Cervical cancer is the world's second most common cancer in women. Close to half a million women will contract the disease worldwide. Almost two-thirds of them will die. Most of these cases occur in the developing world, where there's little screening for cervical cancer.
Cancer researcher John Sellors from McMaster University in Canada says scientists now know that the vast majority of cervical cancers are caused by exposure to a virus called human papilloma virus or HPV. He got involved in an effort to find a rapid screening test for HPV, something that would be simpler than a Pap smear – a test that has been available since the 1950s.
The Pap smear has served its purpose very well in lowering the death rates from cervical cancer in the developing world, in Europe and in North America, Sellors reports. But in less well-resourced countries worldwide, cervical cancer is a real problem and over the last 50 years, since Pap smears existed, it has really failed to be the answer for places where the resources are very low.
The Pap smear is complicated. It requires the expertise of a doctor or a nurse to take a sample of cells from deep in a woman's vagina. The sample then needs to go to a lab for analysis, so it also takes time. And it can be expensive to perform the analysis. Finally, Sellors says, there's a shortage of the correct equipment to actually take samples.
In a lot of countries, especially in African countries, there is an absence of vaginal specula... the metal object that a health care worker puts into the vagina in order to visualize the cervix, Sellors says. Therefore, it is really an attractive option to be able to sample the cervix just with a vaginal swab that the woman can insert into the vagina herself.
The samples taken with this new swab method are then tested. Within several hours, health care workers have the result, without the need for a lab or even electricity and running water.
This approach could also be of enormous use in countries where cultural norms restrict women from having vaginal exams.
Sellors and his colleagues tried this new swab test on 2,500 women and found it to be about 90 percent accurate. He says the next step is operational research – that's the process of getting people to actually use it, see how well it works in a public setting and report back their results.
"[We are] giving the new test to governments, to government areas... public health services in India, one in Uganda and one in Nicaragua and actually trying to test out in real life situations, actual public health clinics in low resource settings," he says.
The experiences of these public health services will give Sellors and his colleagues information about how well health care workers and women accept the test and what needs to be done to improve it.
His
research is published in the British journal, the Lancet Oncology.