Cervical cancer, a major killer in India
In low-resource settings, testing for human papillomavirus (HPV) might be the most effective method of cervical cancer screening.
In low-resource settings, testing for human papillomavirus (HPV) might be the most effective method of cervical cancer screening. Compared with cytologic testing and visual inspection of the cervix with acetic acid (VIA), a single round of HPV testing significantly reduced the incidence of advanced cervical cancer and related mortality among women in rural India.
About 1.3 lakh new cases of cervical cancer (a quarter of the 5 lakh cases globally) are reported every year in India. Cervical cancer is a malignant cancer of the cervix (the neck of the uterus). It may present with vaginal bleeding but symptoms may be absent until the cancer is in its advanced stages. Lack of awareness, multiple sexual partners and unhygienic living conditions are mainly attributed for the rise of cervical cancer, which causes the largest number of deaths among women worldwide.
Researchers surveyed the incidence of cervical cancer and the associated rates of death in the Osmanabad district in India.
In this cluster-randomized trial, 52 clusters of villages, with a total of 131,746 healthy women between the ages of 30 and 59 years, were randomly assigned to four groups of 13 clusters each. In all, 34,126 women underwent screening by HPV testing, 32,058 underwent cytologic testing or VIA (Visual Inspection of the cervix with Acetic acid - 34,074 women) against 31,488 women in the control group who received standard care.
Women who had positive results on screening underwent colposcopy and biopsies, and those with cervical precancerous lesions or cancer received appropriate treatment.
There were 34 deaths from cancer in the HPV-testing group, as compared with 64 in the control group. No significant reductions in the numbers of advanced cancers or deaths were observed in the cytologic-testing group or in the VIA group, as compared with the control group.
This indicates that a single round of HPV testing was associated with a significant reduction in the numbers of advanced cervical cancers and deaths from cervical cancer.
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