Cervical cancer prevention: How one student is making a difference in Peru

It was my first day volunteering with the gynecology team at a free clinic in Iquitos, Peru, when I met the patient whose story would reshape my own.

I was a second-year student at MSUCOM in East Lansing, and was working in Peru as part of the school’s global outreach program. Outside the clinic, a line of patients spanning three blocks waited to enter. Inside, countless patients and families waited patiently to see a physician. Many lived in the city of Iquitos, while others had traveled from villages down the Amazon River to see a doctor for the first time.

My first patient was a young woman whose visit revealed a devastating diagnosis: advanced cervical cancer. While she remained calm throughout our encounter, I could sense her shock and disbelief and my heart broke for her.

During my time in Peru, I saw several other patients with the same diagnosis, which was especially disheartening since cervical cancer can be prevented altogether through vaccination and early detection.

My interactions and experiences with these women are what inspired my research on cervical cancer prevention in Peru.

Screening for cervical cancer

Every August, the MSUCOM global outreach program travels to Peru with a team of medical students and physicians. Students raise money for medications, conduct research projects, and work alongside physicians to provide primary care to Peruvian patients. As a second-year medical student, I was selected to co-coordinate a women’s health research project in Iquitos with my classmate, Chantal Bhan.

Because cervical cancer is the leading cause of cancer deaths among Peruvian women, and human papillomavirus (HPV) is responsible for the vast majority of cervical cancer, we decided to conduct a cervical cancer screening project. Of the women we examined at the MSUCOM clinic in Iquitos, 35% screened positive for precancerous cervical lesions. This number was surprisingly high, as other studies conducted in Peru had shown positive screening rates between 6% and 18%.

Analyzing prevalent strains of HPV

Because HPV infection is the primary cause of most cervical cancers, our next step was to analyze which HPV genotypes are most common in Peru. With the help of a grant from the American Medical Association Foundation, I returned to Peru in August 2015 to coordinate a project that would do just that. In collaboration with Peruvian pediatrician Rubén Kenny Briceño, MD, from Universidad César Vallejo in Trujillo, my team of MSUCOM physicians and I collected 216 cervical cell samples from women with cervical abnormalities in the cities of Iquitos and Trujillo.

This winter, with the help of Michigan State University, I will use molecular techniques to process these samples in order to determine the prevalence of 13 different high-risk HPV genotypes. Ultimately, I hope to identify the HPV culprits burdening Peruvian women and provide insight for future HPV vaccination campaigns in the country.

Throughout the project, I’ve been inspired by the selflessness of the patients who’ve taken part. Even they knew they would not benefit individually, since we are unable to provide HPV genotyping results due to difficulty with follow-up, these women were more than willing to participate to help others in the fight against cervical cancer.

While I may never again see the woman diagnosed with cervical cancer from my first day in Peru, the impact she had on me will never be forgotten.