Bridging the gap in access to diagnostic testing for pediatric cancer in Mexico

You can’t treat a cancer that hasn’t been diagnosed. For children with suspected cancer, every day without a proper diagnosis can mean delays in care and potentially worse outcomes. Yet, in many regions worldwide, patients face significant barriers to timely, accurate and specialized diagnostic tests. It is essential to start care as soon as possible to treat the disease effectively — but doing so is based on understanding what type of cancer the patient has and whether they fall into a high-risk group.

In Mexico, many hospitals lack the necessary equipment and expertise for specialized diagnosis. Patients living in rural areas also face geographic barriers, making access to specialized care a major obstacle. As a result, many children experience prolonged waits for essential diagnostic tests, jeopardizing both the accuracy of their diagnoses and their chances of receiving appropriate treatment, ultimately diminishing the likelihood of good long-term outcomes.

Building bridges to better cancer care for Mexican children 

The Bridge Project, an initiative by St. Jude Global designed by Mexico Regional Program Director Paola Friedrich, MD, is working to overcome these barriers. The Mexico in Alliance with St. Jude (MAS) collaboration aims to improve childhood cancer outcomes in Mexico, including securing access to diagnostic tests for childhood cancers, particularly acute lymphoblastic leukemia (ALL), which is the most common type of cancer for children across Mexico. By centralizing specialized diagnostic services in a state-of-the-art lab in central Mexico, the project has made it easier to test patient samples from across the country efficiently. 

“Historically, access to pediatric cancer care outside the main cities is limited,” explained Andrea Granadillo, MBA, program coordinator of the Mexico Regional Program, St. Jude Department of Global Pediatric Medicine. “Specialized labs are scarce, and the logistics of shipping bone marrow samples are complex.”

In addition to the lack of diagnostic tests, patients have limited access to key classification tests such as fluorescence in situ hybridization, which detects genetic abnormalities, and minimal residual disease, which measures remaining cancer cells after treatment to evaluate relapse risk. These tests are crucial for accurately classifying leukemia risk and monitoring treatment response. A lack of proper diagnosis can result in leukemia misclassification, resulting in overuse of aggressive chemotherapies, increased risk of toxicity, and higher mortality rates.

“Our mission is to increase the quality of care and survival for children and adolescents battling cancer in Mexico. To achieve this, we’re driving a multisite, intersectional collaboration that leverages innovative education, treatment and research strategies,” said Naomi Echeandia, MSc, senior manager of the Mexico Regional Program, St. Jude Department of Global Pediatric Medicine.

A path to progress

The Bridge Project was conceptualized by Friedrich and launched in 2019 to streamline access to comprehensive diagnostic testing. By centralizing diagnostic services, the project has made it easier for patient samples nationwide to be sent and tested efficiently. This exciting quality improvement initiative is breaking down geographic barriers, ensuring that every patient — no matter where they live — receives the fast, accurate diagnostic information crucial for guiding treatment decisions, minimizing chemotherapy toxicity and boosting survival.

Recently, the Bridge Project reached a significant milestone: providing 1,000 children suspected of having leukemia with access to a comprehensive diagnostic panel. Of those 1,000 children, 864 were diagnosed with ALL, marking a pivotal step toward enhancing early diagnosis and advancing cancer care in Mexico’s health care system. 

That step has only been possible through the collective effort between the program’s collaborators on the ground in Mexico, the expertise provided by St. Jude Global, the contributions of Hospital Infantil Teletón de Oncología (HITO), and the support of local foundations Casa de la Amistad para Niños con Cáncer and Gonzalo Río Arronte. 

“The consensus-derived diagnostic panel was developed through the collaboration of St. Jude experts alongside local experts, combining the latest scientific evidence with local insights to create diagnostic criteria that are clinically effective but also tailored to local realities and the availability of resources,” explained Granadillo. 

This ongoing relationship is central to MAS´s goal of reducing cancer mortality and improving pediatric cancer care in Mexico.

A vision for sustainable change

Pablo-González-Montalvo, MD, a pediatric oncologist in Mexico and a leader of the Bridge Project, has witnessed firsthand the initiative’s transformative impact. As a practicing clinician in Mexico, he has seen how collaboration can overcome the challenges posed by limited resources. 

“Working on the Bridge Project, Mexico in Alliance with St. Jude, and the St. Jude Global Alliance has been a profound learning opportunity. It has shown how collaboration can improve outcomes in childhood cancer, even in settings with constrained resources,” González-Montalvo reflects.

With an eye toward the future, the project has shifted its focus to long-term sustainability. “We hope that this initiative will demonstrate that investing in proper diagnostic tools not only saves lives but also proves to be cost-effective, especially in treating acute lymphoblastic leukemia,” said González-Montalvo. 

As the Bridge Project continues to evolve, its impact is expected to extend well beyond the immediate future, paving the way for a more sustainable and equitable health care landscape for children with cancer in Mexico and beyond.

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