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Open Access
CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(06): E770-E776
DOI: 10.1055/a-1386-2095
Original article

Implementation and results of a gastrointestinal cancer screening program in an Amazon rainforest village: A descriptive study

Pedro Averbach
1   Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
,
Angelo Paulo Ferrari
2   Escola Paulista de Medicina da Universidade Federal de São Paulo, Brazil
,
Cristiana M Toscano
3   Departamento de Saúde Coletiva, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Brazil
,
José Luiz Borges
4   Instituto Sírio-Libanês de Ensino e Pesquisa, São Paulo, Brazil
,
Marcelo Averbach
4   Instituto Sírio-Libanês de Ensino e Pesquisa, São Paulo, Brazil
› Institutsangaben
To make the project feasible, several partnerships were established with both public and private sectors. The municipal health department of Belterra provided the Municipal Hospital facilities and allowed the team of nurses and community health care agents to collaborate on the project. Fujinon Corporation provided endoscopic equipment, such as endoscopes, image processors, and screens, for every expedition. Hospital Sírio-Libanês, through its teaching and research institute, provided the software and expertise for data collection and analysis and performed histopathological tests of the sample specimens. Boston Scientific Corporation was responsible for all costs related to transport and accommodation of the team, and also provided facilities for endoscopic procedures. Moreover, the company also provided a team of two nurses who were sent to Belterra before every expedition in order to set up the working space for the rest of the team. Further, the project was supported by the Hospital Regional do Baixo Amazonas, a local secondary hospital that received patients who needed additional treatment in case of unexpected complications. The sources of funding had no role in the design, conduct, data analysis, and reporting of this study.
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Abstract

Background and study aims Gastrointestinal cancer is an important cause of death worldwide. Remote populations are especially vulnerable to these conditions due to reduced access to screening and adequate treatment. In this context, the Belterra project was designed as a pilot taskforce to deliver gastrointestinal screening to an underserved Amazonian population and to spread knowledge and practice to local health workers. This study aimed to describe the implementation and present the results of the Belterra Project.

Patients and methods The project took place between October 2014 and December 2017 in Belterra, Pará, Brazil. Public-private partnerships were obtained and were essential for funding. The project required complex logistic solutions to provide gastrointestinal screening to every inhabitant between 50 and 70 years of age, including medical equipment and personal transportation to a remote area. Subjects were asked about their medical history, and received a physical examination, endoscopic examinations, and stool tests.

Results Over the course of 19 expeditions, we screened 2,022 inhabitants of Belterra, aged 50 to 70 years. Five colorectal and six gastric adenocarcinomas were diagnosed, as were several lower-stage lesions. Overall, 26 % of the participants undergoing colonoscopy showed some type of colonic lesion.

Conclusions Notwithstanding the geographical, cultural, and financial barriers, this study suggests that the implementation of a gastrointestinal cancer screening program for remote Brazilian populations is feasible, reaching high adherence. Although logistics is very demanding, such campaigns may be a good strategy to provide mass gastrointestinal cancer screening for underserved populations.



Publikationsverlauf

Eingereicht: 05. Juni 2020

Angenommen: 04. Januar 2021

Artikel online veröffentlicht:
27. Mai 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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