Abstract
Background and study aims Gastrointestinal cancer is an important cause of death worldwide. Remote populations
are especially vulnerable to these conditions due to reduced access to screening and
adequate treatment. In this context, the Belterra project was designed as a pilot
taskforce to deliver gastrointestinal screening to an underserved Amazonian population
and to spread knowledge and practice to local health workers. This study aimed to
describe the implementation and present the results of the Belterra Project.
Patients and methods The project took place between October 2014 and December 2017 in Belterra, Pará, Brazil.
Public-private partnerships were obtained and were essential for funding. The project
required complex logistic solutions to provide gastrointestinal screening to every
inhabitant between 50 and 70 years of age, including medical equipment and personal
transportation to a remote area. Subjects were asked about their medical history,
and received a physical examination, endoscopic examinations, and stool tests.
Results Over the course of 19 expeditions, we screened 2,022 inhabitants of Belterra, aged
50 to 70 years. Five colorectal and six gastric adenocarcinomas were diagnosed, as
were several lower-stage lesions. Overall, 26 % of the participants undergoing colonoscopy
showed some type of colonic lesion.
Conclusions Notwithstanding the geographical, cultural, and financial barriers, this study suggests
that the implementation of a gastrointestinal cancer screening program for remote
Brazilian populations is feasible, reaching high adherence. Although logistics is
very demanding, such campaigns may be a good strategy to provide mass gastrointestinal
cancer screening for underserved populations.
