In developing countries, many people don’t have a great deal of money for expensive medical tests to check for cancer. This is true in India where many women cannot afford to have a pap smear to check for cervical cancer. However, in a medical breakthrough that took many years to achieve, doctor Surendra S. Shastri has decided to use a technique to check for cervical cancer using common household vinegar.
Cervical cancer is somewhat rare in developed countries because of testing procedures – for most people anomalies are found before becoming a serious life threatening cancer. Cervical cancer deaths in the United States amount to 4000 every year. In developing countries however, more than 200’000 women die every year from cervical cancer. Doctor Shastri considered it his lifetime goal to develop a simple testing procedure that could be used throughout the developing world to catch the illness early.
Cervical cancer first starts as a pre-cancerous lesion that grows into cancer. Spotting that lesion before it turns cancerous is why so many lives have been saved in the United States. The pap smear test was invented in the 1920s and has been used with great success to test for lesions in the cervix. The pap smear takes cells and sends them to the laboratory for testing – a simple procedure, but somewhat expensive for people living in the developing world.
Dr Shastri explains why widespread pap smear testing regimes would be difficult to achieve in India: “We don’t have the kind of laboratories or the kind of trained manpower needed for having a Pap smear. The Pap smear has succeeded in the countries where it has because of good quality control and frequency of screening”
So Dr Shastri decided to use a simple test that doctors perform after a suspicious pap smear result is returned – using a vinegar solution on the cervix and a magnifier to check the condition of cells. If a lesion is present the cells have a less “gooey” consistency and turn white. Healthy cells remain pink under the acetic acid solution.
The doctor didn’t stop there and decided to train health care workers in how to administer the test, so women across India didn’t even have to visit a doctor to have a test for cervical lesions performed.
Dr Shastri received funding from the National Cancer Institute to perform a clinical trial to check how effective the procedure could be. The results are nothing short of extraordinary, with cervical cancer reduced by 31% in the women screened every 2 years with the vinegar test. The results are to be presented at the annual meeting of the American Society for Clinical Oncology later today.
By conservative estimates, widespread use of the vinegar testing method could prevent more than 20’000 deaths from cervical cancer annually in India. If used in other developing countries that would be more than 70’000 lives saved every year.
Based on those results, the Indian government is rolling out the program to more parts of the country. Health workers are also using technology to further improve the results with digital cameras being used to train Health workers and to examine the results of the tests. The test itself is very low tech but with some simple and cheap technological tools it could be even more effective.
The developed world is even moving on to a more advanced method of testing for cervical cancer, with tests for the human papilloma virus DNA in women, the most common cause of the lesions that lead to the cervical cancer. Those viral DNA tests are very expensive however, and may be years off from widespread usage.