Kobetz changing how cancer is detected in Miami’s Little Haiti

Erin Kobetz wants to catch cancer before it starts, and if people won’t go to her, she’ll go to the people.

Erin Kobetz, PhD, MPH, of the University of Miami’s Sylvester Comprehensive Cancer Center

Kobetz is the driving force behind the “Game Changer”, a vehicle launched at the University of Miami’s Sylvester Comprehensive Cancer Center that brings cancer screenings and health information to underserved communities in south Florida. She recently detailed her efforts to reduce the incidences of cancer in Miami’s Little Haiti community at the University of Illinois Cancer Center’s Director’s Series seminar.

“We are taking Sylvester to the streets,” said Kobetz, PhD, MPH, associate director of population science and cancer disparity at Sylvester. The van, she said, helps her and her colleagues understand how people in the community are contracting cancer.

Kobetz focuses on disparities research, and throughout her career has been involved in numerous community-based research projects to understand racial differences in breast and cervical cancer outcomes. She is a member of the UI Cancer Center’s External Advisory Board (EAB) and visited the Center to learn about its Federally Qualified Health Center’s (FQHC) research and engagement models that takes brick and mortar to the streets closer to patients.

Upon returning to her native Miami after receiving her PhD from the University of North Carolina, Chapel Hill, Kobetz discovered that an area of Northeast Miami-Dade County had an unusually high rate of cervical cancer. The area, she said, was known as Little Haiti, where 38 women out of every 100,000 had the disease. The rate was more than four times that of women in other parts of Florida and the United States. Cervical cancer, according to the World Health Organization, is the second most common cancer in women in Haiti, and the second leading cause of cancer deaths in women, right after breast cancer.

Reaching out to Haitian community leaders to learn why, Kobetz learned that black and white women underwent Pap smears for cancer screenings at the same rate; that was not so for Haitian women. To them, the test harbored many negative misconceptions, with the women believing, among other things, that their partners would not approve of it, Kobetz said.

Kobetz felt she needed to devise a strategy that would be acceptable to Haitian women. Instead of a Pap smear, a student of Kobetz’s suggested using a self-sampler that had been utilized, up until then, only in a clinical setting. Kobetz armed Creole-speaking community health workers with a kit to ascertain if female Haitian immigrants would agree to collect their own vaginal cells in the privacy of their homes.

“Any time a community health worker would show up at the home of a woman whom she had previously set up an appointment with, that woman had her aunt, her cousin, her sister, there. Everyone wanted to do it,” Kobetz told those in attendance at the UI Cancer Center seminar.

Women were taught how to use the swab, which resembled a tampon, and dip it into a solution that is shipped to a lab. The specimen is then tested for the human papillomavirus (HPV), the primary cause of cervical cancer. If the test was positive, the woman would need additional care. The self-collection exam removed barriers of a pelvic exam.

Over the past 12 years, Kobetz said, the number of Haitian women getting regular screenings has increased from 44 percent to 60 to 70 percent. The research in Miami’s Haitian population has influenced screening initiatives in Haiti, and she’s teaming up with Haiti sans Cervical Cancer, a group of U.S.-based providers, to create a cervical cancer registry.

In April 2019, UIC unveiled its own mobile research clinic to facilitate enrollment in the All of Us Research Program, a landmark National Institutes of Health program that aims to advance individualized prevention, treatment and care for people of all backgrounds. The specialized vehicle will enable researchers to reach communities that are underrepresented in biomedical research, and that tend to have poor access to health care due to geographic barriers or limited transportation options. Robert Winn, MD, director of the UI Cancer Center, is a principal investigator on the All of Us Precision Medicine Initiative.

The next Director’s Seminar Series will be held on Tuesday, June 25, from 1:30 p.m. to 2:30 p.m. in room 7175 in the College of Medicine Research Building, 909 S. Wolcott Ave. Dana Rollison, PhD, vice president and chief data officer at Moffitt Cancer Center in Tampa, Fla., will present “Advancing Multidisciplinary Cancer Research through Enterprise Wide Analytics and Data Science.”

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