INDIA — In some parts of the world, cancer patients are treated with some of the newest targeted cancer drugs which can cost more than$100,000 per year, while in other regions, patients don’t even know they have cancer because they’re not being screened.
But where pap smears are not available, there may be a decidedly low-tech way to screen for cervical cancer and reduce cancer deaths, according to a large clinical trial released Sunday at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago: swabbing a woman’s cervix with vinegar.
This study out of India is one of the top five out of more than 5,300 studies presented at the conference. It was given a spotlight usually reserved for the newest blockbuster drug research.
Worldwide, there are 500,000 cases of cervical cancer and 250,000 women die from it each year, according to the World Health Organization.
“Unfortunately we have no cervical cancer screening program in India,” where it’s the number-one cancer killer among women, says lead study author Dr. Surendra Srinivas Shastri, “mainly because pap smear screening is not feasible.” Shastri attributes lack of a resources, laboratory infrastructure and trained medical staff. A pap smear requires growing the cells from a sample and having a pathologist analyze them.
As a result, Shastri says, the cervical cancer incidence and mortality in India alone contributes to 30% of the global burden of this disease.
So he and his colleagues designed a trial to determine if using a simple visual test, which doesn’t require a laboratory, can be an effective screening tool. They borrowed a tried-and-true method called visual inspection with acetic acid (VIA), where the cervix is swabbed with a 4% vinegar solution. This is something doctors in poor and rich countries do as part of a procedure called a colposcopy.
Gynecologists in the United States use this type of test for visualization in a colposcopy, says Dr. Carol Aghajanian, a gynecological expert from Memorial Sloan-Kettering Cancer Center in New York and ASCO spokeswoman. “What’s new here is that it’s being used as a screening tool.”
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