Preventive Oncology International

POI Summer 2025 blog

Dear Friends,

Preventive Oncology International, Inc. (POI) was established in 1997, and became the international research arm of the Division of Gynecologic Oncology in the Department of Gynecology and Obstetrics at The Cleveland Clinic in Cleveland, Ohio. On the 29th of July 2008, with my retirement from clinical practice at the Cleveland Clinic, POI became its own 501(c)3.

To date POI has conducted research in China, Malaysia, Mexico, Peru, USA, Dominican Republic and collaborated with research groups working in India, Haiti, Kenya, Brazil, The Netherlands, Belgium, and the USA.

POI has followed a few consistent guiding principles:

1. To blend clinical care with our research, particularly in medically underserved communities.

2. To have a POI staff on site but to primarily work with an “in-country” research team plus local (community) caregivers.

3. Conduct only investigator initiated (designed) clinical trials.

4. To always provide opportunities for students to join our teams for personal experience and in pursuit of advanced degrees.

Over the past 27 years we have worked with hundreds of physicians, nurses, clinical assistants, and graduate students; we are indebted to the many women and their families who have participated in our clinical investigations and genuinely hope they feel their participation provided value for their lives and they felt the respect and gratitude we had for them for joining in our work.

The overwhelming feeling from our more than a quarter century of work was experienced the first time we entered a rural village and realized: the only reason the women were going to receive medical care was “because we were there”.

Our major accomplishments (published, as of now, in 148 peer-reviewed manuscripts):

1. The introduction of HPV testing and liquid based cytology into China

2. The defining of how a self-collected specimen for HPV could be as sensitive as a physician obtained direct cervical sample for cervical cancer screening.

3. The first large (10,000 participants) randomized prospective trial of HPV self-collection with clinical endpoints that demonstrated the equivalent sensitivity of self and physician collected specimens for the detection of high-grade cervical pre-cancer and cancer.

4. The demonstration that the self-collection device is secondary in self-collection to processing the specimens with PCR (polymerase chain reaction) laboratory technologies.

5. Multiple studies on patient acceptance of self-collection in multiple cultures

6. Studies of specimen transport modalities culminating in simple dry brush transport

7. Developing community based and internet-based screening models

8. Demonstrating the inaccuracy of visual diagnostic methodologies (VIA/Colposcopy)

9. Collaborating in the development of the first HPV assay using next generation genomic sequencing

10. Providing care in our trials and the implementation that followed for hundreds of thousands of women with technologies that we were involved in their development and investigation.

Then in 2025 the “newly elected” begin an assault on international aid programs and science. Caught up in this web of “government efficiency” were some of our countries most seasoned and accomplished scientists. The National Institutes of Health, our nation’s premier home for quality science and adjudicated funding was not spared. One example was the PAVE consortium (Papillomavirus Automated (A.I.) Visual Evaluation). PAVE is a novel strategy for cervical cancer screening and prevention targeting low-income and hard to reach populations. It integrates self-collection for the human papillomavirus and A.I. assisted visual evaluation to provide a risk of having high grade cervical pre-cancer or cancer. . PAVE’s current accomplishments include bringing together personnel from 4 continents (9 countries plus the USA) to achieve the goal of preventing cervical cancer globally. The personnel include epidemiologists, physicians, statisticians, public health specialists, laboratory scientists, AI specialists, and engineers focused on working together to address the fact that 600,000 women develop cervical cancer every year, and 300,000 die from the disease. The women who are most at risk are those who were born before the HPV vaccine was available, were unable to get the vaccine prior to infection, or have no access to the vaccine. Over the past 7 years using the latest developments in Human Papillomavirus technologies (in part developed by PAVE) and AI assisted visual examination (refined by PAVE), a novel low cost highly accurate screening strategy has been developed for resource-limited settings. Now with the finish line in site, the NIH funding has been eliminated as of June 2025. To complete the work the algorithm needs to be validated against current models and their cost-effectiveness demonstrated so world-wide acceptance and implementation can occur.

So now POI is energized and charged with a new mission. Do everything in our power to support our colleagues and help facilitate the completion of their work which is expected to require 2.5 years.

POI has now received a significant contribution that will support PAVE for the next 6 months. POI will continue to seek funding to support our own work, which will focus on PAVE, as well as the integration of data from future international and potential US sites. The studies are intended to demonstrate replicability of the new AI module on IRIS devices (camera) across different field sites, to assess the agreement between provider management decisions and the new model generated risk estimates, and to evaluate the acceptability of the new strategy through provider and patient feedback as well as examining the real costs of implementation.

We are proud as an organization to be able to integrate our work and help PAVE continue for the women of the world. As the saying goes “life happens when you are making plans”. POI has new life, and we hope you will support us.

Warmest wishes,

Jerry

Jerome L. Belinson, M.D.

President, Preventive Oncology International, Inc.

Clinical Professor in the Department of Ob/Gyn & Reproductive Biology

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University

www.poiinc.org