Project ECHO: A Telementoring Program for Cervical Cancer Prevention and Treatment in Low-Resource Settings.

Cervical cancer incidence and mortality rates are significantly higher in low- and middle-income countries compared with the United States and other developed countries. This disparity is caused by decreased access to screening, often coupled with low numbers of trained providers offering cancer prevention and treatment services. However, similar disparities are also found in underserved areas of the United States, such as the Texas-Mexico border, where cervical cancer mortality rates are 30% higher than in the rest of Texas. To address these issues, we have adopted the Project ECHO (Extension for Community Healthcare Outcomes) program, a low-cost telementoring model previously proven to be successful in increasing local capacity, improving patient management skills, and ultimately improving patient outcomes in rural and underserved areas. We use the Project ECHO model to educate local providers in the management of cervical dysplasia in a low-resource region of Texas and have adapted it to inform strategies for the management of advanced cervical and breast cancer in Latin America and sub-Saharan Africa. This innovative approach, using ECHO, is part of a larger strategy to enhance clinical skills and develop collaborative projects between academic centers and partners in low-resource regions.
Competing Interests: The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc. Melissa S. LopezNo relationship to discloseEllen S. BakerStock or Other Ownership: MerckAndrea M. MilbourneNo relationship to discloseRose M. GowenNo relationship to discloseAna M. RodriguezNo relationship to discloseCesaltina LorenzoniNo relationship to discloseCatherine MwabaResearch Funding: Mylan Zambia (Inst) Travel, Accommodations, Expenses: Fresenius Kabi South AfricaSusan Citonje MsadabweTravel, Accommodations, Expenses: AstraZenecaJosé Humberto TavaresNo relationship to discloseGeorgia Fontes-CintraNo relationship to discloseGustavo Zucca-MatthesNo relationship to discloseDonato Callegaro-FilhoNo relationship to discloseDanielle Ramos-MartinNo relationship to discloseIcaro Thiago de CarvalhoNo relationship to discloseRobson CoelhoNo relationship to discloseRenato Moretti-MarquesNo relationship to discloseThiago ChulamTravel, Accommodations, Expenses: A.C. Camargo Cancer CenterMila Pontremoli-SalcedoNo relationship to discloseFernanda NozarNo relationship to discloseVeronica FiolTravel, Accommodations, Expenses: UrufarmaMauricio MazaNo relationship to discloseSanjeev AroraNo relationship to discloseErnest T. HawkEmployment: MD Anderson Cancer Center Honoraria: National Cancer Institute, Huntsman Cancer Institute, Mayo Clinic Cancer Center, Kansas University Medical Center, Ohio State University Comprehensive Cancer Center, Roswell Park Cancer Institute, Simmons Comprehensive Cancer Center, University of Nebraska Medical Center, University of South Alabama Mitchell Cancer Institute, Johns Hopkins University, Oncology Nursing Society Conference, Weill Cornell Medical College, ASCO, American Association for Cancer Research Consulting or Advisory Role: Cancer Prevention Pharmaceuticals, PLx Pharma, POZEN Research Funding: National Institutes of Health/National Cancer Institute (Inst), the Cancer Prevention Research Institute of Texas (Inst), Cancer Prevention Pharmaceuticals (Inst) Patents, Royalties, Other Intellectual Property: John Wiley & Sons Travel, Accommodations, Expenses: National Cancer Institute, American Association for Cancer Research, Huntsman Cancer Institute, Kansas University Medical Center, Mayo Clinic Cancer Center, Ohio State University Comprehensive Cancer Center, Roswell Park Cancer Institute, Simmons Comprehensive Cancer Center, University of Nebraska Medical Center, Johns Hopkins University, Oncology Nursing Society Conference, Weill Cornell Medical College, ASCO, American Association for Cancer Research, American Cancer Society, Association of American Cancer Institutes—Cancer Center Administrators Forum, Alliance Prevention Committee, First Annual Meta-ECHO MeetingKathleen M. SchmelerResearch Funding: Becton Dickinson Patents, Royalties, Other Intellectual Property: UpToDate