I thought as I head into the holiday season and my slightly stolen holiday with my parents and sister (there's no real 'Christmas vacation' here, but I'm not gonna hang out at the office my parents in Beijing!) that I would recap what I've done in my research so far this year. As most of you probably know, I am working in the department of epidemiology at branch of the Peking Union Medical College, called the Cancer Institute, Chinese Academy of Medical Sciences, or CICAMS for short. I am on the team that focuses on cervical cancer, and I have several projects on different aspects of detection, prevention, and awareness, which I will outline here (sorry for the length!).
1) Review paper about serology and DNA prevalence of HPV (the virus that causes cervical cancer) around the world. My US mentor gave me this project to work on in July, before coming to China, so I would have a project from the beginning and something to work on when things are slow around here. She seemed to think that this would be a quick project but it has been anything but; however, I have come a long way. I have finished finding new papers to include the results of, have written the results and discussion sections, and am currently editing, formatting, and designing tables and figures. We hope to submit this to a journal in the next month or so.
2) Survey about women's response to cervical cancer screening and results from screening tests. I designed the study based on prior studies done in this area in the US, visited the site where the study would be carried out earlier this semester, and it is currently underway in Yangcheng, Shanxi Province. Designing this survey took multiple attempts and revisions, especially since I don't speak/read Chinese and it was hard to communicate exactly what I was trying to ask! Grace, an awesome grad student in the epi department who is in Yangcheng is helping me input the data into a database and will translate it for me.
3) Sexual debut in China paper. Sexual debut, or the age when a person first has sexual intercourse, is an important fact to know about a population when dealing with a sexually transmitted disease like HPV, especially when there is a vaccine. The vaccine will only be effective if we vaccinate girls before they become sexually active. The Chinese government is currently deliberating about approving the vaccine (already approved in a large part of the world some time ago, just approved for men in addition to women in the US last year) so now is the time to really figure out the age of sexual debut, so a national vaccination program can be designed that will work. The epi department did a survey assessing the age of sexual debut in thousands of women last year, and the data was just waiting for someone to write up. I have written a manuscript with Shangying, Adam's Fogarty twin, and we are waiting for input from other authors (people at the research sites) before we submit to a journal. Our idea was to submit this week, but as tomorrow's Friday and I will be gone afterwards, I imagine we will submit sometime in early January.
4) HIV-HPV screening trial. HIV infected women are much more susceptible to HPV infection, and thus cervical cancer, because they have no immune system to fight the virus. Now that antiretroviral therapy can extend the lives of HIV+ women, they are living long enough to die of cervical cancer. There is a large population of HIV infected women in Yunnan Province, and we are designing a trial to test different screening methods in this population. We also want to see the effects of antiretroviral therapy on the progression of cervical lesions and cancer; this is a new factor in the recent past and the scientific community does not completely understand it yet. I have written the protocol for the study, designed the data collection forms, and met appropriate people in Yunnan last month. We hope to launch the study at the end of February. I also have some data from a pilot study in this same population with 95 women that I am currently analyzing to publish a short descriptive paper.
5) VIA/VILI paper - VIA/VILI stands for Visual Inspection with Acetic acid/Visual Inspection with Lugol's Iodine, and is a very cheap and easy screening method for cervical cancer. Its a great technique for resource poor areas, and has been shown to be much more effective than no screening at preventing cervical cancer death. There have been many studies proving its worth in other areas of the world, but none in China so far. Several years ago the Chinese government launched a pilot screening program using this technique, and data has been gathered about the number of cases of cervical cancer and lesions among those screened. I have written a first draft of a paper about this, but we are currently waiting for all the field sites to send their data to the epi department so we can finish.
And that's it folks, that's what I've done at work in the last 4 months! Nothing finished yet, but a few things nearing the end of the tunnel, and many more things getting going. I hope to have a very productive year!
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