Alternative screening could cut cervical cancer deaths in poor nations

In the right hands, a swab of vinegar and a flashlight may detect more cervical cancer around the world than the recommended cytological screening known as a Pap smear. At the right time, a single DNA test for the virus that causes cervical cancer may also outperform repeated Pap smears.

In fact, dime for dime, either test is a better deal for poor countries that want to emulate the success of wealthy countries in sharply reducing cervical cancer rates, says a cost- effectiveness analysis of the three screening methods in five developing countries.

If developing countries screened all women at least once in their mid-30s, they could cut the number of cervical cancer deaths by up to 25 percent, reports the paper in the Nov. 17, 2005 New England Journal of Medicine. With a second screening several years later, the two tests could potentially halve the number of women dying from cervical cancer.

“No matter which option – the high-tech DNA test or low-tech visual inspection – the most important point is the simple fact of being able to deliver the treatment with the screening in one or two visits,” said lead author Sue Goldie, Harvard School of Public Health associate professor of health decision science.

Annual cytological testing of exfoliated cervix cells has been the global standard for decades, but the numbers tell the story of its failure to curb a highly preventable cancer in many regions. Cervical cancer tops the cancer mortality charts in poorer countries, which account for 80 percent of all cervical cancer deaths. It tends to kill women in their 40s, leaving large young families to fend for themselves.

Happily, abnormal cells destined to become cervical cancer are easily detected and safely treated in the earliest stages.