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Could New Technology Eliminate Cervical Cancer?
A 32-year-old woman has made the trek to Matibabu Hospital in western Kenya with her five young children in tow. Though she has given birth to five babies, the widow has never before been screened for cancer. Her tall, slim figure dressed in a colorful cotton dress typical for Kenya, she lies down on the table in the simple exam room for her first cancer screening. Matibabu means “medicine” or “treatment” in Saheli.
“Preventative health care is simply not available for Kenyan women,” says Melissa Miskell, an OB/GYN from Texas and executive director of PINCC (Preventing Cervical Cancer Globally), an NGO dedicated to eliminating cervical cancer worldwide. “We see 50-year-old women who have never been screened.” Her team is in the rural hospital in the Lake Victoria Region to deliver new equipment for cancer screening and treatment, and to train the local health care staff.
But this particular exam brings devastating news: The young widow has stage four cancer, and her chances of survival are slim. The hospital can only offer her morphine for the pain.
One of PINCC’s young volunteer team members breaks down crying. “It is utterly heartbreaking to see that it’s too late,” she says in a documentary about the program. “I keep thinking of her young children. They are going to be orphans. This could all have been prevented.”
New technology has made it much simpler to screen for and treat cervical cancers in Kenya and elsewhere. Credit: PINCC
Few diseases reflect global inequities as much as cancer of the cervix. According to the World Health Organization (WHO), 350,000 women die from cervical cancer globally each year — one every minute and a half. Nearly 94 percent of the deaths occur in low- and middle-income countries.
“In the US, the fatality risk of a woman with cervical cancer is approximately two to four percent,” Miskell explains. “The fatality risk of a woman with cervical cancer in a low-income country is upwards of 50 percent.” What troubles Miskell and her team most is that the illness is completely preventable.
Therefore nonprofits like PINCC, Rotary International and the Clinton Health Access Initiative are scaling up their efforts to bring new technology for screening and treating cervical cancers to low-income areas, with the goal of eliminating it completely.
PINCC was established by gynecologist Kay Taylor in 2005 after a medical mission to Honduras. Taylor saw more fatal cases of cervical cancer in that one trip than she had during her entire career in the US. So she launched the first PINCC trip to Honduras in late 2005 with only three eager volunteers and began training local health care workers in cervical cancer screening and treatment at three Honduran clinics. Since 2017, executive director Melissa Miskell has expanded PINCC’s global reach and established programs in Uganda, Kenya, Bolivia, Tanzania, Guatemala, Cameroon, Cambodia, India and Nepal.
The small PINCC team spends a training week in a hospital and leaves behind the state-of-the-art equipment. Credit: PINCC
“Early detection is the key to controlling cancer of all types, but cervical cancer is the one cancer we can eliminate globally,” explains Richard Godfrey, a retired surgical oncologist and Rotarian in Fremont, California, who is on the board of PINCC and has been delivering equipment to Matibabu for Rotary since 2012. “Why? Like polio, it’s caused by a virus, the human papillomavirus (HPV).”
While an active immune system can clear the virus, a weak immune system fails to prevent HPV from causing cancer. This is why women with HIV face a sixfold increased risk of cervical cancer — and in Kenya, both HIV and HPV are widespread.
The WHO has set a goal to help all low-income countries achieve its triple-intervention targets by 2030: fully vaccinate 90 percent of girls with the HPV vaccine by the age of 15, screen 70 percent of women twice by the age of 45 and treat 90 percent of women with cervical cancer.
In the US, too, about 13,820 new cases of invasive cervical cancer will be diagnosed this year, and more than 4,300 women will die from it. Regular screenings are the best way to prevent these numbers from rising. Doctors are concerned about the rise of the virus in the US and other wealthy states because HPV is estimated to be the most common sexually transmitted infection in the country. The American Social Health Association estimates that about 75 to 80 percent of sexually active Americans will be infected with HPV at some point in their lifetime, and doctors are worried about increasing vaccine hesitancy since Covid-19. Several countries, including Belgium and Austria, have made the HPV vaccines mandatory for young girls; many others offer them for free to encourage voluntary vaccination. The HPV virus also impacts men as it can cause mouth, throat and penile cancers.
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