On November 16th, the Gynecologic Cancer Initiative (GCI) hosted a session on “Knowledge Mobilization to Extend the Impact and Access of Evidence-Based Gynecologic Cancer Interventions in BC” at the 2023 BC Cancer Summit. Facilitated by GCI’s Gavin Stuart, Jessica McAlpine, Michelle Woo, and Nicole Prestley, the session highlighted not only the ground-breaking scientific discoveries made by GCI researchers that have led to advances in prevention, screening for and management of gynecologic cancers but also provided a forum for exchange to improve implementation and uptake of interventions across the province, and Canada. Through curated pan-Canadian presentations, unique challenges in access to each of the interventions in different jurisdictions and communities were brought to the forefront.
Carol Gordon and Ariadne Holness de Hiller, GCI Patient Partners, were pivotal guest speakers sharing how GCI’s research has impacted their cancer care. Carol shared how one of the initiatives discussed in this session, involving molecular stratification of vulvar cancer, had not been available to her at time of her diagnosis and treatment and the possibility of a tool to guide who needs additional toxic therapies vs. who can be spared is so valuable to patients. In contrast, Ariadne did have access to molecular classification of her endometrial cancer which directed where and how her treatment unfolded. Even though she lives in a community nine hours drive from Vancouver, she had access to the same precision tools as she would have in Vancouver. Carol and Ariadne have been working closely with the GCI team in directing research priorities and are among the biggest advocates of the GCI’s work.
Dr. Stuart and Dr. McAlpine provided a foundation for the seminar by acknowledging the scientific successes of the GCI community and how they are using knowledge mobilization (KMb) to enhance the access and use of evidence-based interventions. Nicole Prestley, Research + Knowledge Translation Manager at the WHRI, defined knowledge translation as the following:
“The reciprocal and complementary flow and uptake of research knowledge between researchers, knowledge brokers and knowledge users—both within and beyond academia—in such a way that may benefit users and create positive impacts within Canada and/or internationally, and, ultimately, has the potential to enhance the profile, reach and impact of social sciences and humanities research.”
Most Promising Gynecologic Cancer Interventions to Date
The session covered five of the latest and most promising gynecologic cancer interventions.
The diverse group of guest speakers shared valuable insight on the current state of the interventions, the barriers they face to implementation, and their vision or future state.
- Cervical Cancer Self-Collection:
- Dr. Gina Oglivie presented “Cervix Screening in BC: From Cytology (PAP Test) to HPV Primary Screening”
- Dr. Mary Kinloch and Dr. Jennifer Brown-Broderick presented “HPV Self-Sampling for Primary Cervical Cancer Screening in Underserved Saskatchewan People”
- Molecular Stratification for Endometrial Cancer:
- Dr. Jessica McAlpine and Dr. Blake Gilks presented “Endometrial Cancer: Molecular Stratification to Inform Cancer Management”
- Identification and Stratification of Vulvar Cancer Lesions:
- Dr. Amy Jamieson and Dr. Lien Hoang presented “Identification and Molecular Stratification of Vulvar and Pre-Cancerous Invasive Lesions to Direct Care”
- Opportunistic Salpingectomy for Ovarian Cancer Prevention:
- Dr. Gillian Hanley presented “Ovarian Cancer: Opportunistic Salpingectomy for Prevention”
- Dr. Rebecca Stone presented on “The current state of Opportunistic Salpingectomy in the United States and any barriers affecting nationwide uptake”
- Genetic Testing for Ovarian and Endometrial Cancer:
- Dr. Lesa Dawson presented on “Hereditary Gynecologic Cancer Genetic Testing and Cancer Prevention in BC”
- Dr. Intan Schrader presented on “Ovarian and Endometrial Cancers: Genetic Testing to Identify At-Risk Families for Prevention and Treatment”
The audience was invited to contribute to finding solutions for pan-Canadian uptake of the interventions. The facilitators used the COM-B as a framework for this discussion, focusing on behaviour change, as the goal (Michie et al., 2011). The following questions were probed:
- Do we have the knowledge, skills, and abilities to engage in the behaviour? How can we improve our capability to engage in the behaviour?
- What opportunities our outside factors can we utilize to make the behaviour possible?
- What motivates people to engage in this behaviour?
These questions and concepts gave rise to rich discussion. The session highlighted the immense need for multi-level and interdisciplinary collaboration, including increased engagement with individuals in health policy and health economics, community, and provider, systemic changes to overcome challenges implementation due to healthcare funding silos, the need to utilize social media and community-specific channels to enhance the reach of awareness for these interventions, as well as workshops to educate both providers and patients.
Ending the day, the GCI highlighted initiatives underway in the upcoming year. This includes the provincial roll-out of self-collection for cervical cancer screening in BC. The team will also be launching the first-of-its-kind STRIVE trial both in BC and internationally, which seeks to assess the value of incorporating molecular stratification to direct treatment for vulvar cancer patients. Additionally, the GCI aims to ensure molecular stratification is available for every newly diagnosed endometrial cancer patient in BC to allow more patients’ lives to be changed by this impactful intervention. A partnership with the Ovarian Cancer Research Alliance will also help expand the impact of opportunistic salpingectomy for ovarian cancer prevention beyond BC. Through BC Cancer’s Hereditary Cancer Program, expansion of their mainstreaming approach for genetic testing will enable more high-risk individuals to benefit from life-saving screening and prevention procedures. Two key initiatives will be to expand the Gyne-Cancer Patient Advisory Group across Canada to bring more representation and diversity to the patient voices guiding current gynecologic cancer research and develop working groups for each of the five interventions explored during the seminar to tackle the most pressing challenges precluding equitable access to gynecologic cancer care.
We invite all of you to join the GCI and Ariadne Holness de Hiller’s call to action:
“Ocean to ocean to ocean, let’s do this! … I call everyone here to action, to put their ideas together, and as a team, think about how we can bring these proven interventions forward and help more of those of us who are patients fight this disease.” – Ariadne Holness de Hiller, GCI Patient Partner
Interested in collaborating with us to help bring these gynecologic cancer interventions to more patients? Reach out to us at info@gynecancerinitiative.ca!
CITATIONS:
Michie, S., van Stralen, M. M., & West, R. (2011a). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6(1). https://doi.org/10.1186/1748-5908-6-42