Vinegar test to prevent
cervical cancer death
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Tata Memorial’s cheap vinegar test detects
cervical cancer faster
A simple vinegar test could prevent 73,000 deaths from cervical cancer worldwide
each year, the authors of a large-scale study of women in India said on Sunday.
The research effort was led by Dr. Surendra Shastri of Tata Memorial Hospital in
Wealthy countries have managed to reduce cervical cancer deaths by 80 per cent
thanks to the widespread use of regular Pap smears. ( The Pap test, also called
a Pap smear, checks for changes in the cells of your cervix. The cervix is the
lower part of the uterus It can tell if you have an infection, abnormal
(unhealthy) cervical cells, or cervical cancer. It is a costly test ). But
cervical cancer 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 vinegar test, while not perfect,
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. Usha Devi, one of the women who participated in the study, says
it saved her life. "Many women refused to get screened. Some of them died of
cancer later," Devi said."NowI feel everyone should get tested. "
This low-tech visual examination cut the cervical cancer death rate by 31
percent, the study found. It could prevent 22,000 deaths in India and 72,600
worldwide each year, researchers estimate. "That's amazing. That's remarkable.
It's a very exciting result,"said Dr.Ted Trimble of the National Cancer
Institute in the US, the main sponsor of the study.
India has nearly one-third of the world's cases of cervical cancer - more than
140,000 each year. "It's not possible to provide Pap smear screening in
developing countries. We don't have that much money or staff or equipment, so a
simpler method had to be found, Shastri said.
Starting in 1998, researchers enrolled 75,360 women to be screened every two
years with the vinegar test. Another 76,178 women were chosen for a control, or
comparison group that just got cancer education at the start of the study and
vouchers for a free Pap test - if they could get to the hospital to have one.
Women in either group found to have cancer were offered free treatment at the
hospital. Still, this quick and free cancer screening was a hard sell in a
deeply conservative country. Social workers were sent into the slums to win
"We went to every single house in the neighborhood assigned to us introducing
ourselves and asking them to come to our health talks. They used to come out of
curiosity, listen to the talk but when we asked them to get screened they would
totally refuse," said one social worker, Vaishnavi Bhagat. "The women were both
scared and shy. There was a sense of shame about taking their clothes off.
Sometimes just the idea of getting tested for cancer scared them," said Urmila
Hadkar, another health worker.
The study was planned for 16 years, but results at 12 years showed lives were
saved with the screening. Hence independent monitors advised offering it to the
women in the comparison group.
However, an ethics controversy developed during the study. The US Office for
Human Research Protections faulted researchers for not adequately informing
participants in the comparison group about Pap tests for screening. A letter
from the agency in March indicated officials seemed to accept many of the
remedies study leaders had implemented.
Others defended the study. "We looked at the ethics very carefully" and felt
them to be sound, and visited the project in India, said Trimble of the National
"There really was no wrongdoing there,"said Dr. Sandra Swain, a cancer
specialist at Medstar Washington Hospital Center.
More progress against cervical cancer may come from last month's announcement
that two companies will drastically lower prices on HPV vaccines for poor
countries. Pilot projects will begin in Asia and Africa; the campaign aims to
vaccinate more than 30 million girls in more than 40 countries by 2020.
Times of India )