Dr. Neal Palafox has looked at health care issues across the Pacific for decades. One of his recent focuses has been cervical cancer.
As the principal investigator for a project in Yap in the Federated States of Micronesia, he was bothered that the mortality rate for cervical cancer in some island nations is the highest in the world.
"The death rates were high because it was caught late in Guam, CNMI. The illness should have been diagnosed way early, and there is the technology to do that. So we said we have to do something to make sure that existing technology is applied, because it's totally preventable," Palafox said.
The rate of cervical cancer cases can reach up to 50 per 100,000 women in some Pacific nations, compared to the U.S. rate of 7 per 100,000.
With more than $4 million from the federal government, Palafox has been working for the last four years to set up testing and treatment systems in Yap and Guam. He works at the University of Hawaiʻi John A. Burns School of Medicine and the UH Cancer Center.
Cervical cancer is most often caused by certain strains of the human papillomavirus. Palafox's project focuses on clinician and self-collected primary HPV DNA testing.
"I think the wonderful thing about the new technology is that it can be done in the field, meaning that the current platforms that can find the DNA for these high-risk strains can be done in very rural settings," Palafox said.
"Unlike pap smears, which were the former technology, which actually looked at cellular changes, which is sometimes late in the game, they require a pathologist, another lab, you have to look at it under a microscope and so forth — and so the infrastructure you need is much more, and many rural areas don't have that," he said.
The project also focused on setting up infrastructure for follow-ups, should someone test positive for HPV and need treatment.
"We really wanted to reassure women, whether it's in Guam or in Yap, that not only can you do the test, but we will develop your system to have it so that you're not stuck," Palafox said.
He emphasized that the insurance structure of the U.S. health care system is a barrier to implementing the new technology in the states.
"It's because of different interests in insurance and in, you know, who pays for what, what are the rules, do you have this code to make sure that this is correct, and all these different things," Palafox added.
This interview aired on The Conversation on Sept. 10, 2024. The Conversation airs weekdays at 11 a.m. on HPR-1.
