# Prognostic value of quantitative HPV viral load in determining cervical cancer treatment response and recurrence

> **NIH NIH K08** · UNIVERSITY OF PENNSYLVANIA · 2021 · $135,000

## Abstract

PROJECT SUMMARY
This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA-
21-033. The COVID-19 pandemic dramatically and rapidly altered the delivery of cancer care globally, providing
a compelling opportunity to empirically study how the pandemic and subsequent practice changes impacted
patients and treatment pathways. Cervical cancer is one of the most common female cancers worldwide with
over 600,000 new cases and 340,000 deaths estimated in 2020. The vast majority of incident cases and deaths
occur in low- and middle-income countries (LMICs), particularly those with high rates of human
immunodeficiency virus (HIV) as cervical cancer is an HIV-associated and acquired immunodeficiency syndrome
(AIDS)-defining malignancy. In Botswana, a Sub-Saharan African country that is burdened with high rates of
cervical cancer (incidence rate of 34.4 per 100,000) and HIV (18.5% prevalence), advanced stage at diagnosis
and poor treatment completion contribute to high rates of mortality (20.1 per 100,000) in both HIV-positive and
HIV-negative women. Despite this substantial burden, very few studies have focused on understanding
modifiable drivers of treatment delays in Botswana. Furthermore, little is known regarding which interventions
may be most impactful and sustainable to improve timeliness of care in LMICs before, during, or after the
pandemic. As such, there is a critical need to identify effective strategies to ensure timely initiation and completion
of treatment, and to understand contextual factors that may shape response to interventions. Prior to the COVID-
19 pandemic, our quantitative and qualitative data from an existing cohort of over 1,000 women receiving
treatment for advanced cervical cancer in Botswana documented substantial delays in diagnostic testing and
treatment initiation, driven by myriad challenges including patient knowledge and awareness, geographic and
structural barriers, and limited healthcare resources. Expanding upon this prior work, the objective of this project
is to: 1) quantitatively evaluate patterns of treatment initiation and completion for cervical cancer during the
COVID-19 pandemic using an existing cohort of patients receiving care for advanced cervical cancer at Princess
Marina Hospital in Gaborone, Botswana; and 2) qualitatively assess contextual determinants (e.g., patient fear,
social distancing policies, shifts to telemedicine) contributing to experiences and timeliness of care and identify
intervention strategies to target contextual determinants using the Expert Recommendations for Implementing
Change (ERIC) framework. The results of this project will provide empirical data on how the COVID-19 pandemic
impacted cervical cancer care and provide scientific knowledge on how different delivery approaches may have
shaped outcomes for patients in Botswana. This project will also identify contextually-aligned interventions to be
tested in a future implementation...

## Key facts

- **NIH application ID:** 10380979
- **Project number:** 3K08CA230170-03S1
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Surbhi Grover
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $135,000
- **Award type:** 3
- **Project period:** 2019-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10380979

## Citation

> US National Institutes of Health, RePORTER application 10380979, Prognostic value of quantitative HPV viral load in determining cervical cancer treatment response and recurrence (3K08CA230170-03S1). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10380979. Licensed CC0.

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