Family Medicine and Community Health’s Neal Palafox has been invited to speak at the Institute of Medicine’s National Cancer Policy Forum on Oct. 26-27 in Washington D.C.
Dr. Palafox will be sharing his expertise with other national leaders in cancer control on the topic of “Sociocultural considerations in advancing cancer prevention and control in low resource settings.”
The Institute of Medicine, created during Abraham Lincoln’s presidency, advises national leaders on health issues. Its membership includes John A. Burns School of Medicine (JABSOM) Dean Jerris Hedges, MD.
Dr. Palafox, who serves at both the John A. Burns School of Medicine and the University of Hawai’i Cancer Center, is part of a team that also was recently awarded a five-year, $5.5 million grant to support its ongoing partnership addressing cancer health disparities among Pacific Islanders in Hawai’i, Guam and neighboring U.S. Associated Pacific Islands.
“This award will support research to prevent cervical cancer, oral cancer and other cancers of regional significance. We look forward to pooling our collective knowledge, experience and resources in our ongoing efforts, together with the University of Guam and with communities across the Pacific region, to reduce the disproportionate cancer burden in Pacific Island populations,” said Dr. Palafox.
Research Will Include First of its Kind Inquiry into Betel Nut Affects
Palafox is directing the partnership along with two other renowned senior investigators at the NCI-designated UH Cancer Center, Carl-Wilhelm Vogel, MD, PhD, and David Ward, PhD. The focus of the Partnership is cancer research and outreach as well as other activities that facilitate cancer research such as student education in biomedical and biobehavioral research and career development for early stage investigators.
“This award will continue to support the infrastructure and the many research collaborations that we’ve established over the past 12 years, in addition to providing funds for new and innovative cancer research unique to the Pacific Region,” said Vogel, founding PI of the University of Guam (UOG) and UHCC Partnership. Research projects funded in the new cycle (2015-2020) include a health communications study designed to increase cervical cancer screening among Micronesian women in Hawai’i and Guam; a betel nut cessation intervention for adults in Guam – the first of its kind; and a study to identify molecular components of Areca (betel) nut that promote chronic inflammation (in the immune system), an important role in forming cancer.
Betel nuts are the fourth most commonly used psychoactive substance in the world. Betel nut chewing is practiced by many Pacific Island populations in the Western Pacific region, including Chamorros, Palauans, Yapese and Chuukese, and the practice is growing as Micronesians migrate to neighboring jurisdictions, including Hawai’i where betel nut is available in local retail outlets. Chewing betel nut causes oral lesions and skin changes in the mouth that can lead to the development of esophageal and oral cancers as well as other diseases. “Our betel nut research is of global and regional importance as study findings will inform future public health interventions and clinical recommendations for betel nut users in the Pacific region and worldwide,” said Dr. David Ward.
Stubborn Health Disparities Persist
Disparities in the numbers of fatal cancers have risen among populations and socio-economically disadvantaged groups, despite significant progress in other aspects of cancer research. Pacific Islanders, specifically Micronesians, have some of the highest rates of cancer in the world; cervical cancer among Micronesian women is higher than the national average (79.7/100,000 vs 9.9/100,000).
Many investigators, staff, and research/graduate assistants have contributed to growing cancer health disparities research, outreach and training activities supported by the Partnership. During the past six years, over 60 peer-reviewed manuscripts have been published; nine grants were awarded; 15 master’s students and five doctoral students, including two PhD graduates, were awarded training fellowships; and, as a result of outreach activities, landmark tobacco control legislation was adopted in Guam, most notably tobacco tax legislation which provides approximately $1M in annual revenues to support cancer screening and direct patient services on Guam.
Together with the UOG’s award of $4.1M, the combined Partnership award brings nearly $10M in cancer research dollars to the Pacific region. The University of Guam/UH Cancer Center Partnership is one of only 13 Comprehensive Partnerships to Advance Cancer Health Equity (CPACHE), a program funded by the National Cancer Institute (NCI) to develop cancer research capacity at institutions serving underserved health disparity populations and underrepresented students (ISUPS), and to explore factors contributing to cancer health disparities and their impact on underserved and socio-economically disadvantaged populations. The UOG/UHCC Partnership is the only partnership within NCI’s CPACHE program that serves Pacific Islanders, specifically Micronesians.
Pictured: Dr. Palafox with Dean Hedges and Dr. Allen Hixon, Chair of JABSOM Family Medicine & Community Health.