Cheap and Noninvasive: Detecting HPV in Sanitary Pads
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The incidence of cervical cancer in India is approximately 19 per 100,000 women. For the past 15 years incidence in the United States has stalled at approximately 7 per 100,000. In India, there are no organized screening programs and most cervical cancer is regional or distant metastatic at diagnosis. In the United States, 52% of new cases are advanced, and half of these are among women who have never or rarely been screened. There is a critical need for new strategies to reach this population. Almost all cervical cancers are triggered by HPV, most commonly high-risk HPV16 and HPV18, although there are more than 200 types. HPV testing is taking over from cytology (Papanicolaou test) for secondary prevention of cervical cancer. The trial of screening for HPV in menstrual pads that is ongoing in India was the brainchild of Atul Budhuk, PhD, a government public-health researcher and professor at the Centre for Cancer Epidemiology, Tata Memorial Centre, in Mumbai.
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@insiya A team of researchers from India and France compared outcomes for women over 8 years after cervical screening by HPV, cytology, or visual inspection with acetic acid (VIA). The control group was "usual care," where women were advised how to seek screening at local hospitals. Women who screened positive were referred for colposcopy, biopsy, and treatment. Over the 8-year follow-up, advanced cervical cancer was found in twice as many women left to their own devices compared with women who had HPV testing during the study (82 vs 39; hazard ratio [HR] for HPV, 0.47, 95% CI, 0.32 - 0.69). Similarly, cervical cancer deaths in the control group were nearly two times higher than among the women who were screened for HPV in the study (64 vs 34; HR for HPV 0.52, 95% CI, 0.33 - 0.83). The study proved that rural Indian women were dying unnecessarily because they weren't seeking cervical screening. And education wasn't the problem.