Brett Smith for redOrbit.com – Your Universe Online
In more affluent countries, Pap smear tests have been credited with an 80 percent reduction in deaths fromcervical cancer. However, costs and cultural norms have prevented India from conducting widespread testing, resulting in cervical cancer being the leading cancer-related cause of death among the country’s women.
In a new study, a test using simple vinegar was found to have a rate of accuracy comparable to that of Pap smears, providing a cheap and easily accessible screening mechanism. Researchers reported the cervical cancer mortality rate was cut by 31 percent among the 150,000 Indian women who were involved in the study, and they speculate that it could save 22,000 lives in India and 72,600 worldwide each year.
“That’s amazing. That’s remarkable. It’s a very exciting result,” Dr. Ted Trimble study-sponsor of the National Cancer Institute told the Washington Post.
To perform the test, a trained health care worker swabs the female patient’s cervix with vinegar, causing any pre-cancerous tumor cells to turn white. The worker then visually inspects the cervix using a bright light.
Researchers admitted to having difficulty recruiting volunteers in the deeply conservative country where women must often ask permission from husbands, fathers or other family members before making even routine decisions.
“Many women refused to get screened. Some of them died of cancer later,” study participant Usha Devi told the Post. “Now I feel everyone should get tested. I got my life back because of these tests.”
Beginning in 1998, the research team enrolled over 75,000 women to be screened every two years using the vinegar test. A control group of 76,000 women received cancer education at the start of the study and vouchers for a free Pap smear test. Any participants who had cancer were offered free treatment at their local hospital.
Health worker Urmila Hadkar told the Post that many women resisted the procedure.
“There was a sense of shame about taking their clothes off. A lot of them had their babies at home and had never been to a doctor,” she said. “Sometimes just the idea of getting tested for cancer scared them. They would start crying even before being tested.”
When they were performed, the vinegar-based tests proved to be an overwhelming success. The study was slated to last 16 years, but results were so positive after the first 12 that independent monitors recommended offering it to the women in the control group.
In fact, the vinegar test was so successful that the US Office for Human Research Protections initially said researchers did not adequately inform participants in the control group about Pap tests for screening. However, officials later accepted how study leaders had handled the comparison group.
Officials in India have said they are already making plans to expand the vinegar testing to a wider population.
“It’s just not possible to provide Pap smear screening in developing countries,” said Dr. Surendra Shastri of Tata Memorial Hospital in Mumbai. “We don’t have that kind of money.”
In May, two companies announced that they will drastically lower prices on HPV vaccines for underdeveloped countries, with pilot projects beginning in Asia and Africa.
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