According to the World Health Organisation, around a quarter of a million people die from cervical cancer each year, and there are some 500,000 cases in existence worldwide. Due to a lack of resources, infrastructure and trained staff, in India, as in many poor countries around the world, no cervical cancer screening program exists despite this being the biggest cancer killer among the country's population of women. Shockingly, the incidence and deaths caused by cervical cancer in India alone comprises 30% of the global burden of the disease.
The study, funded by the National Cancer Institute, borrowed a tried-and-tested method called visual inspection with acetic acid to determine whether a simple visual test, which does not require the costly infrastructure of a laboratory, could be an effective screening tool. In the past, this method has been used in both rich and poor countries as part of colposcopy procedures, and involves swabbing the cervix with a 4% vinegar solution. However, the test has never before been used as a screening tool.
Over the course of the study, some 75,000 women were offered education and screened every two years, whilst around 76,000 women in the control group were educated about cervical cancer symptoms and not screened, which represents the current standard of care in India. Striking results followed; nearly 905 of the women participated in the trial, and a 31% reduction in deaths from cancer was achieved through the use of the vinegar test. The scientists that conducted the survey suggest that over 22,000 deaths from cervical cancer each year could be prevented if the program were to be implemented across India. They envisage, furthermore, an overall reduction of the number of deaths from cervical cancer by around 72,000 if this program were to be implemented in other developing countries in a similar manner.
This new test has many benefits; firstly, its results are immediate and can be observed within minutes of administering the test. This is a distinct advantage over traditional methods, which require a long wait for cells to grow in a laboratory, and is especially important as many women in rural areas of India have to make long and difficult journeys to obtain medical treatment. Since doctors and nurses are in short supply in many areas of the country, moreover, local Indian women were trained for four weeks on how to administer this simple test.
Within just a minute, the person administering the test can see, with the aid of the naked eye and a light, if there are abnormal cells - which the acid in the vinegar causes to turn white, due to the coagulation of the protein in the cells' nuclei - on the surface of the cervix. If abnormal cells are found, a small tissue sample is taken and biopsied. Following this, if cancer is diagnosed, Indian women can obtain the cancer care they need for free through India's healthcare system.Dr. Bruce Roth, a cancer expert from Washington University in St. Louis and an ASCO spokesman, has commented on just quite how important these findings could be in the development of cancer treatment, as the study seems to have found a remarkably cheap, fast and low-tech solution to a massive problem. "You can buy a lot of vinegar for $100,000, " says Roth.