CHICAGO— A simple vinegar test cut cervical cancer rates among Indian women by nearly a third and could prevent 73,000 deaths worldwide each year, the authors of a large-scale study said Sunday.
Wealthy countries have managed to reduce such fatalities by 80 percent thanks to the widespread use of regular Pap smears that can detect the disease at an early, treatable stage.
But it remains the leading cause of cancer death among women in India and many other developing countries lacking the money, doctors, nurses or laboratories for widespread screening.
The inexpensive vinegar test, which has a comparable accuracy to Pap smears, offers a solution to that problem.
A primary health care worker swabs the woman’s cervix with vinegar, which causes pre-cancerous tumors to turn white. The results are known a minute later when a bright light is used to visually inspect the cervix.
Aside from the cost savings, the instantaneous results are a major advantage for women in rural areas who might otherwise have to travel for hours to see a doctor.
The test could also be useful in the United States, where 40 percent of women do not get treatment following an abnormal Pap smear, said Electra Paskett, a gynecological cancer expert at Ohio State University.
“We have a problem with follow-up,” Paskett told AFP at the American Society of Clinical Oncology’s annual meeting in Chicago where the study was presented.
“The thing in their program that was really wonderful is they assured follow-up— their completion rate was phenomenal.”
The randomized study of 150,000 women living in Mumbai slums found that the vinegar test was able to reduce cervical cancer deaths by 31 percent through early detection and treatment.
The 15-year study also found that the vinegar test sidesteps a common problem of overdiagnosis.
The incidence of cervical cancer was essentially the same among the women who were screened every other year and those who were simply taught how to watch for warning signs.
“We hope our results will have a profound effect in reducing the burden of cervical cancer in India and around the world,” said lead study author Surendra Srinivas Shastri, a professor of preventive oncology at Mumbai’s Tata Memorial Hospital.
“This is the first trial to identify a cervical cancer screening strategy that reduces mortality and is feasible to implement on a broad scale throughout India and in other developing countries.”
India has already established a vast network of community health workers who deliver basic services such as vaccinations to people in rural or remote areas and those living in urban slums.
Establishing widespread screening will only require adding a month of training to their core competence, said Rajendra Badwe, director of Tata Memorial Hospital.
Health officials in the state of Maharashtra, where the study was conducted, are preparing to train those primary health care workers to provide the vinegar screening to all women aged 35 to 64 in the state.
The national health service has also begun implementing a plan to train primary health care across the country, starting with six districts in each state.
That will take about two and a half years but the pace will speed up as more primary health care workers are taught how to pass along the skills, Badwe said.
In the past decade, cervical cancer mortality rates in India have dropped from 28 to 11 per 100,000 women but the illness is still considered the prime cancer killer. Overall, cancer causes 12 percent of deaths among Indian women.
Once the vinegar testing program is fully implemented, it could prevent 22,000 cervical cancer fatalities in the country every year.
That number would rise to 73,000 if it is implemented in resource-poor nations worldwide.
Badwe would also like to see primary health care workers trained to perform biopsies when cancerous cells are detected.
“It can be done,” Badwe told AFP.
