By Sam van Heerden, Masters student in Philosophy
Cancer incidence in South Africa and globally is on the rise and it is predicted that the burden of non-communicable diseases such as cancer will overtake that of infectious diseases in Africa in the next decade. In the Eastern Cape, in particular, cervical cancer has a high incidence rate among rural women, who are underrepresented in terms of medical research and genetic analyses. Rhodes University Lecturer and Researcher in Biochemistry, Dr Jo-Anne de la Mare, hopes to change this. The South African Medical Research Council (SAMRC) has awarded her with funding made available by the Department of Science and Innovation (DSI), through the Strategic Health Innovation Partnerships (SHIP) programme, to study cervical cancer based on tumour samples from Eastern Cape women.
Dr de la Mare explains that "cervical cancer is a disease of inequality" and noted that death rates for the disease are higher in developing countries among women who have less access to healthcare. Regular check-ups are essential for early detection, and where healthcare is poor or inaccessible, cases are often caught too late.
Unequal representation also permeates medical research. Researchers use cancer cell lines established from patient biopsies to analyse the biology of cancer and to test new compounds as potential cancer medications
Dr de la Mare explained that of the cell lines one can buy commercially, none are derived from South African women, and very few come from women of African descent.
"This means that even at the start of the pipeline of drug discovery, there is a problem with the model if you are an African woman," explained Dr de la Mare. This is because cancer is a product of both environmental and genetic factors, and different biological ancestry can affect how cancer arises due to genetic mutations.
The genetic background of one population may produce cancer-causing mutations that are different to mutations observed in other population groups, for example, those in the United States.
This difference can have life or death consequences. "In terms of the success of a drug, what you put in is what you get out. If [the cell line model you are using] is not representative of your population's genetics, then the drugs may not be as effective for South African women," explained Dr de la Mare. Her work over the last decade has focused on screening novel compounds for anti-cancer activity in cell line models. I feel passionate about [this project] because it has been such a frustration to get these [potential anti-cancer compounds] and screen them in models that I know are not necessarily relevant for us," she said.
This problem is not unique to South Africa but affects the whole continent. Despite Africa being the most genetically diverse region, it is severely underrepresented in genetic research. "This new research project is a step towards greater genetic representation. Research on cancer cell lines from South African women can ensure that there are more relevant models for anti-cancer drug discovery both in South Africa and on the continent more generally. The research can also improve cancer diagnosis and prognosis. Should a previously unknown genetic mutation be found to drive cervical cancer development in South African women, screening for this change in those with a family history of cervical cancer could result in earlier detection. In addition, if researchers can link a specific genetic change to an advanced stage of cancer, doctors can screen cancer patients for that gene to make better predictions about their future health," she explained.
Dr de la Mare's research group, "FEMCR2U" (Female Cancers Research at Rhodes University), consists of postgraduate students ranging from Honours to postdoctoral level. The funding from the SAMRC is a part of the Eastern Cape Strategic Health Innovation research and development initiative. The initiative is part of a growing project portfolio undertaken by the SAMRC in partnership with the Department of Science and Innovation through the Strategic Health Innovation Partnership program. This seed funding amount of R500 000 over two years, will help develop the capacity and proof of concept required to scale up such initiatives within the region
The project team for this work is entirely comprised of women. "The idea of FEMCR2U is research done for women by women," explained Dr de la Mare. Cervical cancer biopsy samples from consenting Eastern Cape women will be collected at Nelson Mandela Academic Hospital, which has close ties with Walter Sisulu University, both of whom host collaborators on the project. The samples will then be transferred to Rhodes University to be studied by the group. The first challenge will be to see whether the researchers can get the cell lines to grow in a laboratory, and the genetic analysis will follow.
Although local, this research can contribute to better cancer healthcare on the African continent. The research follows a broader trend on the continent to improve Africa's representation in genetic information linked to disease, thereby contributing to the "African Cancer Genome". FEMCR2U uses an Afrocentric approach inspired by this broader movement.
Dr de la Mare hopes to source additional funding to recruit black South African female researchers to the group to further address under-representation in research. This "can help to develop human capacity from traditionally underrepresented groups [in scientific research in our country]," explained Dr de la Mare. "Both my recruitment of postgraduates and the actual study are attempts to redress and address inequalities in the healthcare and education of women in Africa."Source: Communications
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