The Pap smear, colposcopy, biopsy. These are proven lifesavers that screen women for cervical cancer, but only for the women who can access them. For hundreds of millions of women in low and middle income countries, these technologies and treatment innovations (such as CryoPen and thermal coagulation) are expensive, hard to deliver, and often out of reach.
That’s all changing.
In a new commentary in the prestigious New England Journal of Medicine, PATH’s Dr. José Jerónimo and Dr. Vivien Tsu lay out a plan that will not only expand these technologies to low-resource settings, but will do so at less cost. Here are some excerpts from their perspective:
One notable advance in screening methods is visual inspection with acetic acid (VIA), which allows trained health workers to spot cervical abnormalities with just a speculum exam. We now also have highly sensitive molecular tests that detect HPV infection or its consequences — the precursors to cervical cancer. Molecular testing technology continues to progress, and though some of these tests require sophisticated laboratory infrastructure, others are closer to the point-of-care or lower-infrastructure models that can be implemented in LMICs.
In recent years, we also have seen improvements in preventive treatment using technologies, such as CryoPen and thermal coagulation, that are not dependent on the hard-to-obtain compressed gases needed for conventional cryotherapy. Advances in the use of mobile phones for tracking health information and reaching patients, and the explosive growth of their availability in LMICs, represent another opportunity to improve cervical cancer prevention.
Developing and advancing new cervical cancer screening and treatment technologies won’t result in saving lives unless they get to the women who need them. Photo: PATH/Rose Slavkovsky.
It’s also important to build service delivery systems that can incorporate even better technologies as they become available. Argentina, El Salvador, Guatemala, Honduras, and Nicaragua have already taken steps in this direction, using self-collected specimens for HPV testing. Some countries are now testing community tracking mechanisms that can ensure that women who have screened positive return for treatment, as well as incorporating relevant indicators in national health information systems.
To read “Saving the World’s Women from Cervical Cancer” in its entirety, visit the New England Journal of Medicine.
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