UB graduate student helps facilitate major health studies in India

Michael Healy, a graduate student in the School of Public Health and Health Professions, recently returned from Kolkata, West Bengal, India, where he spent the summer working on two major projects that will employ new technologies to screen for cancers.

“In the first case,” says Healy, a second-year student in the Department of Social and Preventive Medicine, “I helped the Chittaranjan National Cancer Institute (CNCI) in Kolkata write and submit a research protocol for a research project that will test the effectiveness of the portable VELscope in the early diagnosis of oral cancers.

“In the second, I am writing a cost-benefit analysis of a CNCI cervical cancer screening project, the largest such project in eastern India and one that also employs new diagnostic technology,” he says. “The analysis will facilitate the institute’s application to extend the study.”

The VELscope is an autoflourescence device developed by LED Dental Inc. to define surgical margins (the visible normal tissue or skin margin removed with the surgical excision of a tumor, growth or malignancy) in a hospital-based population, and aid in the diagnosis of oral cancer — in this case in a population with a high prevalence of the disease and a high risk of developing it.

“This major three-year study represents the first collaboration between CNCI and Roswell Park Cancer Institute (RPCI),” Healy says.

The principle investigator is Mary Reid, associate professor of oncology at RPCI, where she directs collaborative research in the Department of Medicine. Reid also is a research professor of social and preventive medicine at UB.

Arthur Goshin, clinical professor of global health in the UB School of Public Health and Health Professions, founded and directs the Healthy World Foundation, which supports public health initiatives that serve the world’s poorest and most vulnerable populations.

The Healthy World Foundation paid for Healy’s participation in this oral screening study, purchased the portable VELscope — its portability is a requirement for use in rural areas — and provided funding for pilot testing of the study.

As Healy points out, carcinomas of the head and neck are especially prevalent in India, where they account for 30 percent of all cancers. In fact, such cancers are most common in developing countries. By way of comparison, they account for 5 to 10 percent of cancers in the U.S.

Researchers say the rate of incidence in India is due in large part to the extensive use of tobacco, the common practice of chewing betel nut and exposure to human papillomaviruses (HPV).

“More than 60 percent of Indians with cancer of the oral cavity present with late stage disease, which has the poorest prognosis,” Healy says. “Early diagnosis is difficult in poor rural areas of India, where routine oral cancer screening is nonexistent and poverty greatly influences the decision to seek health care.

“This project will train and assist Indian health practitioners working with a rural population in the use of the portable VELscope and examine its effectiveness in conjunction with other screening methods in the early diagnosis of oral cancer,” he says, “when it is is more amenable to treatment.”

While working on the oral cancer protocol, Healy was asked by Partha Basu, head of the CNCI Department of Gynecology-Oncology, to conduct a cost-effectiveness analysis for a second CNCI undertaking. Basu is project coordinator for the CNCI Cervical Cancer Prevention and Control Initiative.

His project involves screening women for cervical cancer with visual inspection of the cervix using acetic acid and Hybrid Capture, a new technology that detects the presence of HPV DNA. HPV is implicated in cervical cancer. The Hybrid Capture test is being provided by Qiagen.

“This is the largest such evaluation project in eastern India” Healy says, “and so far has screened 30,000 of the 50,000 women it set out to examine. The cost-effectiveness analysis I produce will be used by project directors to apply for funding from the Indian government to continue the project beyond 2015.”

Healy is using his work with the cervical cancer initiative to complete an integrative project, an analog of a master’s thesis that is a qualification for his master’s degree in public health.

He says that upon graduation he plans to work for the U.S. Public Health Service (PHS).

“My interest lies in building rapport with disenfranchised and underserved populations in programs that aim to improve their health status,” he says, “and I would like to work specifically with the Alaska Area Indian Health Service.”

This is a PHS program that works with Alaska native tribes and tribal organizations to provide comprehensive health services to about 142,000 indigenous Alaskans.

“My experiences with the projects in India,” Healy says, “have given me an entirely new perspective on the developing world and taught me how working in a low-resource environment can foster the kind of innovation and teamwork that overcomes obstacles to public health success.”