Browsing by Author "Luciani, S"

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Catalyzing Childhood Cancer Care in Peru After One Year of the Global Initiative for Childhood Cancer
(American Society of Clinical Oncology, 2021) Vasquez, L; Maradiegue, E; Rojas Montoya, J; Zapata, A; Ugaz, C; Pascual, C; Santillán, C; Wachtel, A; Celis, E; Bernedo, H; Rossi, J; Saldaña, L; Diaz, R; Morales, R; Perez, V; Metzger, ML; Luciani, S
Tesis desarrollada en el ámbito de la Ingeniería, orientada al análisis y/o solución de problemáticas técnicas propias de la disciplina.
Impact of COVID-19 in pediatric oncology care in Latin America during the first year of the pandemic
(John Wiley and Sons Inc, 2022) Villanueva, G; Sampor, C; Palma, J; Villarroel, M; Valencia, D; Lombardi, MG; Garcia, WG; Caceres, EL; Sobrero, V; Garcia, L; Cabrera, V; Maza, I; Velasquez,T; Ugaz, C; Vasquez, JM; Coronado, RD; Gonzalez, N; Aguiar, S; Dabezies A; Moreno, F; Sardinas, S; Gamboa, Y; Maradiegue, E; Fu, L; Gassant, P; Moreno, K; Gonzales, O; Schelotto, M; Luna-Fineman, S; Antoneli, CG; Fuentes-Alabi, S; Luciani, S; Cappellano, A; Chantada, G; Vasquez, L
Background: The ongoing coronavirus 2019 disease (COVID-19) pandemic strained medical systems worldwide. We report on the impact on pediatric oncology care in Latin American (LATAM) during its first year. Method: Four cross-sectional surveys were electronically distributed among pediatric onco-hematologists in April/June/October 2020, and April/2021 through the Latin American Society of Pediatric Oncology (SLAOP) email list and St Jude Global regional partners. Results: Four hundred fifty-three pediatric onco-hematologists from 20 countries responded to the first survey, with subsequent surveys response rates above 85%. More than 95% of participants reported that treatment continued without interruption for new and active ongoing patients, though with disruptions in treatment availability. During the first three surveys, respondents reported suspensions of outpatient procedures (54.2%), a decrease in oncologic surgeries (43.6%), radiotherapy (28.4%), stem cell transplants (SCT) (69.3%), and surveillance consultations (81.2%). Logistic regression analysis showed that at the beginning of the first wave, participants from countries with healthcare expenditure below 7% were more likely to report a decrease in outpatient procedures (odds ratio [OR]: 1.84, 95% CI: 1.19–2.8), surgeries (OR: 3, 95% CI: 1.9–4.6) and radiotherapy (OR: 6, 95% CI: 3.5–10.4). Suspension of surveillance consultations was higher in countries with COVID-19 case fatality rates above 2% (OR: 3, 95% CI: 1.4–6.2) and SCT suspensions in countries with COVID-19 incidence rate above 100 cases per 100,000 (OR: 3.48, 95% CI: 1.6–7.45). Paradoxically, at the beginning of the second wave with COVID-19 cases rising exponentially, most participants reported improvements in cancer services availability. Conclusion: Our data show the medium-term collateral effects of the pandemic on pediatric oncology care in LATAM, which might help delineate oncology care delivery amid current and future challenges posed by the pandemic. © 2022 Wiley Periodicals LLC.
Performance of visual inspection of the cervix with acetic acid (VIA) for triage of HPV screen-positive women: results from the ESTAMPA study
(John Wiley and Sons Inc, 2023) Baena, A; Mesher, D; Salgado, Y; Martínez, S; Villalba, GR; Amarilla, ML; Salgado, B; Flores, B; Bellido-Fuentes, Y; Álvarez-Larraondo, M; Valls, J; Lora, O; Virreira-Prout, G; Figueroa, J; Turcios, E; Soilán, AM; Ortega, M; Celis, M; González, M; Venegas, G; Terán, C; Ferrera, A; Mendoza, L; Kasamatsu, E; Murillo, R; Wiesner, C; Broutet, N; Luciani, S; Herrero, R; Almonte, M
VIA is recommended for triage of HPV-positive women attending cervical screening. In the multicentric ESTAMPA study, VIA performance for detection of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) among HPV-positive women was evaluated. Women aged 30-64 years were screened with HPV testing and cytology and referred to colposcopy if either test was positive. At colposcopy visit, study-trained midwives/nurses/GPs performed VIA ahead of colposcopy. VIA was considered positive if acetowhite lesions were observed in or close to the transformation zone. Ablative treatment eligibility was assessed for VIA positives. Performance indicators were estimated. Three thousand one hundred and forty-two HPV-positive women were included. Sensitivity for CIN3+ was 85.9% (95% CI 81.2-89.5) among women <50 years and, although not significant, slightly lower in women 50+ (78.0%, 95% CI 65.9-86.6). Overall specificity was 58.6% (95% CI 56.7-60.5) and was significantly higher among women 50+ (70.3%, 95% CI 66.8-73.5) compared to women <50 (54.3%, 95% CI 52.1-56.5). VIA positivity was lower among women 50+ (35.2%, 95% CI 31.9-38.6) compared to women <50 (53.2, 95% CI 51.1-55.2). Overall eligibility for ablative treatment was 74.5% and did not differ by age. VIA sensitivity, specificity, and positivity, and ablative treatment eligibility varied highly by provider (ranges: 25%-95.4%, 44.9%-94.4%, 8.2%-65.3%, 0%-98.7%, respectively). VIA sensitivity for cervical precancer detection among HPV-positive women performed by trained providers was high with an important reduction in referral rates. However, scaling-up HPV screening triaged by VIA will be challenging due to the high variability of VIA performance and providers' need for training and supervision.
Perspectives on Strengthening Cancer Research and Control in Latin America Through Partnerships and Diplomacy: Experience of the National Cancer Institute's Center for Global Health
(American Society of Clinical Oncology, 2018) Frech, S; Muha, CA; Stevens, LM; Trimble, EL; Brew, R; Perin, DP; Luciani, S; Mohar, A; Piñeros, M; Vidaurre, T; Morgan, DR; Hawk, ET; Schmeler, KM; Foxhall, LE; Rabadan-Diehl, C; Duran, D; Rendler-Garcia, M; Cazap, EL; Santini, L; Zoss, W; Delgado, LB; Pearlman, PC; Given, L; Hohman, K; Lopez, MS; Kostelecky, B
According to the Pan American Health Organization, noncommunicable diseases, including cancer, are the leading causes of preventable and premature death in the Americas. Governments and health care systems in Latin America face numerous challenges as a result of increasing morbidity and mortality from cancer. Multiple international organizations have recognized the need for collaborative action on and technical support for cancer research and control in Latin America. The Center for Global Health at the US National Cancer Institute (NCI-CGH) is one entity among many that are working in the region and has sought to develop a strategy for working in Latin America that draws on and expands the collaborative potential of engaged, skilled, and diverse partners. NCI-CGH has worked toward developing and implementing initiatives in collaboration with global partners that share the common objectives of building a global cancer research community and translating research results into evidence-informed policy and practice. Both objectives are complementary and synergistic and are additionally supported by an overarching strategic framework that is focused on partnerships and science diplomacy. This work highlights the overall strategy for NCI-CGH engagement in Latin America through partnerships and diplomacy, and highlights selected collaborative efforts that are aimed at improving cancer outcomes in the region.