Screen test

researchers from the Tata Memorial Centre (tmc), Mumbai and the International Agency for Research on Cancer, Lyon (France) have found a cheap substitute for a popular but expensive method to detect cervical cancer. They say a combination of two tests -- visual inspection with acetic acid (via) and visual inspection with Lugol's iodine (vili) -- costs a fraction of the commonly used human papilloma virus (hpv) test but works as well. The hpv test costs at least Rs 350 (subsidised rate at tmc) while via and vili together cost Rs 35 per person screened.

The cost is important because of the 470,000 cervical cancer cases reported worldwide every year, as many as 80 per cent occur in the developing world, where people cannot afford expensive medication. In India, of the 126,000 new cases reported yearly, about 71,000 women die. A cheap diagnostic method would enable screeing of entire populations and increase the chances of survival through early detection.

The scientists compared five methods of screening for cervical cancer. Besides hpv, via and vili, the two other methods studied were cytology and the visual inspection with acetic acid using low-level magnification, or viam. All the five tests were conducted on 4,039 women 35-60 years of age chosen from two slums in Mumbai. The researchers found that using a combination of via and vili proved to be highly sensitive and could be used for screening the population. The positive cases could then be verified using the standard pap smears. "As this removed the need to test the whole population using the more expensive method, the cost of screening comes down," says Surendra S Shastri of tmc.

On the basis of these results, tmc is currently carrying out a population-based cancer screening in two districts -- Ratnagiri and Sindhu Durg -- of Maharashtra.