Indian doctors develop low-cost screening for cervical cancer

Cancer cells

MUMBAI: Tata Memorial Centre, a premier cancer treatment institute in the country, today announced that its researchers have found an inexpensive way to screen for cervical cancer — the most common cancer among Indian women — which can prevent 72,600 deaths worldwide each year.

The procedure, involving use of vinegar, curbed the deaths caused by the cancer by 31 percent in a group of 1.5 lakh women, it said. Cancer of the uterine cervix is the most common cancer affecting Indian women with an estimated 142,000 new cases coming to light every year and 77,000 women dying of the disease, a TMC spokesperson said here today. “India accounts for one-third of the global burden of cervical cancer. The disease is caused by infection with a virus called human papilloma virus (HPV) and is related to poor genital hygiene. “The disease develops slowly and most women experience no symptoms until it reaches advanced stages when treatment is often unsuccessful. Cervical cancer is preventable if the disease is detected at early and treated in time. “Cervical cancer incidence declined dramatically in high- income countries after introduction of organised population-based screening programmes using cervical cytology (Pap smear test),” he said.

“However, in India, a national population-based Pap smear screening programme is difficult to implement because of logistic problems related to need for laboratory facilities and expert cytologists.” Visual inspection of the cervix after application of 4 per cent acetic acid (VIA) is a low-cost alternative, he said. However, efficacy of VIA test, conducted by trained health workers, was yet to be ascertained. So Tata Memorial Centre embarked on this research; funds were provided by National Cancer Institute, USA, supplemented by TMC and Women’s Cancer Initiative, Mumbai.

The study involved 150,000 women in the age group of 35-65, living in “relatively low socio-economic settings in 20 clusters in Mumbai suburbs”, TMC spokesperson said, adding that participation was entirely voluntary.

The researchers divided the participants into two groups: 75,000 women living in 10 clusters were allocated to the `screening group’ while another 75,000 women were allocated to the `control group’. Women in the `screening group’ were invited to a cancer education programme followed by VIA test. This group received four rounds of screening and cancer education every two years. Women in the `control group’ did not receive the VIA test but were given cancer education. They were also asked to report to TMC in case they experienced any symptoms suggestive of cervical cancer.

According to TMC, results showed that VIA screening is safe, feasible and “acceptable to Indian women”, as there was an “overwhelming participation”. “The study data recorded at the completion of 12 years show that cervical cancers were detected significantly early among the screening group….There was 31 per cent reduction in death-rate from cervical cancer in the screening group compared to the control group. Many more `pre-cancers’ were also detected in the screening group and were treated, indicating that these women are unlikely to get cervical cancer in future,” the spokesperson added.

VIA test can prevent 22,000 cervical cancer deaths in India and 72,600 deaths in “resource-poor” countries world-wide annually, TMC says. The results of the study were announced at the annual meeting of American Society of Clinical Oncology, underway in Chicago.