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News — A five-year, $5 million grant has been awarded by the National Cancer Institute (NCI) to the UTHealth Houston to support research and training in implementation science, with a focus on improving cancer control efforts in Mexico and Latin America.

The grant brings together researchers from UTHealth Houston, the Mexican National Institute of Public Health (INSP), the Mexican National Cancer Institute (INCan), and the University of California San Francisco (UCSF).

The grant will fund a new center, LISTOS for Cancer Control – Leveraging Implementation Science To Optimize Strategies for Cancer Control. The multiple principal investigators are , PhD, vice president of population health and implementation science at UTHealth Houston and co-director of the Institute for Implementation Science; Martin Lajous, MD, DSc, faculty-researcher in the Center for Research in Population Health at INSP; and Karla Unger, MD, DSc, researcher in the Department of Epidemiology at INCan.

“This collaborative center aims to bridge the gap between evidence-based cancer prevention and control interventions and their real-world implementation,” said Fernández, the Lorne Bain Chair in Public Health and Medicine and professor in the Department of Health Promotion at UTHealth Houston School of Public Health. “It will also empower local professionals to use implementation science to enhance cancer control equity in Mexico and Latin America. We anticipate that the impact of this center will have a lasting effect on addressing these issues for years to come.”

LISTOS is one of the four centers selected by the NCI, part of the National Institutes of Health, under the Global Implementation Science for Equitable Cancer Control funding opportunity. Its primary mission is to bolster research capacity for implementation science in low- and middle-income countries and to facilitate research that identifies, comprehends, and overcomes obstacles to the adoption, adaptation, integration, dissemination, and sustainability of evidence-based cancer control interventions in these countries. Notably, LISTOS is the sole site dedicated to enhancing cancer control in the Latin American and Caribbean region.

Researchers will tackle significant cancer-related disparities by designing and testing new implementation strategies that are culturally relevant and fit the local context. Additionally, they will advance the field of implementation science in Latin America by providing training, mentorship, and other engaging activities to foster the next generation of implementation science leaders.

The initial phase of the LISTOS Center will include two studies aimed at enhancing early cancer detection within health care systems. The findings from these studies will contribute to innovative strategies that support the long-term implementation of colorectal cancer screening and the integration of rapid breast cancer diagnosis.

“In low- and middle-income countries, there is much that can be done to improve cancer control, yet the translation of evidence-based interventions into real-world practice lags behind what we know works. Our research aims to enhance cancer control in the region, reducing the burden of breast cancer and bolstering prevention and early detection of colorectal cancer,” Lajous said. 

The goal of the colorectal cancer screening project is to adapt evidence-based interventions (patient education, patient reminders, and patient navigation), design implementation strategies to deliver these interventions, and evaluate the effectiveness, cost-effectiveness, and implementation outcomes. This project will take place in Mexico’s publicly funded health system for people with social security. The breast cancer research project seeks to develop and test implementation strategies designed to improve integrated care for rapid breast cancer diagnosis across various levels of the health care system, particularly for women presenting with breast symptoms in primary care settings. This project will be implemented within Mexico’s public health system accessible to the uninsured population.

“LISTOS will allow us to partner with local health systems to develop laboratories for innovation in cancer screening and early diagnosis and demonstrate both clinical and implementation outcomes that can be replicated nationally in Mexico,” said Michael Potter, MD, with UCSF, who is co-lead investigator of the colorectal screening study and a member of the LISTOS Executive Committee.

The LISTOS Center is also working with Leticia Torres Ibarra, DSc, with INSP; and Olga Martínez, MD, MPH, of the Mexican Institute of Social Security on a pilot project to study implementation of an ongoing program to improve human papilloma virus testing among women working in factories and hotels.

“Due to a highly segmented health care model and insufficient evidence on effective implementation strategies, populations in low- to middle-income countries are disproportionately impacted by cancer compared to those in higher-income countries. Our center and the studies we conduct will help address these issues and contribute to the science of implementation in these countries that can be applied to many other health issues,” Unger said.

The NIH funding is under grant U54CA284109.