New Visual Test Using Acetic Acid To Detect Cervical Cancer Lesions Could Be Effective In Developing Countries, Study Says

Main Category: Cervical Cancer / HPV Vaccine
Also Included In: Women's Health / Gynecology
Article Date: 08 Aug 2007 - 15:00 PDT

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A low-cost, simple test that uses acetic acid to detect some early signs of cervical cancer could significantly reduce the number of cases of the disease in developing countries, according to a study published on Thursday in the journal Lancet, Reuters reports (Reuters, 8/2). The visual screening test is performed by a nurse or trained health care worker who washes a woman's cervix with acetic acid -- a key ingredient in vinegar -- and gauze. Any pre-cancerous lesions turn white after one minute and can be seen with the naked eye under a halogen lamp, the AP/San Diego Union-Tribune reports.

The study, which was funded by the Bill & Melinda Gates Foundation, was conducted by Rengaswamy Sankaranarayanan of the International Agency for Research on Cancer and colleagues between 2000 and 2006 in the Dindigul district of India. The women in the study were between ages 30 and 59, appeared to be healthy and had no past history of cervical cancer. The researchers screened 49,311 women with the new method during the first three years of the study. When precancerous lesions were found, health workers administered immediate treatment to destroy the abnormal tissue (Cheng, AP/San Diego Union-Tribune, 8/2). A total of 3,088 women were screened as positive using the new method and received further examinations or a pap test. These examinations found 1,874 cases of precancerous lesions, 72% of which received treatment (AFP/Yahoo! News, 8/3). The control group was composed of 30,958 women who received standard care. They were told to watch for symptoms of cervical cancer and encouraged to go to health facilities where cervical cancer screening was available. These women were followed from 2000 to 2006.

During the six-year span, the researchers recorded 167 cervical cancer cases and 83 deaths among the women who received the screening, compared with 158 cases and 92 deaths among those who did not. The data represent a 25% lower cervical cancer rate and a 35% lower death rate among those screened with the new method.

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Pilot projects for the test are under way in several countries in Asia and Africa. Experts think that the method could be rolled out in developing countries "relatively easily," the AP/Union-Tribune reports. However, the test has shown to produce false positives, so health care workers performing the test must be properly trained. The test also cannot be used among postmenopausal women or among women who have had more than two or three children because precancerous lesions in those women develop in parts of the cervix not normally visible (AP/San Diego Union-Tribune, 8/2). Sankaranarayanan said that combined with "good training and sustained quality assurance," the technique is an excellent preventive tool for developing countries (AFP/Yahoo! News, 8/3). "This study has given us a road map of how we can deliver this kind of screening widely," David Kerr -- Rhodes professor of Clinical Pharmacology and Cancer Therapeutics at Oxford University who was not involved with the study -- said (AP/San Diego Union-Tribune, 8/2).

The study is available online.

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