Low-cost testing with vinegar reduced deaths due to cervical cancer by 31 per cent

A simple screening program to detect cervical cancer using vinegar and visual exams helped reduce deaths due to the disease by 31% in a group of 150,000 poor women in India, researchers said on Sunday. The team believed that this could help prevent at least 22,000 deaths from cervical cancer in India and at least 72,000 deaths all over the developing world each year. We had a 31 percent reduction in cervical cancer deaths. That was very significant, Dr Surendra Shastri of the Tata Memorial Hospital in Mumbai said. The study also showed a 7 percent reduction in deaths from any cause, although that finding was not statistically significant.

Cervical cancer is the leading cause of cancer deaths among women in India and also in the rest of the developing world. This kind of screening could revolutionise detection of cervical cancer in the developed world where PAP smears aren t available or accessible to people. Dr Shastri added that there are no cervical cancer screening programs in India, mainly because PAP smear screening isn t possible due to infrastructure issues, the high population and high costs. We hope our results will have a profound effect in reducing the burden of cervical cancer in India and around the world, Shastri said.

The study involved 20 slums in the city of Mumbai and the team took the help of religious and political biggies to gain support for the program. For the screening program, the team trained young women with at least a 10th grade education on how to apply the vinegar solution and evaluate results. As a result of these efforts, The screening participation rates were 89 percent, huge for a country like India, Shastri told the briefing. It involved two groups one of them were given education about cervical cancer while the others were tested.

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The procedure is in general very simple. Trained women apply vinegar to the cervix which makes the pre-cancerous tissues turn white under a flashlight. The screening group got four rounds of this vinegar treatment and visual inspection plus cancer education every two years. All of the women in the study were offered treatment for their cervical cancers. Among women in the screening group, there was a 31 percent reduction in cervical cancer deaths compared with women in the education-only group.

Based on the study, Shastri said the Indian government plans to set up the screening program on a population basis. In the state of Maharashtra, where the trial was done, health officials are training to primary healthcare workers to provide the screening of all women in the state aged 35-64.

This could be a low-cost alternative to PAP testing. What we're talking about is the use of vinegar in a large screening program where PAP testing is not available. There have been studies that have demonstrated that the accuracy of these programs is comparable, said Electra Paskett, an ASCO spokeswoman and an expert in gynecologic cancers at the Ohio State University Comprehensive Cancer Center. Dr Monique Spillman of the University of Colorado Cancer Center, said similar efforts have been tried in parts of Africa. This quick and cheap procedure could identify women who need to see a physician for treatment of cervical pre-cancer or cancer, while reassuring women who have normal results, she said.

Schmeler of MD Anderson is conducting similar studies in Brazil and El Salvador using the vinegar technique in combination with testing for human papillomavirus or HPV, the virus that causes cervical cancer, to try to improve on the accuracy of such screening programs, which can sometimes result in overtreatment. The work we're doing is to try to go to the next step to determine who are the false positives, Schmeler said.

What is cervical cancer?

Cervical cancer refers to the cancer of the cervix and is one of the most common forms of cancer in women along with breast cancer. Most cases of cervical cancer are caused by the human papillomavirus (HPV). Cervical cancer can be considered one of the few types of cancer that are contagious because the HPV can spread through unprotected intercourse. The Pap smear test, a cervical screening test to identify precancerous changes is the best way to diagnose cervical cancer early.

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