The developing world has the potential to control cervical cancer for the first time, say experts, thanks to new screening techniques and vaccination against the human papillomavirus (HPV).

At the World Cancer Congress in Geneva, Switzerland, last week (28 August) a group of international cervical cancer researchers launched a monograph documenting current research in the field, including regional and national reports to guide policymakers.

Around 80 per cent of the 250,000 annual cervical cancer deaths occur in developing countries. Without intervention, the researchers say, this figure could rise in coming years with growing and aging populations in many countries.

A lack of resources and infrastructure mean that few developing countries have conventional cytology screening programmes — where the cells of the cervix are assessed for changes caused by cancer.

But newer techniques may be more suited to developing countries.

"We're moving to a point where cytological screening can be replaced both in the developed and developing world with testing for the virus that causes the disease," said Jack Cuzick, professor of epidemiology at the Wolfson Institute of Preventive Medicine, United Kingdom.

Testing for HPV DNA in cervical cells would be required less often than conventional screening, reducing the burden and cost of screening on health systems. Some tests can be performed in two hours, allowing women to be screened and treated in the same day.

"This will be important in the developing world where the chances to screen will be much less common," said Cuzick.

Other simpler techniques such as painting the cervix with vinegar to find cancerous changes have also shown promise (see Vinegar 'simple and cheap' cervical cancer test).

And vaccines against HPV-16 and 18 — which cause most types of cervical cancer — have proved themselves in clinical trials, but at US$360 per person, are currently too expensive. Experts previously calculated that a course of vaccination would have to be less than US$25 to be cost effective in Latin American countries (see Cost the 'biggest hurdle' for cervical cancer vaccine).

Jon Andrus, lead technical advisor for the immunisation unit at the Pan American Health Organization, called for the time lag between the introduction of vaccines in industrialised and developing countries to be reduced.

"We all need to be working collectively to bring down the price barriers and make sure these vaccines get to the women who need them most in developing countries," he said at the press conference.

The monograph is published in the journal Vaccine.

Source: SciDev Net
Date: 01 September, 2008