Stanford researchers have used a quick, effective test for cervical cancer among low-income women in Thailand – the first successful use of the test, which could be broadly applied in the developing world.
Cervical cancer rates have declined by 80 percent in the United States and other developed countries as a result of the commonly used Pap smear. But in the developing world, these kinds of prevention programs have failed, and the disease is a major public health problem, says Stanford ob-gyn Paul Blumenthal, MD, MPH.
Blumenthal has pioneered techniques for simple screening and treatment programs to prevent this potentially fatal cancer. He collaborated recently with a colleague in rural Thailand, as well as University of California, Berkeley medical student Lee Trope, in a study that used a test, called careHPV, which detects cervical cancers caused by the human papilloma virus. The test is inexpensive – about $5 – and can give women results almost immediately. A positive test can be combined with the application of acetic acid – simple household vinegar – to confirm that cancer is present (if there are pre-cancerous lesions, these will show up as opaque raised white patches, easily visible to a clinician).
In the study, Blumenthal told me, “We show that real-time HPV testing is feasible in a rural setting in a developing country, and in combination with the vinegar test and treatment with cryotherapy (freezing the malignant tissue), an approach to single-visit cervical cancer prevention is a realistic possibility.”
The testing was done among 431 women in a province in northeastern Thailand. The women did a vaginal self-swab, which was analyzed in three hours. Those who were positive for cancer were offered treatment on site. This is important, Blumenthal said, because if there isn’t an immediate link between testing and treatment, women often become lost to follow-up.
“To be sure this is a small, feasibility study, but no one has even ever attempted to use this test at the community level, and we showed that in rural Thailand, it’s possible,” he said. “This has important implications for the future of cervical cancer prevention in these kinds of settings.”
The study appears in the July issue of the Journal of Lower Genital Tract Disease.