Highly effective cervical cancer screening for low income countries

March 3, 2017, Queen Mary, University of London
Highly effective cervical cancer screening for low income countries
A cytologic smear under the microscope. Credit: Queen Mary, University of London

Cervical cancer is the second most common cancer in women in developing countries, and globally some quarter of a million women die from the disease each year - most of them from low and middle income countries (LMICs).

To reduce the incidence of cervical cancer in developed , nationwide screening is offered to all . Taking a small cluster of cells ('') to diagnose disease before it progresses to cancer has been extremely effective. But in less developed countries, a lack of infrastructure and quality management have hampered widespread implementation of effective screening programmes.

In the first study to evaluate the use of cytology to diagnose cervical cancer in LMICs, the researchers looked at cytology results from 717 cervical cancers from 23 studies in countries including India, Bangladesh, China, Thailand, Kenya, South Africa, Uganda, Peru, El Salvador, Costa Rica, Nicaragua, Brazil, Argentina and Egypt. They argued that cytology in these countries might be used to diagnose cervical cancer earlier.

An excellent screening tool

The researchers found that even in these low-resource settings, cytology was very sensitive and consistent for detecting invasive cancer. Cytology was found to successfully find cancer with 95.9 per cent accuracy in high-risk women showing symptoms.

Corresponding author Dr Alejandra Castanon from QMUL's Wolfson Institute of Preventive Medicine said: "Cytology has long been established as an excellent screening tool to prevent cervical cancer by detecting precancerous lesions. However, little research has been carried out regarding its sensitivity to cancer.

"We've found that this is an excellent tool for targeted screening of populations at high risk of cervical cancer, leading to early diagnosis. In resource-poor settings with limited facilities to treat advanced cancers, this could have a big impact on cervical cancer mortality."

Reducing burden and cost

The researchers say that restricting cytology to symptomatic women and referring only those with severe lesions would lead to substantially fewer women requiring further investigation. This could mean a reduction in burden on resource and cost, and could result in the diagnosis of cervical cancers at an earlier stage to improve overall survival from the disease.

Co-author Professor Peter Sasieni from QMUL's Wolfson Institute of Preventive Medicine added: "The implications are that, even when a country lacks infrastructure to implement a quality-assured cervical programme nationally, it might be able to facilitate early diagnosis of by using cervical cytology, and only referring women with severely abnormal smears."

The study was funded by Cancer Research UK and published in the Journal of Global Oncology.

Explore further: Low incidence of cervical cancer, CIN3+ for HPV-negative women

More information: Alejandra Castanon et al. Systematic Review and Meta-Analysis of Individual Patient Data to Assess the Sensitivity of Cervical Cytology for Diagnosis of Cervical Cancer in Low- and Middle-Income Countries, Journal of Global Oncology (2017). DOI: 10.1200/JGO.2016.008011

Related Stories

Low incidence of cervical cancer, CIN3+ for HPV-negative women

October 7, 2016
(HealthDay)—Human papillomavirus (HPV)-negative women have low long-term incidence of cervical cancer and cervical intraepithelial neoplasia (CIN) grade 3 or worse (CIN3+), which supports an extension of the cervical screening ...

ACOG: New recommendations for cervical cancer screening

December 23, 2015
(HealthDay)—In a practice bulletin published in the January issue of Obstetrics & Gynecology, new recommendations are presented for cervical cancer screening and prevention.

Screening, HPV vaccine can prevent cervical cancer: FDA

February 8, 2017
(HealthDay)—Women can reduce their risk of cervical cancer through vaccination and screening, the U.S. Food and Drug Administration says.

More than two-thirds of cervical cancer deaths prevented by screening

September 19, 2016
Cervical screening prevents 70 per cent of cervical cancer deaths and if all eligible women regularly attended screening this would rise to 83 per cent, according to research led by Queen Mary University of London (QMUL).

HPV testing could cut cervical cancers by a third

June 14, 2013
(Medical Xpress)—Testing women for the human papillomavirus (HPV) first, instead of using the traditional cervical screening test to detect abnormal cells in the cervix, could prevent around 600 cases of cervical cancer ...

Recommended for you

Do prostate cancer cells have an Achilles' heel?

April 25, 2018
Researchers at the University of Illinois at Chicago describe new ways to selectively kill prostate cancer cells by exploiting the cells' revved-up metabolism. They report their findings in the online journal, eLife.

Research shows possible new target for immunotherapy for solid tumors

April 24, 2018
Research from the University of Cincinnati (UC) reveals a potential new target to help T cells (white blood cells) infiltrate certain solid tumors.

Changes in breast tissue increase cancer risk for older women

April 24, 2018
Researchers in Norway, Switzerland, and the United States have identified age-related differences in breast tissue that contribute to older women's increased risk of developing breast cancer. The findings, published April ...

Targeting molecules called miR-200s and ADAR2 could prevent tumor metastasis in patients with colorectal cancer

April 24, 2018
Colorectal cancer is the third most common cancer worldwide and the third-leading cause of cancer-related deaths. The main cause of death in patients with colorectal cancer is liver metastasis, with nearly 70% of patients ...

Experimental arthritis drug prevents stem cell transplant complication

April 24, 2018
An investigational drug in clinical trials for rheumatoid arthritis prevents a common, life-threatening side effect of stem cell transplants, new research from Washington University School of Medicine in St. Louis shows. ...

Scientists develop a new model for glioblastoma using gene-edited organoids

April 24, 2018
Glioblastoma multiforme (GBM) is an incredibly deadly brain cancer and presents a serious black box challenge. It's virtually impossible to observe how these tumors operate in their natural environment and animal models don't ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.