Two tests in a lifetime will halve cervical cancer numbers in poor countries

Nov 20 2005

Most women in developed countries are regularly screened for cervical cancer, but this is often not the case in poorer countries.

But now according to a new study, just two health clinic visits in a lifetime could halve the cancer risk for women in developing regions.

Sue Goldie, and her colleagues say that a one-time screening at age 35, combined with surgical treatment for women with an abnormal result, would cut the lifetime risk of cervical cancer by 25 to 36 percent.

A second examination, at age 40, would further reduce the risk by about 50 percent.

Goldie maintains that the study adds strong support to changing the long held perception that screening will be too difficult to implement and sustain in the world's poorest countries.

Cervical cancer deaths are uncommon in the United States, there are only about 4,000 per year, they are however a leading cause of cancer death in the poor regions of the world.

Goldie, of the Harvard School of Public Health, said one test that would be practical in the nations studied, India, Peru, Thailand, Kenya and South Africa, looks for human papillomavirus (HPV), the virus that causes cancer in cervical tissue.

The other involves looking at the cervix after it has been treated with acetic acid, which turns precancerous tissue white.

The best-known test for cervical cancer is the Pap smear, but that requires laboratory facilities and highly trained workers to read the smears, making it impractical in developing countries.

The Goldie team said that with costs ranging from $24 to $111 per screening, depending on the country, their strategies would be among the most cost-effective interventions available.

Researchers are testing a vaccine against the types of HPV responsible for 70 percent of cervical cancers, and according to experts Mark Schiffman and Philip Castle of the National Cancer Institute, they expect multiple tools to be available within a few years, not only to improve cervical-cancer screening, but also to restrict the spread of its viral cause.

They say as it is feasible to prevent cervical cancer and to avert the suffering it causes so many women and their families, cervical cancer deserves to be a high priority among the global efforts to prevent cancer.

The study is published in The New England Journal of Medicine.