Wiping the Cervix Plus Visual Inspection Detects 75 Percent of Tissue Abnormalities

An inexpensive, easy test that changes the color of precancerous tissue could be used to screen women for cervical cancer and its precursors in geographic areas where Pap smears may not be available, according to a study of African women by researchers at Johns Hopkins and the University of Zimbabwe.

Results of the study, published in the March 13 issue of the British journal The Lancet, showed that nurse-midwives who wiped a patient's cervix with acetic acid (vinegar) and then visually inspected the area accurately detected more than 75 percent of potential cancers among the study participants. Tissue harboring precancerous lesions turns white when exposed to vinegar. The test identified almost twice as many cases of disease as did Pap smears.

A simple screening test such as this is urgently needed, the authors say, because only 5 percent of women in developing countries are routinely screened for cervical cancer compared to up to 70 percent in industrialized nations. Cervical cancer -- a sexually transmitted disease caused by the human papilloma virus -- is the leading cause of female cancer deaths in parts of Africa, Asia and Latin America, killing 200,000 women each year.

"In most developing world countries, cervical cancer screening programs are small-scale or nonexistent," says Paul D. Blumenthal, M.D., M.P.H., an author of the paper and an associate professor of gynecology and obstetrics at Hopkins. "Even in countries where Pap smear-based screening is available, it is often done only in urban settings or in the private sector, which serves a relatively small proportion of the female population.

"This technique easily could be used by health care workers in areas with limited resources. The test is safe, affordable and effective, and can help health care workers make an on-the-spot decision a
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Contact: Karen Infeld
kinfeld@jhmi.edu
410-955-1534
Johns Hopkins Medical Institutions
12-Mar-1999