Andrea Rivas Nieto, MD

Andrea Cecilia Rivas Nieto

Nominated From: University of Washington

Research Site: Peru

Research Area: Oncology

Primary Mentor: Joseph Zunt

Research Project


Community-Created Digital Stories to Motivate Indigenous Women to Engage in Cancer Care


Breast and Cervical Cancers are leading causes of mortality for women in Peru. Breast and cervical cancers are the most common cancers and represent approximately 20% of cancer related deaths among Peruvian women. (1) Mortality rates for breast cancer have remained stable, but rates for cervical cancer have increased dramatically from 2001 to 2010 in Peru.(1)

Furthermore, Peruvian women are more likely to die of diagnosed breast and cervical cancer relative to women in other Latin American countries and geographic regions. (1) For instance, the age-standardized mortality rate for cervical cancer in Peru is 12.0/100,000, compared to 2.7/100,000 in the United States and 8.1/100,000 in Mexico. These alarmingly poor prognoses have been attributed in part to elevated rates of late stage detection (2-5) and a lack of access to cancer-related care. (6-10) Indigenous women likely experience a greater cancer burden relative to other women. (11) Two factors that can explain this is that indigenous women appear to be less likely to obtain cancer screening in general: previous research has suggested a 15- 27% difference between indigenous and non-indigenous women who have obtained Pap tests. (12-14) Low rates of screening may result in late stage detection. (7,15) Second, there is lower engagement in health care related to breast and cervical cancer due to reliance on curanderos (traditional healers) and herbal remedies. (15-17)


Specific Aims

We aim to design and test a community-created digital story curriculum to inspire indigenous women to make healthier and safer decisions in cervical and breast cancer screening.

Research Significance

This project will produce innovative community-driven Photovoice videos to improve breast and cervical cancer screening and treatment among indigenous Peruvian women – a group that has been neglected by traditional healthcare systems. These videos will be accessible via the internet or handheld smartphones. If successful, this same technology could be replicated in the United States and Latin American countries to improve awareness and detection of breast and cervical cancer among rural and indigenous populations of women.



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