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A do-it-yourself test could help identify women at risk for cervical cancer who don't have easy or regular access to Pap smear tests, scientists said.
The DIY test, which detects the human papillomavirus (HPV), was widely accepted in a trial involving 20,000 women in Mexico and was more effective than traditional smear tests at picking up early signs of disease.
British researchers who helped develop the test and led the trial said the results, published in the Lancet, suggest the DIY kit has the potential to help thousands of women who live in countries where smear testing is difficult or impossible.
Cervical cancer is more common and more deadly in those countries because it is often detected late.
Deaths rising
A study in September by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington found that both breast and cervical cancer cases and deaths are rising in many countries, especially in poorer nations where more women are dying at younger ages.
In wealthier developed countries, cervical screening programs have been in place for many years, and more recently, national immunisation programs using vaccines from drug makers Merck and GlaxoSmithKline have been launched to protect girls from HPV.
Attila Lorincz, a professor of molecular epidemiology at Queen Mary, University of London, who worked on the trial of the DIY test, said it could also help some women in wealthier nations who will not or cannot have smear tests in a clinic and are declined HPV vaccination.
"Unlike many forms of disease, we can actually prevent cervical cancer—but only if women have access to screening or if young girls are vaccinated against the virus," he said in a statement.
Burden on health care
In the trial in Mexico, around half of the 20,000 volunteers used the DIY test on vaginal samples collected at home, while the other half went to clinics for smear tests. Any woman with a positive test was referred for colposcopy.
The DIY test identified more than four times as many women with cervical cancer and more than three times as many women with cervical intraepithelial neoplasia.
Crucially, uptake for the at-home test was higher than for the smear test, Lorincz said, suggesting that women prefer this type of screening.
Our findings show that women are happy to take the test and that it is very sensitive at picking up women who are at risk of developing cancer, he said. This sensitivity is vital for a woman who may only get tested once or twice in her life.
The research team said the test still has limitations. For example, it tends to produce more false positives and this adds to the burden on health care services. They said further research was needed to address these problems.
(Reuters Health, November 2011)
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