Focus & Objectives

In high-income countries, cancer control strategies including HPV vaccination and cervical screening have led to a steep decline in cervical cancer, but these remain largely inaccessible to women in low- and middle-income countries (LMICs). As of now, the highest rates of cervical cancer incidence and related death occur in Sub-Saharan Africa, where 60 percent of cervical cancer cases are in women living with HIV/AIDS. Other LMICs face similar challenges to this urgent women's health crisis. The CGO is leading bold and innovative research in cervical cancer control, including cervical cancer implementation science, the development of a West African Cervical Cancer Control Network and, with generous foundation funding, the introduction of mobile HPV testing.

Human papillomavirus (HPV) causes around 5 percent of cancers worldwide, including an increasing proportion of Oral and Oropharyngeal cancers (OOPCs). In the United States, the prevalence of HPV-related OOPC is increasing by an alarming 2.5 percent per year, and similar trends follow throughout Europe. Sub-Saharan Africa has an even higher prevalence of 15 percent. This worsening public health problem is even more serious in countries with high human immunodeficiency virus (HIV) prevalence. This evolving public health challenge requires creative research initiatives, including developing novel approaches to improve OOPC early detection that are non-invasive and cost-effective enough for large-scale screening. Find the EpOOCH project on our Research Projects page to learn more about the CGO’s partnership with researchers at the University of Ibadan to study epigenetic biomarkers for identifying HPV-infected PLWH who are at risk of progression to invasive OOPC.

In Africa, liver cancer, specifically hepatocellular carcinoma (HCC), ranks as the second most common cancer in men and the third most common in women. Sub-Saharan Africa experiences the youngest age (median age: 35 years) at diagnosis, highest prevalence of Helicobacter pylori infection and lowest survival rates in the world. We seek to understand the intricate relationship between Helicobacter pylori infection and liver cancer to develop preventive and therapeutic strategies, including the potential use of Helicobacter pylori eradication treatments, to combat liver cancer.

Due to challenges in diagnosing lung cancer, often leading to late diagnoses, there is a need to improve early detection and prevention methods. We are focusing on identifying new epigenetic biomarkers to facilitate early detection and personalized treatment opportunities. By analyzing the epigenetics of lung cancer in Malian patients, particularly in the context of TB, the research seeks to uncover new genetic and epigenetic biomarkers that could enhance diagnosis and treatment strategies.

While breast cancer incidence rates remain higher in high-income countries compared to low- and middle-income countries (LMICs), the mortality rates in LMICs significantly surpass those in high-income nations. This alarming trend is exacerbated by limited access to breast cancer screening and late-stage diagnosis, which restricts treatment options and escalates mortality rates. Recent research suggests that between 28 to 37 percent of these fatalities could be prevented with earlier detection and appropriate treatments. Our current investigations in Mali focus on elucidating the role of epigenetics in breast cancer through the analysis of blood and tissue samples, with the ultimate aim of developing early biomarkers (IGH Catalyzer Funding). Furthermore, our efforts extend to exploring the molecular pharmacogenetic dynamics underlying breast cancer treatment outcomes in Mali through the Beginning Investigator Grant for Catalytic Research (BIG CAT) project with funding from the American Association for Cancer Research awarded to Dr. Brehima Diakite.

We are also currently pioneering the development of a smart microscope equipped with telepathology capabilities. This technology is specifically designed to address the critical need for breast cancer screening in remote rural areas that lack access to traditional screening methods.

Prostate cancer is the most commonly diagnosed cancer in men and the second-highest cause of cancer-related death. The disparity in prostate cancer remains the highest cancer disparity in the U.S., with Black men facing an estimated 78 percent higher incidence and 230 percent higher mortality than white men. Black men also tend to be diagnosed with more aggressive PCa, and at younger ages, than white men. However, our current understanding of risk factors for prostate cancer such as socioeconomic status (SES), smoking, diet and genetics/family history cannot fully explain these racial disparities. New approaches are needed to understand racial disparities in prostate cancer and how genetic and environmental factors interact to drive it, to augment current screening approaches (i.e., Prostate-Specific Antigen) and improve health equity. Studying genetic ancestry as a component of health disparities outcomes is an important way global health approaches can benefit the health of all and shed light on the unique ways ancestry can impact cancer. One such study at the CGO is the Impact of Genetic Ancestry and DNA Methylation on Prostate Cancer in African and African American Patients.

Telepathology is the practice of pathology and cancer biology at a distance. As part of a global health initiative, it is pivotal to establish telepathology, which can provide a powerful platform for remote medical education, research and consultation. The secure remote sharing of images in telepathology allows for a histology review process across geographic barriers. Visit our Research Projects page to learn how investigators at the CGO are screening and collecting hundreds of cervical cancers of different geographic regions, with considering different HIV and HPV status in multi-institution collaboration with experts and clinicians, epidemiologists, pathologists and basic scientists.

Screening people for cancer and cancer-causing infectious agents when and where it is convenient for them is a major component of effective cancer control across the globe and is especially crucial in low- and middle-income countries (LMICs). Developing and supporting patient-centered and community-based point-of-care testing for cancer screening is a major goal of the CGO: 

• The CGO is addressing the pressing need for effective cervical cancer screening in Sub-Saharan Africa, particularly at the community level. Our objective is to overcome existing barriers to CC screening by developing a cost-effective, user-friendly, point-of-care human papillomavirus (the causative agent of cervical cancer) self-testing system tailored for community-based screening. This system will not only facilitate the detection of high-risk HPV strains but also enable risk stratification for targeted interventions among individuals testing positive. 
• We are also interested in discovering and developing epigenetic biomarkers for the early detection of cervical, breast and liver cancers.
• In addition, we are currently pioneering the development of a smart microscope equipped with telepathology capabilities. This technology is specifically designed to address the critical need for breast cancer screening in remote rural areas that lack access to traditional screening methods.