Abstract 41: International Collaborative Rwanda Endoscopy Week Conferences Demonstrate Feasibility and identify H. pylori Testing as an Important Target for Capacity-Building Interventions

Purpose: Gastrointestinal (GI) endoscopy is a growing field in Rwanda, a country of 12.6 million with significant GI morbidity and mortality. Endoscopy alongside Helicobacter pylori identification and eradication aids in GI cancer prevention and diagnosis in this population. Our collaborative training-focused endoscopy conference provides preliminary data to focus future training and capacity building programs in Rwanda to improve oncologic outcomes. Methods: Since 2017, ‘Rwanda Endoscopy Week9 (REW) is held annually at multiple hospitals throughout Rwanda. It consists of several days of didactic training in endoscopy, oncology and research, followed by a week of endoscopy procedures performed jointly by visiting and hosting endoscopists, and ending with a summary of results of didactic and endoscopic activity. Results: Four (4) hospitals performed 244 training endoscopies in 2017 and 448 cases in 2018. In 2019 this expanded to 668 endoscopies performed at 7 hospitals, including academic, district, and private hospitals. The case distribution remained similar over 3 years at 86.0% (1170/1360) upper endoscopies, 13.2% (180/1360) colonoscopies, and 0.7% (10/1360) endoscopic retrograde cholangiopancreatographies. Thirty-nine (5.8%, 39/668) patients had a tumor finding suspicious for gastric (4.0%, 27/668), colorectal (1.5%,10/668), ampullary (0.1%, 1/668), or gallbladder (0.1%, 1/668) malignancy. 54% of patients receiving endoscopy were tested for H. Pylori (367/669); 38% of those tested had inconclusive results (141/367) and 20% were positive (74). There were 2 non-serious bleeding events. Conclusions: Participation by Rwandan urban, district, public and private hospitals in a cooperative international GI training conference has experienced a nearly three-fold increase in patients and identified malignant pathology while maintaining safe endoscopic care over a three-year period. H. pylori, ubiquitous in this population, is an important risk factor for gastric cancer and gastric diseases. Necessary next steps include increased training and capacity-building interventions to improve the quality of the testing and surveillance of those treated. Citation Format: Nikitha Gangasani, Eric Rutaganda, Felcien Shikama, Steve Bensen, Vincent Dusabejambo, Mary Chamberlin. International Collaborative Rwanda Endoscopy Week Conferences Demonstrate Feasibility and identify H. pylori Testing as an Important Target for Capacity-Building Interventions [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 41.