By Marilyn Chase
April 1 (Bloomberg) -- One-stop screening for the virus that causes cervical cancer, followed by simplified same-day treatment, may cut the disease’s death rate by 47 percent, a study of nearly 132,000 women suggests.
The project compared women in rural India who received screening and immediate treatment for the human papilloma virus against those receiving education and referral. The results led researchers to estimate that if 80 percent of women aged 30 to 59 worldwide had same-day screening and treatment for HPV, the number of cervical cancer malignancies and deaths would drop by almost half within 10 years.
About 500,000 cases of cervical cancer and 270,000 deaths occur each year, the researchers said. The study, published online today in the New England Journal of Medicine, could save many women in poor countries hard-hit by cervical cancer, said Mark Schiffman and Sholom Wacholder of the National Cancer Institute in an editorial accompanying the report.
“The implications of the findings of this trial are immediate and global: international experts in cervical cancer prevention should now adopt HPV screening for widespread implementation,” Schiffman and Wacholder wrote.
In the study, 132,000 Indian women were divided into four groups. Three of the groups were offered same-day treatment with screening; one by traditional PAP smears, a second group by a swab with acetic vinegar, and the third by HPV test. The last group was simply educated about cervical cancer, its spread by a sexually transmitted HPV virus, and urged to seek screening.
Reduction in Deaths
Only HPV-screened group showed a reduction in deaths compared with the education-and-referral group.
The study was funded by the Bill and Melinda Gates Foundation and PATH, a Seattle, Washington-based nonprofit organization supporting technology for developing world use.
“This shows that you can reduce deaths from cervical cancer and that’s very significant,” said Tom Wright, a professor of pathology at Columbia University, in a telephone interview, Wright wasn’t involved in the study.
While a host of studies have shown screening can reduce cancer incidence, Wright said the most recent research is the first to prove reduction in mortality.
“For the first time, this opens up a real strategy for providing screening to women globally,” Wright said.
HPV Tests
Qiagen NV, the Dutch maker of viral assays for the cancer- causing HPV virus, will donate one million HPV tests worth $30 million to screen women in developing countries over the next five years, the company said in a statement today. The company contributed tests for the research.
The screening test, which costs $30, will be produced in a simplified version for rural use for about $5, said Qiagen Chief Executive Officer Peer Schatz in a telephone interview.
Qiagen in October, 2008, reported its new streamlined careHPV test, which doesn’t require electricity, clean running water or sophisticated lab support, could be deployed in rural China using a system without text.
“We asked a farmer’s daughter to perform the test after being trained for a few hours,” Schatz said. “She performed the test with a quality approaching that in Europe or the U.S.”
The study was led by Rengaswamy Sankaranarayanan, chief of screening at the International Agency for Research on Cancer, an agency of the World Health Organization based in Lyons, France. Sankaranarayanan said he would eventually like to see an HPV test priced “at $1 or less. Many countries won’t be able to afford it” otherwise, Sankaranarayanan said.
On-Site Treatment
Key to the study was offering women immediate treatment on- site to avoid losing patients to follow-up, Sankaranarayanan said in a telephone interview. The downside of this method is that a certain number of women will be mistakenly diagnosed as having a precancerous growth and unnecessarily treated, he said.
“The treatment is so safe, it may protect them from future cancer,” Sankaranarayanan said. Women who were found to have invasive cancer were referred for standard biopsy and surgery.
To contact the reporter on this story: Marilyn Chase in San Francisco at mchase6@bloomberg.net
Last Updated: April 1, 2009 18:20 EDT
No comments:
Post a Comment