blumenthal, who has taught with her. In 1971, as a young doctor, she moved from Albany to Baltimore to help start the Johns Hopkins Program for International Education in Gynecology and Obstetrics.

In 1999, she read one of Dr. Blumenthal’s papers and asked him to introduce VIA/cryo in Thailand. Without her connections and powers of persuasion, said Dr. Bandit, it would have been impossible to get the conservative Royal Thai College of Obstetricians and Gynecologists to give up Pap smears, or to persuade Parliament to allow nurses to do cryotherapy, a procedure previously reserved for doctors.

The free screenings at public clinics are crucial to people like Yupin Promasorn, 36, who was part of Miss Maikaew’s group.

She sells snacks in Bangkok, and her husband drives a tuk-tuk motorcycle taxi. With two children, she has no time to wait at Bangkok’s jammed public hospitals, and she is too poor to see a private doctor. So she and her husband drove the 12 hours here, to her native village, in his tuk-tuk. When she found out she was negative, she sat in a chair fanning herself.

“I feel like a heavy mountain is gone from my chest,” she said.

http://www.nytimes.com/2011/09/27/health/27cancer.html?_r=1

September 28th, 2011

Shobha Krishnan, MD, returns from a visit to India

GIAHC has made a lot of progress in the past few months. Here are some of the highlights:


Kutch: KMVS/Bhojay in Kutch have scaled up their cervical cancer program substantially. They are screening an average of two villages per week.

Kutch- KMVS/ Bhojay cervical screening camp
Kutch - KMVS/Bhojay cervical screening camp

Kutch-Cervical Screening clinic held at a school in a small village
Kutch - Cervical Screening clinic held at a school in a small village

Mysore: Dr. Krishnan was invited to attend a cervical cancer screening camp conducted by the Public Health Research Institute (PHRI) Mysore and Prevention Internation, No Cervical Cancer (PINCC), San Francisco. GIAHC and PINCC are hoping to collaborate on their activities.

Mysore Cervical screening camp- Shobha Krishnan, MD(GIAHC),with physicians from U.S(PINCC) and PHRI(Mysore)
Mysore Cervical Screening Camp - Shobha Krishnan, MD (GIAHC), with physicians from U.S.(PINCC) and PHRI (Mysore)

Setting up for Cryotherapy- Mysore
Mysore - Setting up for Cryotherapy

Dr. Rhoda Nussbaum and John Adams (PINCC) with Shobha Krishnan, MD (GIAHC)
Dr. Rhoda Nussbaum and John Adams (PINCC) with Shobha Krishnan, MD (GIAHC)

Chennai: Adyar Cancer Institute will continue to play a leading role with GIAHC in the cervical cancer-training program. Dr. Anna Guiliano, member of GIAHC's Board of Directors from Moffitt Cancer Center, Florida, visited Chennai to learn more about the program and facilitate collaborations.

Chennai, India-With doctors at Adyar Cancer Institute
Channai, India - With doctors at Adyar Cancer institute


September 2nd, 2011

Congratulations to Dr. Santosham

PACE Members -

I'm proud to share the exciting news that our fellow PACE member Mathuram Santosham will be
honored by U.S. Secretary of Health and Human Services
Kathleen Sebelius today for his
tremendous contributions to the U.S.
Indian Health Service, including his three decades of
research and leadership in
childhood immunizations on the White Mountain Apache Reservation.
This
is a major honor from the Obama Administration. Please join me in congratulating Mathu!

Best,
Ciro

Ciro A. de Quadros, MD, MPH

Executive Vice-President
Albert B. Sabin Vaccine Institute (SVI)
2000 Pennsylvania Ave., N.W., Suite 7100
Washington, D.C. 20006
Phone:202-265-6515
Fax: 202-842-7689
e-mail; ciro.dequadros@sabin.org<mailto:ciro.dequadros@sabin.org>


July 8th, 2011

May 12th Online HPV & Head & Neck Cancer Seminar for YOU

*HPV and Head & Neck Cancer: What You Need to Know*

Join Sara Pai, MD, PhD, Associate Professor of Otolaryngology-Head and Neck
Surgery and Oncology at Johns Hopkins Medicine as she talks about human
papillomavirus (HPV) and its connection to head and neck cancers in men and
women. She will discuss new research studies that detail the growing trend
of these cancers, as well as the tailored treatments being developed for
these cancers.


*DATE & TIME:* Thursday, May 12, 2011 -- 7 p.m. to 8 p.m. (EST)


*REGISTRATION & INFOR: Visit*:
http://www.hopkinsmedicine.org/healthseminars#online or
https://classfindweb.beryl.net/ClassInformation.aspx?clientid=10939&classid=60922
(for U.S. residents) or
http://www.hopkinsmedicine.org/healthseminars/international_seminar_registration.html
for International participants.


Regards,

National Cervical Cancer Coalition (NCCC)

Global Initiative Against HPV & Cervical Cancer (GIAHC)

May 3rd, 2011

FDA Approves New HPV Test

FDA Approves New HPV Test
Test for Human Papillomavirus Identifies Highest-Risk Cervical Cancer Viruses

By Daniel J. DeNoon <http://www.webmd.com/daniel-j-denoon>
WebMD Health News

April 20, 2011 -- The FDA has approved Roche's new test for human papillomavirus (HPV<http://www.webmd.com/sexual-conditions/HPV-Genital-Warts/>), the first one-pass test to specifically identify the two HPV strains that cause 70% of cervical cancers.

The sexually transmitted human papillomavirus causes nearly all cervical cancers. Current HPV
tests<http://www.webmd.com/sexual-conditions/hpv-genital-warts/hpv-symptoms-tests>
can detect the presence or absence of over a dozen HPV types linked to cancer<http://www.webmd.com/cancer/>.
Roche's new cobas 4800 test does this, too, but also tells a woman whether she has HPV-16 or HPV-18.

Another FDA approved HPV test, Hologic Inc.'s Cervista HPV 16/18, can identify these dangerous HPV types but is used only in women who already have tested HPV-positive in less sensitive tests.

In a Roche study of over 47,000 women, those who tested positive for HPV-16 had a 31.5% risk of a precancerous cervical lesion.

"Screening for high-risk HPV genotypes provides important additive information to Pap <http://women.webmd.com/pap-test> testing. Screening for the two highest risk types, HPV-16 and HPV-18, can provide predictive information about a woman’s risk for having cervical precancer or cancer," says Mark H. Stoler, MD, professor of surgical pathology at the University of Virginia Health System.

Stoler led the Roche study and has been a consultant for Roche and several other makers of HPV tests.

The new Roche test detects precancerous lesions over 90% of the time. But it also gives false-positive results about 30% of the time.

A woman whose Pap smear is abnormal often has to undergo a cervical examination (colposcopy) and possibly a cervicalbiopsy<http://www.webmd.com/cancer/what-is-a-biopsy> to determine whether she really has a cancer or precancer. A colposcopy or biopsy would be more likely for women who test positive for high-risk HPV -- particularly when it's HPV-16 or HPV-18.

April 21st, 2011

2011 Women's Health Conference - Washington, D.C.

Dr. Krishnan will be presenting on GIAHC’s model at the 2011 Women’s Health conference in Washington D.C on Friday, March 31.

http://www.bioconferences.com/CONFERENCES/WomensHealth/program

March 22nd, 2011

Eurogin 2011

The European Congress on Gynecological Infections and Neoplasia has invited Dr. Krishnan to present GIAHCs grassroots effort in India in Portugal on May 8.

http://www.eurogin.com/2011/

March 22nd, 2011

Kutch Project Update

Kutch Project Women

Several more women have been screened and referred for treatment in Kutch. More villages are interested in having their women screened and treated for cervical cancer.

 

 

Left: Dr. Shobha Krishnan with Community Health Workers at Kutch.

 


March 22nd, 2011

Sexual Issues Often Unaddressed in Women Who Survive Cancer

Sexual Issues Often Unaddressed in Women Who Survive Cancer
Doctors discuss sex with prostate cancer survivors, but not women who have cancer, researchers say

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_108902.html (*this news item will not be available after 05/17/2011)

By Robert Preidt
WEDNESDAY, Feb. 16 (HealthDay News) -- Many women who survive breast or gynecologic cancers say they want help for sexual issues, but few of them actually ask for it, according to a new study from the University of Chicago Medical Center.

Few doctors have the expertise to discuss women's concerns about the effect of cancer on their sexuality, although doctors routinely bring up such questions among men treated for prostate cancer, senior author Dr. Stacy Tessler Lindau, an associate professor of obstetrics and gynecology, said in a medical center news release.

"It is critical that physicians caring for [female] cancer patients know that sexual concerns are often physical," she said. "The physical problems associated with cancer treatment can strain relationships, cause worry and stress, and can be very isolating -- many women come to us feeling ashamed, guilty, or alone. They feel like the problem is primarily in their head."

Pain, vaginal dryness, loss of desire, arousal and orgasm difficulties, and body image concerns are among the sexual problems experienced by these patients. Some have also reported feeling less attractive after treatment.

The study involved 261 gynecologic and breast cancer survivors, ages 21 to 88, with the average age of 55. Researchers found that 42 percent were interested in receiving medical help for sexual issues, but only 7 percent asked for advice.

Women who had been out of cancer treatment for more than a year were much more likely to want advice than those currently in treatment -- 47 percent vs. 32 percent.

Younger women were more concerned about sexual issues than older women, but more than 22 percent of women over 65 also said they wanted medical care for their sexual issues, said the researchers.

The study was recently published online in the journal Cancer.

"Some women have the courage to raise sexual concerns with their doctor, although repeated studies show they prefer the doctor to initiate the discussion," said Lindau.

"Physicians will often empathize with a patient's concerns, but struggle with a lack of knowledge about how to help," she added. She and other physicians in Illinois are working to establish a program to help both doctors and female cancer patients deal with these issues.

SOURCE: University of Chicago Medical Center, news release, Feb. 14, 2011

February 28th, 2011

The Importance of the Awareness of Cervical Cancer

The Importance of the Awareness of Cervical Cancer
Kristina Emerson- For The Corner News
http://www.thecornernews.com/index.php/loveliest_village/comments/the-importance-of-the-awareness-of-cervical-cancer/

According to the National Cervical Cancer Coalition (NCCC), each year approximately 10,000 women learn that they have cervical cancer. This year nearly 4,000 of these women will die of an advanced form of this disease. These statistics alone prove how important is it for women to become aware of this cancer.


Cervical cancer is the second most common type of cancer for women worldwide. Yet, because it develops over time it is also one of the most preventable types of cancer. It is also the only cancer that is known to be primarily caused by a common virus, the Humanpapillomavirus (HPV).

"We just want women who would not normally think twice about cervical cancer to simply be aware," said Noelle Stewart, clinical dietitian at the HealthPlus Fitness Center and the East Alabama Medical Clinic (EAMC) Cancer Center.

Studies show that certain things that could have been prevented cause this fatal disease. Some of these factors are closely linked to failure to receive a regular Pap test screening, HPV infection, certain sexual behaviors and disorders like HIV and AIDS.

After turning 21, every woman should get a Pap test at least every other year. In January one of NCCC's news releases stated that "in 2010 more than half of the women diagnosed with cervical cancer either never had a Pap or were not screened in the last five years."

"Awareness and vaccination are the main ways women can avoid having cervical cancer affect their lives," said Amy Von Gillern, a senior in microbiology at Auburn University who has recently studied the disease.

Although Pap tests are the best way to detect cervical cancer, vaccines have the potential to protect women from the disease. HPV 16 and HPV 18 cause about 70 percent of cervical cancers. Gardasil is one of the leading vaccines that has been proven to be most effective against HPV strains.

"These vaccines represent a major advancement in women's health and in cancer prevention. With these new tools, we may be able to help ensure no woman in the United States has to endure cervical cancer," says Juan C. Felix, MD, chairman of the NCCC medical advisory panel and chief of OB/GYN pathology at the Women's and Children's Hospital, University of Southern California Keck School of Medicine. "We hope these vaccines will make cervical cancer a concern of the past."

EAMC Cancer Center wants to make sure all women are aware of this information. To find out if you qualify for a free or low-cost mammogram and Pap test and where to get screened, call: (334) 206-5851. To learn even more about cervical cancer and the NCCC, visit their website at http://www.nccc-online.org.

February 28th, 2011

The President's Proposed FY 2012 Budget: Title X and International Family Planning Get Increase

The President's Proposed FY 2012 Budget: Title X and International Family Planning Get Increase

By Jodi Jacobson, Editor-in-Chief, RH Reality Check

In a budget referred to by New York Times columnist Paul Krugman as "nothing to cheer about," President Obama's fiscal year (FY) 2012 budget request nonetheless proposes increased funding for reproductive health and family planning programs here and abroad, drawing lines in what is sure to be a contentious battle with the House GOP leadership, whose proposed Continuing Resolution (CR) all but eliminates the same programs.

The president's budget proposes to allocate $327 million to the Title X family planning program, a $10 million increase over last year's request. It also maintains the current level of funding, $110 million, for the Teen Pregnancy Prevention Program.

Title X funding provides essential health services, especially to low-income women, through a network of more than 4,500 community-based clinics that include State and local health departments, tribal organizations, hospitals, university health centers, independent clinics, community health centers, faith-based organizations, and other public and private nonprofit agencies. Approximately 60 percent of women who receive care in a family planning health center say that such centers-provide their main source of affordable health care. The vast majority of these women and their families live at or below 150 percent of the federal poverty level, and two-thirds lack health insurance, underscoring just how vital these programs are to people otherwise likely to go without primary preventive care.

According to the Department of Health and Human Services:

Over the past 40 years, Title X family planning clinics have played a critical role in ensuring access to a broad range of family planning and related preventive health services for millions of low-income or uninsured individuals and others. In addition to contraceptive services and related counseling, Title X-supported clinics provide a number of related preventive health services such as: patient education and counseling; breast and pelvic examinations; breast and cervical cancer screening according to nationally recognized standards of care; sexually transmitted disease (STD) and Human Immunodeficiency Virus (HIV) prevention education, counseling, testing and referral; and pregnancy diagnosis and counseling. By law, Title X funds may not be used in programs where abortion is a method of family planning.

So for many low-income women, access to Title X clinics may, for example, mean the difference between early detection and early treatment of cervical cancer, or early death from the same.

The budget also proposes $769.1 million for bilateral and multilateral international reproductive health and family planning assistance, an increase of $121 million or 19 percent above the $648.5 million that Congress appropriated in FY 2010.

The proposed increase in international family planning funding "is especially significant," notes Population Action International (PAI), "in light of the difficult economic and budgetary climate and the spending freeze being imposed on domestic programs."

Most of the requested international funding for reproductive health and family planning ($722 million) is for bilateral programs administered by the U.S. Agency for International Development (USAID), which provides family planning assistance in more than 50 countries. The bulk (625.5 million), according to PAI, is for the Global Health and Child Survival (GHCS), an increase of $101 million above current levels. The remaining $96 million is contained in other bilateral accounts, a $28 million increase above current levels.

Of the $769 million requested overall, $47.5 million is proposed for a U.S. contribution to the U.N. Population Fund (UNFPA), which provides critical reproductive and sexual health care in more than 150 countries. The proposed $7.5 million cut from the current contribution of $55 million is "the only disappointing development contained in the President's request [for these programs]," said PAI.

Yet, despite the proposed funding increase, said PAI, "family planning still remains out of reach for the 215 million women in developing countries who do not want to become pregnant but need contraception."

Reproductive and sexual health advocates praised the allocations for reproductive health in the proposed budget, while also warning about the battle ahead, as Republicans seek to slash or eliminate these very same programs.

"Planned Parenthood applauds President Obama for calling for an increased investment today in an essential women's health care program, the national family planning program, Title X," said Cecile Richards, president of Planned Parenthood Federation of America.

The president's newly released budget for Fiscal Year 2012 demonstrates that this administration has the foresight to preserve programs that save money and save lives. The White House has taken a strong stand to prevent teen pregnancy through evidence-based approaches, and to sustain the nation's bedrock family planning program, Title X.

But, she noted, "The new leaders of the House are pushing... dangerous proposals forward at great risk to women, and they are doing so at their own political peril."

Under the guise of deficit reduction, House Republicans are working aggressively to eliminate the Title X program, which has provided lifesaving preventive and primary care for low-income women since President Nixon signed it into law in 1970. Health centers funded through Title X save women's lives by detecting breast and cervical cancer at early stages, by offering testing and treatment for sexually transmitted infections, screening for high blood pressure, and providing immunizations.

These clinics also prevent nearly a million unintended pregnancies every year, thus reducing the need for abortion. And family planning also saves the government money, about $3.74 for every dollar invested.

Nonetheless, notes Richards:

"While working to cut off funding for the Title X program, Representative Mike Pence, with the full support of Speaker John Boehner, will also offer an amendment to prohibit all Planned Parenthood health centers from receiving any federal funds for any purpose, including providing affordable cancer screenings, birth control, HIV testing, and treatment for sexually transmitted infections."

"Eliminating the Title X program at a time like this would not just be shortsighted," stated Richards. "It would be cruel."

On the international front, House Republicans also are proposing extreme cuts, according to PAI.

The Republican spending bill contains a 39 percent cut for international family planning when compared to the President's FY 2011 request, sinking from $716 million to $440 million. House Republicans also aim to eliminate funding for UNFPA, the lead international agency providing family planning services to the poor and hard to reach around the world.



"The President's budget request stands in stark contrast to the extreme cuts being proposed by House Republican leadership in a spending bill to fund the federal government for the remainder of the current fiscal year," said PAI. "These cuts will be debated this week and if passed would return the funding level for overseas family planning programs to the woefully inadequate amount of four years ago."

In addition to cuts, the GOP leadership is pushing to reinstate the Global Gag Rule.

Moreover, said Craig Lasher, Director of Government Affairs at PAI, "The cuts to international family planning are extreme and out of touch with the views of ordinary Americans."

Polls consistently show that Americans overwhelmingly support overseas family planning programs, including 69 percent of Independent and Republican voters, according to PAI. "Family planning is one of our most cost-effective foreign assistance programs and it supports U.S. diplomatic, development and national security priorities."

The GOP push to impose a permanent Global Gag Rule in a spending bill solves no financial issues and further restricts the ability of poor women to access desperately needed, family planning services. For many of these women, family planning clinics are the first entry point into the health care system. A November 2010 poll showed the majority of Americans do not support re-instating the Global Gag Rule.

Fully funding international family planning programs would reduce the annual number of abortions around the world by 14.5 million and reduce the number of women dying in pregnancy and childbirth by 250,000.

"Congress' job is to create responsible spending bills, not to advance an extreme social agenda that jeopardizes the lives of women around the world," said Lasher. "As the world population approaches 7 billion this year, contraceptives should not be withheld from the 215 million women in developing countries who want, but lack access to them. If social conservatives are serious about reducing abortion, they should use common sense and invest in family planning programs."

http://www.rhrealitycheck.org/blog/2011/02/14/presidents-proposed-2012-budget-title-international-family-planning-funding-increase

February 28th, 2011

Bill Gates 2011 Annual Letter

I am writing to share my third annual letter about the work our foundation and its partners are doing. The world has already accomplished so much to improve the lives of poor people, and I see exciting opportunities to do even more. For example, the miracle of vaccines gives us the ability to save millions of children and to eradicate polio from the earth. But in these tough economic times, there is a risk that governments won't maintain their commitment to these goals. The key to building on the progress we have made is bold leadership.

* You can read my letter at
www.gatesfoundation.org/annualletter *

Every one of us can be an advocate for people whose voices are not often
heard. I am optimistic that, together, we can create a world in which all
people have the chance to lead a healthy and productive life. Thank you for
taking the time to learn more.

Sincerely,

Bill Gates
Co-chair, Bill & Melinda Gates Foundation

* Guided by the belief that every life has equal value, the Bill & Melinda
Gates Foundation works to help all people lead healthy, productive lives. *

January 31st, 2011

Male Circumcision Cuts Women's Cervical Cancer Risk

Male Circumcision Cuts Women’s Cervical Cancer Risk
Study Shows Circumcision May Help Reduce Spread of HPV


January, 2011- The study involved more than 1,200 HIV <http://www.webmd.com/hiv-aids/default.htm> -negative, heterosexual couples living in Uganda, where circumcision of male adults is increasingly encouraged as a means of slowing the spread of HIV/AIDS. Jan. 6, 2011 -- Circumcising men can reduce cervical cancer <http://www.webmd.com/cancer/cervical-cancer/cervical-cancer-topic-overview> risk in women, a new study shows.

Half the men received the surgical procedure at enrollment and the other half were scheduled for circumcision after their participation in the trial ended.

Two years later, the female partners of the men who remained uncircumcised were more likely than the partners of the circumcised men to be infected with human papilloma virus (HPV)<http://www.webmd.com/sexual-conditions/HPV-Genital-Warts/> types most often associated with cervical cancer <http://www.webmd.com/cancer/>.

In earlier trials, Johns Hopkins University researcher Aaron A.R. Tobian, MD, PhD, and colleagues showed that male circumcision reduces HIV infection, HPV in men, and genital herpes.<http://www.webmd.com/genital-herpes/default.htm>

The new study appears online Friday in TheLancet.

“It is now clear that male circumcision can reduce HPV in females and possibly prevent cervical cancer in settings where HPV vaccines are not available,” Tobian tells WebMD.
Circumcision Rate Drops in U.S.

The impact of circumcision on cervical cancer risk is less clear in the U.S. and other industrialized countries where cervical cancer screening is routine, says Anna Giuliano, MD, who chairs the department of cancer epidemiology at H. Lee Moffitt Cancer Center in Tampa, Fla.

But she adds that the recent research confirming circumcision’s role in reducing the risk of HIV, HPV, and other sexually transmitted diseases are strong arguments in favor of the practice.

Neither the CDC nor the American Academy of Pediatrics (AAP) recommend routine circumcision of male infants, but the groups do not discourage the practice either.

New figures from CDC released in August confirm that fewer babies in the U.S. are being circumcised. Between 2006 and 2009, the circumcision rate among male newborns declined from 56% to 33%.

Both the CDC and the AAP are reportedly considering revisions to their infant <http://www.webmd.com/parenting/baby/default.htm> circumcision policies in light of the new research.

The CDC is also considering whether circumcision should be recommended for adult men at high risk for HIV infection, according to a statement issued in August 2009.

It has been five years since the AAP last updated its infant circumcision policy, which calls the evidence regarding the impact of circumcision on sexually transmitted disease risk “complex and conflicting.”

The studies by Tobian and colleagues were published after 2005, and Giuliano says the AAP policy statement should be changed to reflect the new research.
Circumcision Debate Emotionally Charged

But Giuliano does not believe policy makers for either group will take a strong stand in favor of male circumcision because the debate surrounding the practice is so emotionally charged.

In an editorial accompanying the study, she writes that new recommendations “should be consistent with the available evidence while considering other factors such as cultural and disease context, and the specific needs of different populations.”

“Different cultures view circumcision in different ways, and there is a huge emotional component” she tells WebMD. “People in Latin America think of circumcision as barbaric. I have even heard this from colleagues in HPV prevention.”<http://www.webmd.com/sexual-conditions/hpv-genital-warts/hpv-virus-information-about-human-papillomavirus>

Circumcision is also not widely practiced in certain countries in Europe, but cervical cancer rates are very low in these countries because screening is common.

Cervical cancer rates are very high in countries like Mexico and Brazil, where neither circumcision nor screening is widespread.

She says in parts of Africa where circumcision is considered a rite of passage, the practice may make a big difference, especially in areas without access to the HPV vaccine. <http://www.webmd.com/sexual-conditions/hpv-genital-warts/hpv-vaccines-human-papillomavirus>

January 12th, 2011

Milestone: Cervical Cancer Training Center

GIAHC and The Adyar Cancer Institute (India) have collaborated to launch a cervical cancer outreach training Center in Chennai, India. The program will commence on January 17th, 2011.  The training is for 12 days and is designed to  give hands-on-training to community health workers in cervical cancer, education, screening and treatment.  We hope to expand and scale up the program as funding becomes available.

 

Drs. Malliga, Shanta, Shobha Krishnan

From Left - Drs. Malliga, Shanta, Shobha Krishnan

http://www.thehpvbook.com/Updates.html

January 10th, 2011

Dr. Anna Giuliano joins GIAHC board of directors

Anna GiulianoCurrent Position/Responsibilities

Dr. Giuliano is Chair of the Department of Epidemiology and Genetics, and Program Leader of the Risk Assessment, Detection, and Intervention Program at the Moffitt Cancer in Tampa, Florida. Dr. Giuliano is a consultant for several large NIH-funded cervical cancer prevention programs, and she serves as an advisory board member to several large international research consortia.

 

Research Interests

Dr. Giuliano is the recipient of several large grants from the NIH, the National Cancer Institute, and the Centers for Disease Control and Prevention for research on HPV infection among women and men, with a specific interest in prevention interventions such as those promoting cervical cancer screening among underserved women in the US and in Latin America and vaccine prevention strategies. Other areas of research interest include understanding the factors that allow HPV infection to progress to disease among women and men, HPV and its association with non-melanoma skin, and other viral associated cancers such as Merkel Cell Carcinoma.

 

Education/History

Anna R. Giuliano, PhD, received her doctorate from Tufts University in Boston, Massachusetts. She continued her studies at the New England Epidemiology Institute (Epidemiology Statistics) in Boston and at the University of Arizona in Tucson as a National Cancer Prevention and Etiology Fellow from 1990-1993.  From 1993 to 1998 she was the recipient of a National Institutes of Health (NIH) National Cancer Institute Preventive Oncology Career Development Award.

 

Professional Society Affiliations

Dr. Giuliano serves as an Advisor to Intercultural Cancer Council and is a member of the Medical Advisory Panel of the National Cervical Cancer Coalition and the Prevent Cancer Foundation. She is also a member of the International Papillomavirus Society, the International Epidemiological Association, the American Association of Cancer Researchers, and the American Public Health Association, among other professional organizations.

 

Publications/Editorial Experience

Dr. Giuliano serves as a reviewer for several NIH grant review panels and as manuscript reviewer for several journals, including the Journal of the National Cancer Institute, International Journal of Cancer, Journal of Infectious Diseases, and JAMA.  She has published over 160 original scientific manuscripts in peer-reviewed journals such as Lancet Oncology, Cancer Epidemiology Biomarkers and Prevention, Journal of the National Cancer Institute, and the International Journal of Cancer.  Dr. Giuliano contributed significantly to the 1999 Institute of Medicine (IOM) report The Unequal Burden of Cancer and to the WHO IARC HPV Monograph published in 2007.

January 10th, 2011

"Indian Journal of Medical Ethics" reviews HPV Vaccine book by Dr. Krishnan

Indian Journal of Medical Ethics reviews HPV Vaccine book by Dr.
Krishnan…(excerpt) the book provides valuable technical knowledge which can
help parents as well as doctors take a stand regarding HPV vaccination.
Despite the technical nature of the book, it can serve as an excellent
referral book for students and the general public.
http://www.ijme.in/183br185.html

January 10th, 2011

Dr. Finkel joins GIAHC Board of Directors

Madelon L. Finkel, PhD, is professor of clinical public health and director of the Office of Global Health Education at the Weill Cornell Medical College in New York City, NY. She has been involved in epidemiological research and health care policy studies for three decades. In addition to writing on U.S. health care policy, her research focus most recently has been on women's health issues including hormone replacement therapy and mammogram screening. New areas of research include cervical cancer screening in rural India, reduction of maternal mortality in Peru, and reduction of preterm birth in Brazil.  Her educational responsibilities involve coordinating and directing medical school course modules in Years 1 and 2, as well as the Public Health Clerkship in Year 4. Dr Finkel has established an eight-week research methodology seminar series, which is presented to Residents at several Weill Cornell Network hospitals. Dr. Finkel has published extensively, including Praeger's Understanding the Mammography Controversy: Science, Politics, and Breast Cancer Screening and Truth, Lies, and Public Health: How We Are Affected When Science and Politics Collide.

November 22nd, 2010

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY REVIEWS THE HPV VACCINE BOOK

One may ask why there is a controversy about a vaccine that has the potential to reduce the incidence of the second most common cause of cancer death in women worldwide (cervical cancer). Dr Krishnan addresses this question from the standpoint of the knowledge of the safety and efficacy of this vaccine and the public's acceptance of the vaccine in 2008, 2 years after its approval by the US Food and Drug Administration (FDA)...Dr Krishnan does an outstanding job of explaining the HPV vaccine ... Furthermore, she provides a superb discussion on counseling patients with HPV infections...This discussion can be a useful guide for the clinician who deals with patients with any STD...In summary, The HPV Vaccine Controversy  is a useful guide for the clinician and for the lay public 4 years after FDA approval of the quadrivalent HPV vaccine... http://www.eblue.org/article/S0190-9622(10)00506-2/fulltext

November 18th, 2010

Powerful woman influencer in India now on GIAHC board of directors

MRS. SUSHMA IYENGAR

Mrs. Sushma Iyengar is the founder of Kutch Mahila Vikas Sangathan (KVMS), an organization of rural women in Gujarat, India, dedicated to empowering women to increase their income in a sustainable way. Today the members of KVMS provide leadership to over 14,000 women and communities in 175 villages. Its collectives focus on issues of ecological restoration and adaptation to drought, strengthening women’s roles and resource access in their traditional economies of animal husbandry and embroidered craft, domestic violence, reproductive health, land tenancy rights and political participation. The collective has pioneered the use of community radio in the country.

As the Coordinating Head of the KMVS network, Iyengar led the relief and rehabilitation  coordination following the 2001 earthquake in the region.  Iyengar’s work brought several awards and recognition. In 1996 she received the Gondhia Award for Social Work. She was nominated in 2005 by India Today as one of the 30 young, powerful women influencers in the country, and in 2007 was featured on CNN-IBN in its series on individuals who have contributed to India’s development.

Sushma obtained her B.A. and M.A degrees in English/Comparative Literature from M.S. University, Baroda in 1985. She obtained her Master in Professional Studies in Development Communication from Cornell University in 1988.

November 18th, 2010

Dr. Santosham, internationally known for his work, joins GIAHC board of directors

Dr. SantaoshamDR. MATHURAM SANTOSHAM

Dr. Santosham was born in Vellore, India and obtained his MBBS degree from the Jawaharlal Institute of Post Graduate Medical Education and research (JIPMER) in, Pondicherry, India in 1970. He subsequently moved to the United States and obtained Board Certification in Pediatrics and an MPH degree from the Johns Hopkins University. He also did a Fellowship in Pediatric Infectious Diseases at Johns Hopkins Hospital. Dr. Santosham currently is part of the Executive Committee for the recently formed Hib Initiative, overseeing activities to help countries make evidence-informed decisions regarding the use of Hib vaccines. He is the Director of the Center for American Indian and Alaskan Native Health, and the Program for Health Systems at the Johns Hopkins University (JHU) Bloomberg School of Public Health in Baltimore, Maryland and a Professor in the Department of International Health, and the Department of Pediatrics at JHU.

Dr. Santosham is internationally known for his work on oral rehydration therapy and for his work on childhood vaccines. He has conducted numerous vaccine efficacy trials, including rotavirus vaccine, H. influenza type b (Hib) conjugate vaccine, and pneumococcal conjugate vaccine. He was the Primary Investigator on the pivotal vaccine efficacy trial that led to the licensure of one of the Hib conjugate vaccines.

Dr. Santosham serves on numerous national and international committees on infant vaccines and oral rehydration therapy. He has acted as consultant for several international agencies including WHO, USAID and UNICEF. He has provided consultation in various aspects of child survival in over 30 countries. He is the author of over 100 peer-reviewed journals and serves as a reviewer for several international medical journals. He is the recipient of numerous awards including the prestigious Thrasher Research Fund award for excellence in research.

November 18th, 2010

Senior finance director at Dow Chemical Company joins GIAHC board after personal experience

SadasivanMR. VENKAT SADASIVAN

Venkat Sadasivan is a senior finance director with the Dow Chemical Company.  He has extensive global financial background in controller’s, Treasury and business finance.

After starting his finance career in1990 in Louisiana, Sadasivan progressed through a variety of assignments in the controller’s function. He then relocated to Midland, Michigan as a manager for treasury accounting activities. In 1999, he was appointed as the Chief Financial Officer and Controller for Dow Thailand and Vietnam operations.

Sadasivan holds an accounting degree from the University of Alabama and has completed management development programs in the Thunderbird and Kelley schools of business. He has served on the board of various joint venture companies and as a member of the tax and legal committee with the American Chamber of Commerce.

He recently lost his wife (46) to stage IV lung cancer (non smoker). His personal journey as the primary caretaker of his wife has given him a deep understanding of the importance of GIAHC’s mission of raising awareness, prevention, early detection and treatment of cancers, and, feels honored to serve on its board.

November 18th, 2010

GIAHC appoints distinguished member to Board of Directors

GIAHC is in the process of forming a board that comprises an experienced, diversified, and, committed group of individuals who will strive to make its vision a resounding success.  The following highlights the addition of a distinguished Gynecological Oncologist from the Cleveland Clinic to the GIAHC board:

J BerlnsonJerome L Belinson is the President and founder of Preventive Oncology International, Inc. (www.poiinc.org)  a research organization that blends humanitarian work with investigative science. 

Dr Belinson has worked for more than 14 years in rural China in multiple provinces throughout the country. His initial study known as SPOCCS I, The Shanxi Province Cervical Cancer Screening Study, received international acclaim and it continues to serve as a model for study design in epidemiology courses around the world. This study provided the true sensitivity and specificity of multiple screening technologies. The work of Dr. Belinson and his P.O.I. colleagues has also been recognized for their careful adherence to human values and the proper conduct of studies involving human subjects in the third world.  In addition to China, POI has conducted studies in the Dominican Republic, Mexico, and the US.

Jerome L Belinson, MD is the Ex-officio Chairman of the Department of Obstetrics and Gynecology at the Cleveland Clinic Foundation 1990-2000. He has dedicated his career to advancing the screening and treatment of gynecologic cancers.

Dr Belinson serves as Professor of Surgery with the Cleveland Clinic Lerner College of Medicine of the Case Western Reserve University. Trained in Ob/Gyn at Columbia University's Presbyterian Hospital in New York City, a fellow in Gynecologic Oncology at the University of Miami, Jackson MemorialHospital, Dr Belinson began the first formal gynecologic oncology service at the University of Vermont in 1977. He has previously held full professorships at the University of Vermont (tenured) and The Ohio State University. Voted teacher of the year at the University of Vermont, and on three occasions at the Cleveland Clinic; Dr. Belinson received the 2004 distinguished graduate Citation of Merit from the University of Missouri Medical School, The Bruce Hubbard Stewart award for humanitarianism  in medicine at the Cleveland Clinic, and is consistently listed among the "Best Doctors in America". In 2010 Dr Belinson received the "Chinese Friendship Award", the highest recognition China gives to a foreigner.

He has served as an advisor to the Ministry of Science in India, the medical advisory board for the Gates Foundation START project (to develop a rapid low cost HPV test), and serves on the Board of Directors of Grounds for Health, an organization that provides care for women in the coffee growing regions of the world.

 

November 17th, 2010

Barnard group raises HPV awareness

A group of Barnard students have banded together to fight cervical cancer.

The newly-formed group, the HPV Education and Outreach Project, joined forces with Well-Woman, a health promotion student group at Barnard College, to increase awareness of women’s health—particularly the risks surrounding human papillomavirus. The group is a partnership of the Global Initiative Against HPV and Cervical Cancer, or GIAHC, which was launched in July by Shobha Krishnan, a staff physician at Barnard and the author of “The HPV Vaccine Controversy: Sex, Cancer, God, and Politics.

To read the article in its entirety please visit: http://www.columbiaspectator.com/2010/11/05/barnard-group-raises-hpv-awareness

November 16th, 2010

Latin American Sub Regional Meeting on Cervical Cancer Prevention

Latin American Sub Regional Meeting on Cervical Cancer Prevention – Purpose, Objectives and Expected Results from the meeting can be found on the link below
http://new.paho.org/hq/index.php?option=com_content&task=blogcategory&id=2300&Itemid=2318

PRESENTATIONS - http://new.paho.org/hq/index.php?option=com_docman&task=cat_view&Itemid=270&gid=2297&orderby=dmdate_published&ascdesc=DESC 

September 24th, 2010

Pan American Health Organization – Organización Panamericana de la Salud

Pan American Health Organization – Organización Panamericana de la Salud

http://new.paho.org/hq/index.php?option=com_frontpage&Itemid=1

September 24th, 2010

Population Reference Bureau’s (PRB) - 2010 World Population Data Sheet

PRB is pleased to announce the availability of the 2010 World Population Data Sheet, providing demographic data and information for more than 200 countries. New in this edition are data on the elderly support ratio, indicating levels of potential societal support available for the elderly; mobile phone subscribers per 100 inhabitants; and percent of population who use improved sanitation. There is also a special section focusing on aging.

View or download the data sheet at www.prb.org/pdf10/10wpds_eng.pdf

September 21st, 2010

NCCC/ GIAHC's First India Chapter

NCCC/ GIAHC's First India Chapter
Chapter Leader: Liladhear Gada

To read more about Liladhear please visit:

http://archive.constantcontact.com/fs014/1101471879587/archive/1103633243509.html

September 18th, 2010

The Bill & Melinda Gates Foundation is now accepting grant proposals for Round 6 of Grand Challenges Explorations

The Bill & Melinda Gates Foundation is now accepting grant proposals for Round 6 of Grand Challenges Explorations.

Available at: http://www.grandchallenges.org/Pages/default.aspx

 

September 17th, 2010

CDC's "Inside Knowledge: Get the Facts about Gynecologic Cancer"

Read more about CDC's "Inside Knowledge: Get the Facts about Gynecologic Cancer"

Available at http://www.cdc.gov/cancer/knowledge/tv_psa.htm

September 17th, 2010

Cervical Cancer Action (CCA) has a new publication on "Coalition Building"

Cervical Cancer Action (CCA) has a new publication on "Coalition Building"

Available at: http://cervicalcanceraction.org/pubs/pubs.php#coalitions

 

September 17th, 2010

WHO Announces New Chair for the Strategic Advisory Group of Experts (SAGE) on Immunization

WHO has announced that Professor Helen Rees, internationally-recognized expert in vaccination and one of South Africa's most well known women scientists, has taken over as the Chair of WHO's leading advisory group on immunization, the Strategic Advisory Group of Experts, or SAGE.

Professor Rees is the founder and Executive Director of the Wits Institute for Sexual and reproductive Health, HIV and Related Diseases of the University of the Witwatersrand in South Africa, where she is also an Ad Hominen Professor in the Department of Obstetrics and Gynaecology. She is co-chair of South Africa's National AIDS Council's Programme Implementing Committee and a member of the National Advisory Group on Immunizations. Professor Rees has a research interest in areas including HIV/AIDS prevention, HIV and human papillomavirus vaccines, and broader issues relating to women's health.


For full story, see http://www.who.int/immunization/sage/news_sage_chair_2010/en/index.html
For biographies of current SAGE members, see http://www.who.int/immunization/sage/members/en/index.html

 

September 2nd, 2010

HPV 2010 Conference: Sharing Knowledge for Global Health

Dr. Krishnan will be speaking on Capacity Building on July 7th, at the International Papillomavirus Society Conference in Montreal, Canada.

Visit the HPV 2010 Conference site for more details.

June 23rd, 2010

Women Against Cervical Cancer (WACC) Conference: Montreal, Canada

Dr. Krishnan will be speaking on "How to Work with Women in the Community" on July 6th, at the International Papillomavirus Society, Women Against Cervical Cancer (WACC) conference in Montreal, Canada.

Download the WACC Conference program pdf for more details.

 

June 22nd, 2010

Interview with the American Social Health Association

Read the Dr. Krishnan interview at the ASHA website.

June 21st, 2010