Husband, wife team up to fight health disparities along the U.S. Mexico border

Hispanic women on the U.S.-Mexico border are more likely to die of cervical cancer and breast cancer than women who live elsewhere in the U.S. or Mexico.

Low participation by Latinas in early detection screening programs is a serious problem, Dr. John Moraros said. That puts women at risk because often the diseases aren’t diagnosed until they are very advanced and treatment options are less effective.

The husband-and-wife team of Moraros and Dr. Yelena Bird hopes their work in New Mexico State University’s Department of Health Science will make a difference. Moraros tracks cervical cancer; Bird studies breast cancer. Their research has been enhanced by $75,000 grants from the Center for Border Health Research, an affiliate of the Paso Del Norte Health Foundation.

Cervical cancer
The cause of cervical cancer is generally acknowledged to be a sexually transmitted infection with the human papilloma virus or HPV. While HPV does not always lead to cancer, 10 percent of the women on the border have abnormal Pap smears. Of this number, 10 percent have HPV that, if left untreated, can lead to cancer.

The situation is especially dire in Mexico, where it’s estimated a patient dies from the disease every two hours. Language barriers, financial problems and the discomfort of pelvic exams often cause Latinas to avoid visiting their doctors.

“People need to pay attention to the health disparity issues facing the border,” Moraros said. “What we see in southern New Mexico and south Texas is just the tip of the iceberg.”

Moraros analyzes HPV DNA to identify current infections and determine the types of HPV most prevalent in southern New Mexico and the northern Chihuahua border. He also works on determining the HPV viral load and using serum antibodies to characterize HPV infections. By using Pap smears and other examination techniques, the correlation between the presence of HPV DNA and the severity of cervical cancer can be determined. Relatively inexpensive screening and treatment technologies that detect and remove abnormal cervical tissue before it progresses can prevent cervical cancer, Moraros said.

A vaccine is likely to be available in the next three years, Moraros said, adding that its effectiveness will depend on the distribution of the different HPV types in the population. Therefore, the prevalence and characterization of different cancer-producing HPV types most frequently occurring among women on the border need to be determined. This will help guide the development and estimate the efficacy of a vaccine.

“We need more binational interdisciplinary research efforts like this one,” Moraros said, “that can act as the impetus and become the foundation on which to build and provide affordable and effective community-oriented screening prevention programs, health care and education to our vulnerable and disadvantaged patient population.”

Hereditary breast cancer
While her husband concentrates on cervical cancer, Yelena Bird studies samples from breast tissues of women who have hereditary breast cancer on the U.S.-Mexico border. As the etiology and progression of breast cancer remain poorly understood, the main purpose of her study is to use molecular biological markers of gene expression to determine a woman’s overall risk of developing the disease when breast cancer runs in the family. Bird said molecular biological techniques are more efficient at detecting abnormal breast cells than mammography or examination of cells or tissue under a microscope.

One of every eight women in the U.S. will get breast cancer during her lifetime, but the rates on the border are higher. Here it is estimated that one of every five Latinas will get the disease. There are two types of breast cancer: sporadic and familial. A woman with sporadic cancer may be the only one in her family with the disease while the more aggressive familial breast cancer runs in the family.

Mammography is the best method of early detection. However, the optimal screening regimen for high-risk women, such as the ones who have had a mother, sister or aunt diagnosed with breast cancer, is not yet known. Therefore, it is critical to develop molecular screening methods to augment mammography for early detection.

As with cervical cancer, lack of education, lack of access to care or finances, and the discomfort of the exams often cause women to shy away from them. Women with breast cancer fight a second battle, Bird said. They may have mastectomies and may have to cope psychologically with the reality that their bodies have been permanently altered.

Bird said the potential of her study’s findings to reduce death rates from breast cancer is contingent upon identifying a screening that, along with mammography, will help in the detection of the disease at an early stage when more treatment
options are available and survival rates are higher.

Making breathing easier

NMSU’s Border Epidemiology and Environmental Health Center (NMSU BEC) and New Mexico Department of Health Office of Border Health are studying air quality in Columbus, N.M., and Puerto Palomas, Chihuahua, Mexico. Air quality monitors have been installed in schools in each community. These are the only air quality monitors on the U.S.-Mexico border between Sunland Park, N.M, and Arizona, said Sonya Andron, environmental health research specialist. Dust or particulate matter can cause skin rash, cough and throat irritation, asthma, respiratory distress, headaches, dizziness, chronic lung irritation, nausea and vision problems. The study began in July and is expected to last one year.

Diabetes research

NMSU researchers are also studying diabetes on the border. This disease has been diagnosed in 9.4 percent of Doña Ana County’s population, 8.9 percent in New Mexico and 6.3 percent of the nation’s population. Wanda Borges, an assistant professor of nursing in NMSU’s College of Health and Social Services, has been awarded a two-year, $250,000 grant from the U.S. Department of Health and Human Services to work with Ben Archer Health Centers to study diabetes education in the U.S.-Mexico border area. Research has shown that Hispanics are twice as likely to have diabetes as non-Hispanics, but they are also less likely to receive patient education. The largest part of diabetes management is self-management and if patients know how to take care of themselves, deaths due to diabetes complications can be reduced, Borges said.

Bob Nosbisch