New Cancer Control co-leader brings cancer screening focus

September 22, 2022
portrait of a main in hallway with light streaming through windows
Dr. Ashish Deshmukh joined MUSC Hollings Cancer Center and the Department of Public Health Sciences in August. Photo by Clif Rhodes

His office walls are still bare, but Ashish Deshmukh, Ph.D., is already finding points of collaboration and synergy across the MUSC campus.

Deshmukh joined MUSC in August as the co-leader of the Cancer Control program at MUSC Hollings Cancer Center and as an associate professor in the Department of Public Health Sciences. He was drawn to the Cancer Control program because of the enthusiasm and collaborative spirit of its members, he said.

Cancer Control is focused on research to reduce cancer deaths by identifying risk factors, developing evidence-based interventions and working with stakeholders and policymakers throughout the state and nation to help to develop public policy and inform practice.

In the past, both program co-leaders were drawn from the field of smoking cessation and tobacco research. Now, Deshmukh, who in addition to cancer epidemiology and decision science focuses on human papillomavirus and the six cancers it can cause, joins co-leader Matthew Carpenter, Ph.D., who focuses on tobacco control and behavioral medicine.

Carpenter said Deshmukh’s skillset nicely complements and strengthens the existing program.

“Cancer control does span a wide continuum. It includes many things, not just tobacco control, which is very relevant to South Carolina, but also cancer screening, which is one of the most important things we can do for cancer control,” Carpenter said. “I think these are two areas that have particular relevance to South Carolina, where cancer disparities still exist, particularly in the outlying areas of our state.”

“I’m very excited and keen to work across disciplines within Cancer Control and beyond, as part of MUSC, to improve cancer prevention and control in the state of South Carolina.”

Ashish Deshmukh, Ph.D.

Deshmukh said he’s excited about getting started with the team.

“The way I would describe my research is that it involves bringing together different disciplines – so I work with epidemiologists, decision scientists, health services researchers and stakeholders across the nation and from different world settings,” he said. “I’m very excited and keen to work across disciplines within Cancer Control and beyond, as part of MUSC, to improve cancer prevention and control in the state of South Carolina.”

Deshmukh comes to Hollings from the University of Texas Health Science Center at Houston, and he said that South Carolina appears to share many of the public health challenges that Texas faces, including barriers to care driven by social determinants of health and growing inequalities.

As an example, South Carolina has had one of the highest increases in anal cancer mortality and has a high concentration of persons living with HIV, he said, yet the state has only a handful of providers trained in anal cancer screenings.

Anal cancer is one of the cancers that can be caused by an HPV infection. In his research, Deshmukh studies vulnerable and minority groups, including people living with HIV and men who have sex with men, who are at higher risk of developing anal cancer; helps to generate evidence-based interventions to prevent HPV infection and intervene in the progression to cancer, such as HPV vaccination and optimal screening approaches; and studies barriers to implementing evidence-based interventions and strategies to overcome them.

Though anal cancer is considered rare, incidence rates and death rates are both increasing. Deshmukh is particularly interested in reaching high-risk groups. Men who have sex with men living with HIV, for example, have an over 80-fold risk of developing anal cancer than heterosexual men without HIV. Women who have had cervical or vaginal cancer are also at increased risk, Deshmukh said.

Knowing that these groups are at risk, the question becomes how to reach them and what screening methods should be considered. Deshmukh, who is part of a team working on screening guidelines, also looks at whether there are better screening methods that could be more effective and less costly. The current screening method involves cytology, or taking a swab of cell samples, and anoscopy, which uses a tube for viewing of the anus. However, there are few providers trained to provide this screening, and there’s a fairly steep learning curve to become proficient, Deshmukh said.

“It’s more about developing screening infrastructure and capacity,” he explained.

Even once the screening guidelines are in place, which could happen soon, high-risk populations won’t be able to follow the guidelines if there aren’t a sufficient number of trained providers in place, he said. And if some regions have the capacity to offer screenings and other regions don’t, then disparities in catching and treating the cancer will start to build.

Deshmukh also studies cervical cancer with colleagues at the University of Puerto Rico Cancer Center. In most of the U.S., cervical cancer rates steadily decreased for decades and then leveled off around 2012. In Puerto Rico, however, cervical cancer rates have been increasing by 3% per year. Deshmukh is studying the barriers to screening in Puerto Rico.

“Hurricanes and COVID-19 have disproportionately impacted cervical cancer screening uptake in Puerto Rico, and the recovery has been slow, so the uptake rate has not recovered,” he said. Even as Puerto Rico continues to recover from 2017’s devastating Category 4 Hurricane Maria, the island was again without power and experiencing catastrophic flooding after Hurricane Fiona made landfall on Sept. 18.

“So, the barriers to cancer care and cancer prevention are more acute, and we still don’t have a very good understanding of what might be driving higher incidence of certain cancers or why the disparities exist.”

Carpenter said Deshmukh’s research interests, his background in health economics and his strong focus on mentoring young researchers make him a strong addition to Hollings and MUSC.

“I’m delighted to have Ashish join our group. He brings great energy, great ideas, great passion and an excellent track record for cancer prevention research,” Carpenter said. “He really brings a complementary focus to our Cancer Control program in ways that balance out the strengths that are already in place.”