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New Findings Support Alternatives To Pap Test
The Alliance for Cervical Cancer
Prevention (ACCP), a partnership of five international public health
research organizations, announced key findings and recommendations
resulting from eight years of studies in more than 20 countries in Africa,
Asia, and Latin America. At the top of the list: early identification of
precancer using simple, visual inspections of women is as effective, and in
some cases more effective, than technically difficult and expensive Pap
testing.
Cervical cancer, caused by the human papillomavirus (HPV), affects
about 500,000 women each year and kills 270,000 annually. There is a huge
discrepancy between cervical cancer deaths in rich and poor nations -- 80
to 85 percent of deaths occur in the developing world. In developed
countries, screening programs using the Pap smear are in place to spot
disease and treat it early, saving countless lives. However, a successful
Pap testing program requires a high degree of organization, sophisticated
laboratory equipment, and highly trained technicians. Unfortunately, in
spite of efforts by many governments, large-scale Pap screening programs
have not worked in poorer regions. It was frustration with this lack of
success that mobilized ACCP efforts to find alternative approaches to Pap
testing. Funding was provided by the Bill & Melinda Gates Foundation.
During a panel presentation at the Goethe-Institut in Washington, DC,
Dr. Jacqueline Sherris of PATH, an ACCP founder, noted that "cervical
cancer represents a huge global inequity with a heavy burden on poor women.
It is an awful disease that shatters families by taking women at the peak
of their productive lives, when they are in their 40s and 50s. Often, and
especially in communities with large numbers of AIDS orphans, these
grandmothers and aunts play a crucial role in raising children and
maintaining social cohesion."
Dr. R. Sankaranarayanan, of the International Agency for Research on
Cancer, has studied alternatives to Pap smear screening in India and other
countries. He explained that cervical cancer is easy to treat if
precancerous signs are detected early. Treatment in low-resource settings
often can be done using a device that destroys the affected tissue by
freezing, the same way that common warts are frozen.
For the visual screening methods tested by the ACCP, a trained health
worker swabs the patient's cervix with vinegar (a painless procedure).
After one minute, any small lesions on the cervix -- signs of potential
future cancer -- can be seen with the naked eye. "In most cases it is
possible to treat the women for precancer during the same visit to the
clinic," says Dr. Harshad Sanghvi of JHPIEGO, another ACCP partner. "This
is important because if a woman is sent home the day of the exam, and asked
to come back days or weeks later to hear the results and be treated, she
may not be able to return. In the past many women have missed the care they
needed for this reason. Treatment in the late stages of cervical cancer --
when women suffer symptoms -- is difficult and often not successful. We
need to screen all women, beginning at age 30, and provide rapid treatment
to those who need it."
"New technologies for cervical cancer prevention are revolutionizing
public health," according to Silvana Luciani of the Pan American Health
Organization. "Visual screening methods, high-tech DNA tests for HPV, and
the new HPV vaccines represent incredible opportunities to strengthen
prevention. We need to protect girls from HPV infection with vaccine, but
immunization is not a substitute for screening. Screening programs are
needed to care for women who may have already been infected with HPV,
because the vaccine does not protect them effectively and there are
cancer-causing types of HPV not targeted by the vaccine. Research indicates
that a combination of vaccination and screening can dramatically reduce
cervical cancer deaths in the coming decades."
In her closing remarks, Dr. Sherris challenged US and European donors
and policymakers to take a leadership role in improving cervical cancer
screening, and HPV vaccination, worldwide. "Every woman has the right to
screening at least once in her lifetime, and girls have the right to HPV
vaccination. This is our goal, and it is achievable."
The ACCP partners are EngenderHealth, JHPIEGO, the International Agency
for Research on Cancer, the Pan American Health Organization, and PATH.
Alliance for Cervical Cancer Prevention
In 1999, five international health organizations (EngenderHealth,
JHPIEGO, the International Agency for Research on Cancer, the Pan American
Health Organization, and PATH) came together to create the Alliance for
Cervical Cancer Prevention (ACCP). They were determined to find effective
methods that health care workers in the developing world could use to
identify cervical cancer early on, when it can be successfully treated in
relatively simple and inexpensive ways. Over the past eight years, and with
generous support from the Bill & Melinda Gates Foundation, the ACCP
partners have been assessing a variety of approaches to cervical cancer
screening and treatment, improving service delivery systems, ensuring that
community perspectives and needs are incorporated into program design, and
raising awareness about cervical cancer and effective prevention
strategies.
PATH/ACCP
http://www.alliance-cxca.org
Noi descoperiri de sprijin alternative la pap test - New Findings Support Alternatives To Pap Test - articole medicale engleza - startsanatate