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Research and Publications

  • clinicians presentation
  • Conducting Global Oncology Research, Mentoring a New Generation of Investigators

    The Center for Global Cancer Medicine (CGCM) collaborates with partner sites in Haiti and Rwanda to promote innovative and relevant global oncology research projects. Faculty and trainees from Dana-Farber Cancer Institute, as well as from across collaborating institutions — including Brigham and Women's Hospital, T.H. Chan School of Public Health, and external foundation partners — engage in research activities that promote local research capacity. CGCM's U.S.-based and in-country clinicians are sharing their research through papers and abstracts published in high-impact, peer-reviewed journals and through participation in cancer conferences around the world.

    Breast Cancer Early Detection in Rwanda

    CGCM works with the Butaro Cancer Center of Excellence and the Rwanda Ministry of Health to examine ways to promote earlier detection of breast cancer. Our previous work examined patient and health system factors associated with diagnostic delays. With the financial support of the Breast Cancer Research Foundation (BCRF), an intervention was subsequently piloted that teaches community health workers to build breast awareness; trains health center nurses to recognize high-risk breast lumps; establishes a referral pathway; and trains district hospital-based nurses and doctors to perform ultrasound evaluations. This intervention is now being scaled to other districts in Rwanda.

    Breast Cancer Outcomes in Haiti

    CGCM supported the local oncology team at the University Hospital of Mirebalais on a project to comprehensively assess breast cancer outcomes. Initial analysis in a retrospective cohort of nearly 350 patients revealed the preponderance of younger patients with more advanced disease and other poor risk features, such as higher-grade disease. This analysis also highlighted significant delays that occur prior to treatment initiation, as well as along the treatment care continuum. We are currently working on an analysis evaluating geospatial accessibility of cancer care and quantifying the impact of travel distance on cancer stage at presentation and on treatment outcomes. We are also evaluating patient communication preferences, and plan to explore the utility of mobile health interventions to improve communication between patient and providers, as well as other future interventions that may improve outcomes.

    Pathology Innovations

    Accurate and timely pathologic evaluation is paramount for quality cancer care. In collaboration with researchers at Brigham and Women's Hospital and the American Society of Clinical Pathology (ASCP), we have evaluated novel resource-appropriate ways of providing pathology services in Rwanda, including sophisticated tissue-processing systems, whole-slide imaging and telepathology.

    Other Disease Initiatives

    Adult and pediatric research programs in Rwanda have empowered local clinicians to engage in disease-specific outcome projects. So far, they have evaluated clinical outcomes and determinants in chronic myelogenous leukemia (CML), acute lymphoblastic leukemia, gestational trophoblastic disease, and Hodgkin's lymphoma and Wilms tumor (WT). In addition, CGCM received support from the Sanofi Espoir Foundation to establish a pediatric patient navigation program in Rwanda for WT to address barriers to pediatric cancer care completion, increase timeliness of diagnosis and treatment, and reduce non-compliance with treatment recommendations.

    Quality Improvement Initiatives

    Quality improvement (QI) initiatives are an important component of building capacity and competency in low-resource settings. With a grant from Celgene, CGCM is engaged in research to evaluate a new, tailored curriculum and coaching program in cancer care quality improvement at the Butaro Cancer Center of Excellence in Rwanda. The goal of this project is to understand barriers and facilitators of QI initiatives and, ultimately, to foster QI culture and mentor leaders that will sustain ongoing QI efforts into the future.

    Future Directions

    With many possible arenas of research engagement opportunities in global oncology, CGCM will utilize a multi-pronged approach to expand our research activities. The Center seeks to:

    • Foster deeper engagement within Dana-Farber itself to draw upon the considerable intellectual resources of the Institute.
    • Establish health services and population science research initiatives to systematically evaluate elements of the current care delivery models, with the goal of maximizing efficiency and improving outcomes.
    • Evaluate molecular diagnostic technologies that would potentially leapfrog current existing pathologic techniques and provide affordable timely diagnosis.
    • Work toward building and supporting local research capacity by establishing research training programs at our sites.

    Recent Publications, Abstracts, and Meetings

    Publications

    Morgan J, DeBoer RJ, Bigirimana JB, Nguyen C, Ruhangaza D, Paciorek A, Mugabo F, Villaverde C, Nsabimana N, Bihizimana P, Umwizerwa A, Lehmann L E, Shulman LN, Shyirambere C. A ten-year experience of treating chronic myeloid leukemia in rural Rwanda: outcomes and insights for a changing landscape. JCO Glob Oncol. 2022; 8: e2200131. doi:10.1200/GO.22.00131

    Ruhangaza D, Umwizerwa A, Nsanzimana O, Mujyuwisha L, Iradukunda E, Shulman LN, Lehmann. Nephroblastoma treatment and outcomes in a low- income setting. JCO Glob Oncol. 2022; 8: e2200036. doi:10.1200/GO.22.00036

    Fadelu TA, Buswell L, Anderson BO. Improving adherence to adjuvant endocrine therapy in Sub-Saharan Africa: challenges and innovative nurse- driven solutions. Oncologist. 2022 Advance online publication. https://doi.org/10.1093/oncolo/oyac112

    Fadelu T, Nadella P, Iyer HS, Uwikindi F, Shyirambere C, Manirakiza A, Triedman SA, Rebbeck TR, Shulman LN. Toward equitable access to tertiary cancer care in Rwanda: A geospatial analysis. JCO Glob Oncol. 2022; 8. doi.org/10.1200/go.21.00395

    Fadelu TA, Erfani P, Lormil J, Damuse R, Pierre V, Slater S, Triedman S, Shulman LN, Rebbeck TR. Gaps in completion and timeliness of breast surgery and adjuvant therapy: a retrospective cohort of Haitian patients with nonmetastatic breast cancer. Breast Cancer Res Treat. 2022; 193(3): 625-635. doi:10.1007/s10549-022-06582-8

    Bhangdia KP, Iyer HS, Joseph JP, Dorne RL, Mukherjee J. Comparing absolute and relative distance and time travel measures of geographic access to healthcare facilities in rural Haiti. BMJ Open. 2022; 12: e056123. doi: 10.1136/bmjopen-2021-056123

    Tuyishime H, Hornstein P, Lasebikan N, Rubagumya F, Mutebi M, Fadelu T. Authorship distribution and under-representation of Sub-Saharan African authors in global oncology publications. JCO Glob Oncol. 2022; 8. https://doi.org/10.1200/go.22.00020

    Hornstein P, Tuyishime H, Mutebi M, Lasebikan N, Rubagumya F, Fadelu T. Authorship equity and gender representation in global oncology publications. JCO Glob Oncol. 2022; 8. doi: 10.1200/GO.22.00020

    DeBoer RJ, Rugo HS, Shulman LN. Reconceptualizing risk-benefit assessment of novel cancer therapies to expand global access and reduce worldwide mortality. JAMA Oncol. 2022; 8(2):203–204. doi:10.1001/jamaoncol.2021.5945

    Park PH, Shyirambere C, Kateera F, Gupta N, Rusangwa C, Mukherjee J, Coutinho A, Lehmann L, Buswell L, Shulman LN, Mubiligi JM, Uwinkindi F, Hirschhorn LR. Implementing cancer care in Rwanda: capacity building for treatment and scale-up. Sustainability 2021; 13(13):7216. https://doi.org/10.3390/su13137216

    DeBoer RJ, Nguyen C, Mutoniwase E, Ho A, Umutesi G, Bigirimana JB, Triedman SA, Shyirambere C. Procedural fairness for radiotherapy priority setting in a low resource context. Bioethics. 2021 Aug 20. doi: 10.1111/bioe.12939. Epub ahead of print. PMID: 34415636.

    Haskins L, Esperance B, Olivier H, Buswell L. Clinical nurse educator mentorship: implementation at an oncology program in Rwanda. Clin J Oncol Nurs. 2021; 25(1): 100-103. doi:10.1188/21.CJON.100-103

    Chiorean EG, Nandakumar G, Fadelu T, et al. Treatment of patients with late-stage colorectal cancer: ASCO resource-stratified guideline. JCO GO 2020; 6(6): 414-438. doi:10.1200/jgo.19.00367

    LeJeune A, Brock, JE, Morgan E, Kasten J, Martei Y, Fadelu T, Rinder H, Goulart R, Shulman L, Milner D. Harmonization of the essentials: matching diagnostics to treatments for global oncology. JCO GO 2020; (6): 1352- 1356. doi:10.1200/go.20.00338

    DeBoer RJ, Fadelu TA, Shulman LN, Van Loon K. Applying lessons learned from low-resource settings to prioritize cancer care in a pandemic. JAMA Oncol 2020; 6(9): 1429-1433. doi:10.1001/jamaoncol.2020.2976

    Pace, LE, Schleimer LE, Shyirambere C, Ilbawi A, Dusengimana JMV, Bigirimana JB, Keating NL. Identifying breast cancer care quality measures for a cancer facility in rural Sub-Saharan Africa: results of a systematic literature review and modified Delphi Process. JCO GO 2020; (6): 1446- 1454. doi: 10.1200/GO.20.00186

    Raza S, Frost E, Kwait D, Bowerson M, Rugema V, Hategekimana V, Umwizerwa A, Shabani K, Shulman L, Lee YS, Huang CC, Mpunga T, Shyirambere C, Dusengimana JV, Pace LE. Training nonradiologist clinicians in diagnostic breast ultrasound in rural Rwanda: impact on knowledge and skills. J Am Coll Radiol. 2020; Sep 8: S1546-1440(20)30871-1. doi: 10.1016/j.jacr.2020.08.013. Epub ahead of print. PMID: 32916158.

    Habinshuti P, Hagenimana M, Nguyen C, Park PH, Mpunga T, Shulman LN, Fehr A, Rukundo G, Bigirimana JB, Teeple S, Kigonya C, Ndayisaba GF, Uwinkindi F, Randall T, Miller AC. Factors associated with loss to follow-up among cervical cancer patients in Rwanda. Ann Glob Health. 2020; Sep 14; 86(1): 117. doi: 10.5334/aogh.2722

    Rubagumya F, Costas-Chavarri A, Manirakiza A, Murenzi G, Uwinkindi F, Ntizimira C, Rukundo I, Mugenzi P, Rugwizangoga B, Shyirambere C, Urusaro S, Pace L, Buswell L, Ntirenganya F, Rudakemwa E, Fadelu T, Mpunga T, Shulman LN, Booth C. State of cancer control in Rwanda: past, present, and future opportunities. JCO GO. 2020; 6: 1171-1177. doi: 10.1200/GO.20.00281

    DeBoer RJ, Shyirambere C, Driscoll CD, Butera Y, Paciorek A, Ruhangaza D, Fadelu TA, Umwizerwa A, Bigirimana JB, Muhayimana C, Nguyen C, Park PH, Mpunga T, Lehmann L, Shulman LN. Treatment of Hodgkin lymphoma with ABVD chemotherapy in rural Rwanda: a model for cancer care delivery implementation. JCO GO. 2020; Jul; 6: 1093-1102. doi: 10.1200/GO.20.00088

    Fadelu T, Damuse R, Lormil J, Pecan E, Dubuisson C, Pierre V, Rebbeck T, Shulman LN. Patient characteristics and outcomes of nonmetastatic breast cancer in Haiti: results from a retrospective cohort. Oncologist. 2020; 25(9): e1372–81. doi:10.1634/theoncologist.2019-0951. Epub ahead of print.

    Schleimer LE, Vianney Dusengimana JM, Butonzi J, Kigonya C, Natarajan A, Umwizerwa A, O'Neil DS, Costas-Chavarri A, Majyambere JP, Shulman LN, Keating NL, Shyirambere C, Mpunga T, Pace LE. Barriers to timely surgery for breast cancer in Rwanda. Surgery. 2019; Dec;166(6): 1188-1195. doi: 10.1016/j.surg.2019.06.021. Epub 2019 Aug 27.

    Habimana O, Mukeshimana V, Ahishakiye A, Makuza P, Hategekimana V, Muhayimana C, Dushimana E, Shyirambere C, Haley J, Urusaro S, Kennell- Heiling S, Buswell L. Standardization of education of patients with cancer in a low- and middle-income country: a quality improvement project using the Cancer and You booklet. J Glob Oncol. 2019; Jul;5: 1-6. doi:10.1200/JGO.19.00118

    Park PH, Davey S, Fehr AE, Butonzi J, Shyirambere C, Hategekimana V, Bigirimana JB, Borg R, Uwizeye R, Tapela N, Shulman LN, Randall T, Mpanumusingo E, Mpunga T. Patient characteristics, early outcomes, and implementation lessons of cervical cancer treatment services in rural Rwanda. J Glob Oncol. 2018; 4: 1-11. doi:10.1200/JGO.18.00120

    Neal C, Rusangwa C, Borg R, Mugunga J, Kennell-Heiling S, Shyirambere C, Pritchett N, Clemence Muhayimana, Elisephan Ntakirutimana, Tapela N, Park PH, Shulman LN, Mpunga T. Cost of treating pediatric cancer at the Butaro Cancer Center of Excellence in Rwanda. J Glob Oncol. 2018; 4: 1-7. doi: 10.1200/JGO.17.00155

    Martin A, Silverstein A, Ssebuufu R, Lule J, Mugenzi P, Fehr A, Mpunga T, Shulman L, Park PH, Costas-Chavarri A. Impact of delayed care on surgical management of patients with gastric cancer in a low-resource setting. J Surg Oncol. 2018; 118: 1237-1242. doi: 10.1002/jso.25286

    Manirakiza A, Dugan G, Hanna C, Nguyen C, Fadelu T, Iradukunda E, Fehr AE, Ruhangaza D, Albert E, Mpunga T, Shyirambere C, Lehmann L. Implementation of a graduated-intensity approach for acute lymphoblastic leukemia in a Rwandan district hospital. Blood Adv. 2018; 2(Suppl 1): 19–20. doi:10.1182/bloodadvances.2018GS112622

    Hanappe M, Nicholson LT, Elmore SNC, Fehr AE, Bigirimana JB, Borg RC, Butonzi J, Shyirambere C, Mpanumusingo E, Benewe MO, Kanyike DM, Triedman S, Shulman LN, Rusangwa C, Park PH. International radiotherapy referrals from rural Rwanda: implementation processes and early clinical outcomes. J Glob Oncol. 2018; 4: 1-12. doi: 10.1200/JGO.18.00089

    Garcia-Gonzalez P, Lopes G, Schwartz E, Shulman LN. The role of humanitarian donations in decreasing preventable mortality from cancer in low-income countries: models to improve access to life-saving medicines. J Glob Oncol. 2018; 4: 1-3. doi: 10.1200/JGO.18.00096

    Dusengimana JV, Hategekimana V, Borg R, Hedt-Gauthier B, Gupta N, Troyan S, Shulman LN, Nzayisenga I, Fadelu T, Mpunga T, Pace LE. Pregnancy-associated breast cancer in rural Rwanda: the experience of the Butaro Cancer Center of Excellence. BMC Cancer. 2018; 18: 634. doi:10.1186/s12885-018-4535-y

    Muvugabigwi G, Nshimiyimana I, Greenberg L, Hakizimana E, Ruhangaza D, Benewe O, Bhai K, Pepoon JR, Fehr AE, Park PH, Butonzi J, Shyirambere C, Manirakiza A, Rusangwa C, Milner D, Mpunga T, Shulman LN. Decreasing histology turnaround time through stepwise innovation and capacity building in Rwanda. J Global Oncol. 2018; 4: 1-6. doi:10.1200/JGO.17.00081

    Rubagumya F, Xu MJ, May L, Driscoll C, Uwizeye FR, Shyirambere C, Larrabee K, Gilbert UD, Muhayimana C, Hategekimana V, Elmore S, Mpunga T, Moore M, Shulman LN, Lehmann L. Outcomes of a low intensity treatment for acute lymphoblastic leukemia (ALL) at the Butaro Cancer Center of Excellence in Rwanda. J Global Oncol. 2018; 4: 1-11. doi:10.1200/JGO.2017.009290

    O’Neil DS, Keating NL, Dusengimana JM, Hategekimana V, Umwizera A, Mpunga T, Shulman LN, Pace LE. Quality of breast cancer treatment at a rural cancer center in Rwanda. J Global Oncol. 2018; 4: 1-11. doi:10.1200/JGO.2016.008672

    Pace LE, Dusengimana JV, Keating NL, Hategekimana V, Rugema V, Bigirimana JB, Costas-Chavarri A, Umwizera A, Park PH, Shulman LN, Mpunga T. Impact of breast cancer early detection training on Rwandan health workers’ knowledge and skills. J Glob Oncol. 2018. doi:10.1200/JGO.17.00098

    Mpunga T, Znaor, A, Uwizeye FR, Uwase A, Munyanshongore C , Franceschi S, Clifford GM. A case–control study of HIV infection and cancer in the era of antiretroviral therapy in Rwanda. Int J Cancer. 2018; 143: 1348-1355. doi:10.1002/ijc.31537

    Davey S, Mpanumusingo E, Fehr A, Butonzi J, Shyirambere C, Hategekimana V, Bigirimana JB, Borg R, Uwizeye R, Tapela N, Randall T, Shulman L, Park P, Mpunga T. Characteristics and early outcomes of cervical cancer patients at Butaro District Hospital, Rwanda: a retrospective review. The Lancet Global Health. 2017; 5. doi:10.1016/s2214-109x(17)30135-3.

    Neal C, Rusangwa C, Borg R, Tapela N, Mugunga JC, Shyirambere C, Ntakirutimana E, Park PH, Shulman LN, Mpunga T. Cost of providing quality cancer care at the Butaro Cancer Center of Excellence in Rwanda. J Global Oncol. 2017. doi:10.1200/JGO.17.00003

    Rubagumya F, Greenberg L, Manirakiza A, DeBoer R, Park PH, Mpunga T, Shulman LN. Increasing global access to cancer care: models of care with non-oncologists as primary providers. Lancet Oncol. 2017; 18(8): 1000-2. doi:10.1016/S1470-2045(17)30519-3

    Pace LE, Shulman LN. Breast cancer in Sub-Saharan Africa: Challenges and opportunities to reduce mortality. Oncologist. 2016; 21(6): 739-44. doi:10.1634/theoncologist.2015-0429

    Pace LE, Dusengimana JMV, Hategekimana V, Habineza H, Bigirimana JB, Tapela N, Mutumbira C, Mpanumusingo E, Brock J, Meserve E, Uwumugambi A, Dillon D, Keating NL, Shulman LN, Mpunga T. Benign and malignant breast disease at Rwanda’s first public cancer referral center. Oncologist. 2016; 21: 1-5. doi:10.1634/theoncologist.2015-0388

    Tapela NM, Mpunga T, Hedt-Gauthier B, Moore M, Mpanumusingo E, Xu MJ, Nzayisenga I, Hategekimana V, Umuhizi DG, Pace LE, Bigirimana JB, Wang J, Driscoll C, Uwizeye FR, Drobac PC, Ngoga G, Shyirambere C, Muhayimana C, Lehmann L, Shulman LN. Pursuing equity in cancer care: implementation, challenges and preliminary findings of a public cancer referral center in rural Rwanda. BMC Cancer. 2016; 16: 237. doi:10.1186/s12885-016-2256-7

    Tapela N, Nzayisenga I, Sethi R, Bigirimana JB, Habineza H, Hategekimana V, Mantini N, Mpunga T, Shulman LN, Lehmann L. Treatment of chronic myeloid leukemia in rural Rwanda: promising early outcomes. J Global Oncol. 2016; 2(3): 129-137. doi:10.1200/JGO.2015.001727

    Shyirambere C, Xu MJ, Elmore SN, Fadelu T, May L, Umuhizi DG, Uwizeye FR, Driscoll C, Muhayimana V, Hategekimana V, Rubagumya F, Nzayisenga I, Shulman LN, Mpunga T, Lehmann LE. Treating nephroblastoma in Rwanda: using International Society of Pediatric Oncology guidelines in a novel oncologic care model. J Global Oncol. 2016; 2(3) 105-113. doi:10.1200/JGO.2015.000067

    Stulac S, Munyaneza RB, Chai J, Bigirimana JB, Nyishime M, Tapela N, Chaffee S, Lehmann L, Shulman LN. Initiating childhood cancer treatment in rural Rwanda: a partnership-based approach. Pediatr Blood Cancer. 2016; 63(5): 813-7. doi:10.1002/pbc.25903

    Nzayisenga I, Segal R, Pritchett N, Xu MJ, Park PH, Mpanumusingo EV, Umuhizi DG, Goldstein DP, Berkowitz RS, Hategekimana V, Muhayimana C, Rubagumya F, Fadelu T, Tapela N, Mpunga T, Ghebre RG. Gestational trophoblastic neoplasia treatment at the Butaro Cancer Center of Excellence in Rwanda. J Glob Oncol. 2016; 2(6): 365-374. doi:10.1200/JGO.2015.002568

    Mpunga T, Hedt B, Tapela N, Nshimiyimana I, Muvugabigwi G, Pritchett N, Greenberg L, Benewe O, Shulman D, Pepoon J, Shulman L, Milner D. Implementation and validation of telepathology triage at cancer referral center in rural Rwanda. J Global Oncol. 2016; 2(2): 76-82. doi:10.1200/JGO.2015.002162

    Tapela N, Mpunga T, Karema N, Nzayisenga I, Fadelu T, Uwizeye F, Hirschhorn L, Muhimpundu M, Balinda J, Amoroso C, Wagner C, Binagwaho A, Shulman LN. Implementation science for global oncology: the imperative to evaluate safety and efficacy of cancer care delivery. J Clin Oncol. 2016; 34(1): 43-52. doi:10.1200/JCO.2015.61.7738

    Buswell L, Umuhizi D, Hategekimana V, Muhayimana C, Kennell-Heiling S. Voices of hope from rural Rwanda: three oncology nurse leaders emerge. Oncol Nurs Forum. 2016; 43(5): 661-4. doi:10.1188/16.ONF.661-664

    Shulman LN, Wagner CM, Barr R, Lopes G, Longo G, Robertson J, Forte G, Torode J, Magrini N. Proposing essential medicines to treat cancer: methodologies, processes, and outcomes. J Clin Oncol. 2016; 34(1): 69-75. doi:10.1200/JCO.2015.61.8736

    Stulac S, Binagwaho A, Tapela N, Wagner C, Muhimpundu M, Ngabo F, Nsanzimana S, Kayonde L, Bigirimana J, Lessard A, Lehmann L, Shulman LN, Nutt C, Drobac P, Mpunga T, Farmer P. Capacity building for oncology programs in sub-Saharan Africa: the Rwanda experience. Lancet Oncol. 2015; 16: e405-13. doi:10.1016/S1470-2045(15)00161-8

    Challinor JM, Galassi AL, Al-Ruzzieh MA, Bigirimana JB, Buswell L, So KW, Steinberg AB, Williams M. Nursing’s potential to address the growing cancer burden in low- and middle-income countries. J Global Oncol. 2016; 3: 154-163. doi:10.1200/JGO.2015.001974

    Pace LE, Mpunga T, Hategekimana V, Dusengimana JMV, Habineza H, Bigirimana JB, Mutumbira C, Mpanumusingo E, Ngiruwera JP, Tapela N, Amoroso C, Shulman LN, Keating NL. Delays in breast cancer presentation and diagnosis at two rural referral centers in Rwanda. Oncologist. 2015; 20: 1-9. doi:10.1634/theoncologist.2014-0493

    Shulman LN, Mpunga T, Tapela N, Wagner C, Fadelu T, Binagwaho A. Bringing cancer care to the poor: experiences from Rwanda. Nature Rev Cancer. 2014; 14: 815-21. doi:10.1038/nrc3848

    Mpunga T, Tapela N, Hedt-Gauthier BL, Milner D, Nshimiyimana I, Muvugabigwi G, Moore M, Shulman DS, Pepoon JR, Shulman LN. Diagnosis of cancer in rural Rwanda: early outcomes of a phased approach to implement anatomical pathology services in resource-limited settings. Am J Clin Pathol. 2014; 142(4): 541-5. doi:10.1309/AJCPYPDES6Z8ELEY.

    Mubiligi JM, Hedt-Gauthier B, Mpunga T, Tapela N, Okao P, Harries AD, Edginton ME, Driscoll C, Mugabo L, Riviello R, Shulman LN. Caring for patients with surgically resectable cancers: experience from a specialized center in rural Rwanda. Public Health Action. 2014; 4(2): 128-32. doi:10.5588/pha.14.0002

    Sharma K, Costas A, Damuse R, Pierre JH, Pyda J, Ong C, Shulman LN, Meara J. The Haiti Breast Cancer Initiative (HBCI): initial findings and analysis of barriers-to-care delaying patient presentation. J Oncol. 2013; 2013: 1-6. doi:10.1155/2013/206367

    Abstracts

    Tuyishime H, Hornstein P, Lasebikan N, Rubagumya F, Mutebi M, Fadelu T. Distribution and underrepresentation of Sub-Saharan African authors in global oncology publications. Presented at Los Angeles Global Health Conference (LAGHC), January 29, 2022 (Virtual).

    Rwamuza E, Stauber C, Bhangdia K, Dusengimana J, Nsengiyumva T, Pace L. Understanding women’s experiences navigating a breast cancer early detection program in 2 rural districts of Rwanda. Presented at AORTIC 2021 Virtual Conference, November 5-10, 2021.

    Habimana O, Tuyisenge D, Tuyishime H, Bihizimana P, Niyibizi J, Fadelu T. Improving efficiency and reducing wait times for oncology adult patients receiving chemotherapy at an oncology hospital in Rwanda. Presented at AORTIC 2021 Virtual Conference, November 5-10, 2021.

    Pacifique U, Girukubonye I, Bigirimana J, Shyirambere C, Cubaka V, DeBoer R. Communication skills training needs and preferences among oncology providers in Rwanda. Presented at AORTIC 2021 Virtual Conference, November 5-10, 2021.

    Nsabimana N, Erfani P, Nguyen C, Bigirimana E, Tuyishime H, Fadelu T. Knowledge of breast cancer risk factors and early symptoms among Rwandan women with breast cancer. Presented at AORTIC 2021 Virtual Conference, November 5-10, 2021.

    Nsabimana N, Erfani P, Nguyen C, Bigirimana E, Fadelu T. Patient-reported barriers among women receiving curative treatment for breast cancer in Rwanda. Presented at AORTIC 2021 Virtual Conference, November 5-10, 2021.

    Nguyen C, Uwamahoro P, Benemariya E, Nsanzimana O, Mujyuwisha L, Buswell L, Lehmann L, Shyirambere C. Acceptability and perceived impact of new pediatric patient navigation program in rural Rwanda. Cancer Epidemiol Biomarkers Prev. July 1 2021 (30) (7 Supplement) 35; DOI: 10.1158/1538-7755.ASGCR21-35. Presented at 9th Annual Symposium on Global Cancer, March 10-11, 2021 (Virtual).

    Uwamahoro P, Tuyishime H, Cubaka V, Mpanumusingo E, Ho A, Van Loon K, DeBoer R. Patient-provider communication in the setting of advanced cancer: experience and views from Rwanda. Cancer Epidemiol Biomarkers Prev July 1 2021 30 (7 Supplement) 42-42; DOI:10.1158/1538- 7755.ASGCR21-42. Presented at 9th Annual Symposium on Global Cancer, March 10-11, 2021 (Virtual).

    Umutoni V, Shyirambere C, Katznelson E, Nguyen C, Bigirimana J, Umwizerwa A, Paciorek A, Bazzett-Matabele L, Ntasumbumuyange D, Triedman S, Shulman L, Mpunga T, DeBoer R. Clinical outcomes and quality metrics of cervical cancer treatment in Rwanda. Cancer Epidemiol Biomarkers Prev July 1 2021 (30) (7 Supplement) 46; DOI: 10.1158/1538- 7755.ASGCR21-46. Presented at 9th Annual Symposium on Global Cancer, March 10-11, 2021 (Virtual).

    Sebahungu F, Tuyisenge D, Buswell L, Habimana O, Benemariya E, Mugabo F, Ndayisaba A, Shyirambere C, Tuyishime H, Lee YS, Stauber C, Cleveland J, Kadish S, Potiris S, Gunderson D, Fadelu T, Bigirimana J, Manzi A, Pace L. Building a culture of quality improvement at Butaro Cancer Center of Excellence in Rwanda. Cancer Epidemiol Biomarkers. Prev July 1 2021 30 (7 Supplement) 49-49; DOI:10.1158/1538-7755.ASGCR21-49. Presented at 9th Annual Symposium on Global Cancer, March 10-11, 2021 (Virtual).

    Fadelu T, Nguyen C, Nsabimana N, Bigirimana E, Mukandayisenga V, Tuyishime H, Shulman L, Rebbeck T. Quantifying transportation barriers in Rwandan patients seeking treatment for breast cancer. Cancer Epidemiol Biomarkers Prev July 1 2021 30 (7 Supplement) 67-67; DOI:10.1158/1538-7755.ASGCR21-67. Presented at 9th Annual Symposium on Global Cancer, March 10-11, 2021 (Virtual).

    Kagabo E, Anderson T, Karema N, Dusengimana J, Hagenimana M, Uwinkindi F, Balinda J, Habinshuti P, Byiringiro J, Chyizuka N, Pace L. A tablet-based electronic medical record system to improve cancer early detection and linkage to care at health facilities in Rwanda. Cancer Epidemiol Biomarkers Prev July 1 2021 30 (7 Supplement) 99-99; DOI:10.1158/1538-7755.ASGCR21-99. Presented at 9th Annual Symposium on Global Cancer, March 10-11, 2021 (Virtual).

    Benemariya E, Haskins L, Buswell L, Dushimimana E. Evaluating oncology nurse workload and implementing workflow process improvement at a national cancer center in Rwanda. Presented at International Conference on Cancer Nursing, February 2-5, 2021 (Virtual).

    Natarajan A, Rudolfson N, O’Neil D Schleimer L, Dusengimana JM, Keating NK, Shulman LN, MpungaT, Sebahungu F, Nguyen C, Umwizerwa A, Fadelu T, Shyirambere C, Kigonya CN, Butonzi J, Pace LE. Sociodemographic factors associated with cancer treatment completion among women with breast cancer at Butaro Cancer Center of Excellence (BCCOE) in Rwanda. J Clin Oncol. 2020; 38(15_suppl): e19220-e19220. doi: 10.1200/jco.2020.38.15_suppl.e19220

    Fadelu T, Sebahungu F, Diasti K, Nguyen C, Yeh T, Shyirambere C, Nkusi E, Nsabimana N, Ruhangaza D, DeBoer RJ, Chamberlin MD, Mpunga T, Shulman LN. Patient characteristics and outcomes of colorectal cancer (CRC) at Butaro Cancer Center of Excellence (BCCOE): Results from a retrospective cohort. J Clin Oncol. 2020; 38(15_suppl): e16081-e16081. doi:10.1200/jco.2020.38.15_suppl.e16081

    DeBoer RJ, Fadelu TA, Shulman LN, Van Loon K. Applying lessons learned from low-resource settings to prioritize cancer care in a pandemic. JAMA Oncol. 2020; Sep 1;6(9): 1429-1433. doi: 10.1001/jamaoncol.2020.2976. PMID: 32761149.

    Morgan J, Bigirimana J, Nguyen C, Deboer J, Shyirambere C, Paciorek A, Lehmann L, Shulman L. Ten years of treating chronic myeloid leukemia in rural Rwanda: feasible approaches for low-resource settings. Blood 2019; 134 (Supplement_1): 4788. doi: https://doi.org/10.1182/blood-2019-126152

    Pace LE, Dusengimana JMV, Shulman LN, Schleimer LE, Shyirambere C, Rusangwa C, Muvugabigwi G, Park PH, Huang C, Bigirimana JB, Hategekimana V, Rugema V, Umwizerwa A, Keating NL, Mpunga T. Cluster randomized trial to facilitate breast cancer early diagnosis in a rural district of Rwanda. J Glob Oncol. 2019; Nov;5:1-13. doi: 10.1200/JGO.19.00209

    Shyirambere C, Deboer R, Butera Y, Driscoll C, Bigirimana JB, Uwizeye FR, Fadelu T, Park P, Paciorek A, Lehmann LE, Shulman LN. Report on the treatment of Hodgkin lymphoma with ABVD chemotherapy at two rural district hospitals in Rwanda. Blood. 2019; 134 (Supplement_1):4053. doi:10.1182/blood-2019-130780

    Lormil J, Bhangdia K, Svoboda L, Pierre V, Buswell, L, Greenberg L, Damuse R., Triedman S, Fadelu T. Implementation and evaluation of video-based tumor board conferencing in Haiti. J Clin Oncol. 2019; 37(15_suppl): e18333-e18333. doi: 10.1200/jco.2019.37.15_suppl.e18333.

    Fadelu T, Damuse R, Pecan L, Greenberg L, Danjoue S, Lormil J, Shulman L. Patterns of treatment non-initiation and early loss to follow-up in breast cancer care in Haiti. J Glob Oncol. 2018; 4_suppl: 75s-75s. doi: 10.1200/jgo.18.45500

    Fadelu T, Damuse R, Pecan L, Greenberg L, Danjoue S, Lormil J, Rebbeck T, Shulman L. Association between living in urban areas and obesity in Haitian breast cancer patients. J Glob Oncol. 2018; 4_suppl: 79s-79s. doi: 10.1200/jgo.18.25600

    Anglade F, Mompremier M, Bhangdia K, Greenberg L, Orozco JD, Brock J, Pepoon J, Milner D. Implementation of anatomic pathology services in Mirebalais, Haiti. J Glob Oncol. 2018; 4_suppl: 31s-31s.

    Davey S. Characteristics and early outcomes of cervical cancer patients at Butaro District Hospital, Rwanda. Lancet Glob Health. 2017; 5: S28-S28. doi: 10.1016/S2214-109X(17)30135-3

    Lansigan F, Costa C, Mpanumusingo E, Kigonya C, Butonzi J, Sebahungu F, Shyirambere C, Mpunga T, Haley J, Figueroa K, Park P, Davis T, Chamberlin M. A novel global health fellowship elective in oncology in Rwanda: a multi-faceted model in education. J Global Oncol. 2017; 35:15 suppl: e18086-e18086.

    Uwizeye FR, Driscoll C, Park PH, Hategekimana V, Umwizerwa A, Umuhizi D, Smith CB, Shulman L. Risk factors for loss to follow-up and treatment abandonment in adult cancer patients at the Butaro Cancer Center of Excellence in Rural Rwanda. Ann. Glob. Health. 2016; 82(3): 414. DOI: http://doi.org/10.1016/j.aogh.2016.04.154

    DeBoer RJ, Driscoll CD, Butera Y, Bigirimana JB, Muhayimana C, Fadelu T, Park PH, Shyirambere C, Uwizeye FR, Mpunga T, Lehmann LE, Shulman LN. Report on the treatment of Hodgkin lymphoma with ABVD chemotherapy at two rural district hospitals in Rwanda. J Global Oncol. 2016; 2(3_suppl): 67s-67s. doi:10.1200/JGO.2016.003764

    DeBoer R, Butonzi J, Nicholson LT, Ruhangaza D, Uwizeye FR, Shyirambere C, Mpunga T, Lehmann L, Shulman LN. Report on the treatment of non- Hodgkin lymphoma with CHOP chemotherapy at a rural cancer center in Rwanda. Presented at Union for International Cancer Control (UICC) World Cancer Congress, October 31 - November 3, 2016, Paris France.

    Buswell L, Elperin A, Houlahan K, St. Croix M, Virchick B, Bigirimana JB, Hategekimana, V, Umuhizi D. Answering the call: US oncology nurses train and mentor nurses in Rwanda. Proc of 18th International Conference on Cancer Nursing, September 2014, Panama City, Panama, 44.

    Meetings

    Lasebikan N, Nakaganda A, Fadelu T, Ibeka P, Haskins L, Cira MK. Demonstration of impact through the evaluation of the 2020-2021 Africa Cancer Research and Control ECHO. Presented at 10th Annual Symposium of Global Cancer Research, (Virtual), March 2022.

    Pace L, Dusengimana JMV, Balinda JP, Benewe MO, Rugema V, Uwihaye JD. Presenting symptoms and stage at diagnosis among women diagnosed with breast cancer through a combined breast cancer and cervical cancer screening program in Rwanda. Presented at 10th Annual Symposium of Global Cancer Research, (Virtual), March 2022.

    Wabl CA, Athanas R, Cubaka V, Mushi B, Ngoma M, Nsabimana N, Sama G, Tuyishime H, Uwamahoro P, Sanders JJ, Sudore RL, Van Loon K, Whitaker E, DeBoer RJ. Serious illness communication in cancer care in Africa: A scoping review of empirical research. Presented at 10th Annual Symposium of Global Cancer Research, (Virtual), March 2022.