A vinegar test decreased cervical cancer death rates in India by one-third, according to a study of 150,000 Indian women that was presented on Sunday at a Chicago cancer conference.
Cervical cancer kills 200,000 women a year in developing countries. In Indian slums, cervical cancer is the leading cause of death among women. In the U.S., 4,000 women die of the illness annually.
Pap smears are used to discover pre-cancerous lesions in the cervix – which can mutate and lead to cancer. The test is a preventative measure that allows many Americans to catch developments before they become malignant. But the testing is expensive. Samples of cervical lining must be sent to laboratories.
“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,” said Dr. Surendra S. Shastri, director of preventative oncology at Tata Memorial Hospital in Mumbai.
Shastri and others turned to a test that typically follows an unusual pap. A doctor swabs the cervix with acetic acid – basically a sterile vinegar solution – and examines it under a magnifier. While the normal cells stay pink, cancer and precancer cells will turn white after a minute.
The cheap exam cut cervical cancer deaths in India by 31 percent. Researchers estimate that the test could prevent 72,600 worldwide deaths per yer.
"That's amazing. That's remarkable. It's a very exciting result," said Dr. Ted Trimble of the National Cancer Institute, the main sponsor of the study.
A study participant, Usha Devi, said the exam saved her life.
"Many women refused to get screened. Some of them died of cancer later," Devi said. "Now I feel everyone should get tested. I got my life back because of these tests."
Devi had four children, but never had a gynecological exam. She had been bleeding for several years.
"Everyone said it would go away, and every time I thought about going to the doctor there was either no money or something else would come up," she said.
Through the study she learned she had advanced cervical cancer. The study paid for her to have her uterus and cervix removed.
Officials in India are already planning to expand the vinegar testing to more areas. It could save 22,000 lives in India each year. The country is home to one-third of world’s cervical cancer cases, more than 140,000 cases annually.
More than 90 percent of cervical cancers are caused by human papillomavirus (HPV) infections. There are over 200 strains of HPV. Unfortunately, there are only two HPV vaccines, Gardasil and Cervarix. Both vaccines protect women from the leading cancer-causing strains, HPV-16 and HPV-18, which are responsible for 70 percent of cervical cancers, 80 percent of anal cancer, 60 percent of vaginal cancer and 40 percent of vulvar cancers.
Because HPV can be contracted from skin to skin contact, condoms cannot completely prevent the contraction of the virus. Two companies said they would drastically lower the cost of the HPV vaccine in poor countries in an expansive effort to decrease the transmission of the virus.