Low-Income Women Might Benefit From Faster Tests for Cervical Cancer
Low-income women in the U.S. and developing countries who have limited access to health care and are at high risk of developing cervical cancer might benefit more from two simplified and quicker types of screening and treatment instead of traditional testing and treatment, according to two studies published on Wednesday in the Journal of the American Medical Association, the New York Times reports (Grady, New York Times, 11/2).
In the first study, researchers from the University of Cape Town in South Africa, Columbia University and other organizations administered Digene's Hybrid Capture 2 human papillomavirus test to women at three clinics in South Africa.
Women who tested positive for HPV -- the sexually transmitted disease that causes most cases of cervical cancer -- were treated during a second doctor's visit a few days later. Six months later, less than 1% of the women who were administered the test were found to have cells damaged by HPV, compared with 3.6% of the women in a control group who were not tested and treated.
Some women with false-positive test results might be treated unnecessarily under this system, but some experts believe the trade-off might save lives in countries where women lack access to care, Bloomberg/Detroit Free Press reports (Fay Cortez, Bloomberg/Detroit Free Press, 11/2).
In the second study, Wendy Brewster of the University of California-Irvine, and colleagues administered Pap smears to 3,521 low-income women in Orange County, Calif. One group of women stayed at the clinic to receive their results, and if their test showed high-grade precancerous cervical lesions, the women underwent a procedure that day to remove a layer of their cervix.
Women in the other group who had abnormal test results were referred for follow-up care at a later time (Johnson, AP/Seattle Post-Intelligencer, 11/1).
The 1,716 women screened and treated during the same visit needed about three hours for their appointments, compared with 75 minutes for the 1,805 women who received standard care. After six months, 88% of the 16 women who had abnormal results and participated in the same-day program had completed treatment, compared with 53% of the women who received standard care.
The one-day testing and treatment could prevent a majority of cervical cancer cases if it were applied to women with Pap test results that show high-grade precancerous lesions, according to the researchers (Bloomberg/Detroit Free Press, 11/2). They added that a lack of testing and follow-up might explain why low-income and minority women, especially Latinos, have higher cervical cancer rates than other populations (New York Times, 11/2).
The first study is available online.
The second study also is available online.
GlaxoSmithKline's experimental HPV vaccine Cervarix, for which the company plans to submit an application for approval in Europe and elsewhere in 2006, induced a more powerful immune response when combined with a new adjuvant, AS04, compared with the same vaccine combined with an aluminum-based compound, according to study released by the company on Wednesday, Reuters reports. GSK said that the stronger response was sustained throughout three-and-a-half years after vaccination in the women that participated in the Phase IIa clinical trial.
The study is to be presented this week at the American Association for Cancer Research International Conference on Frontiers in Cancer Prevention Research in Baltimore.
Cervarix project leader Philippe Monteyne said, "This gives us major hope for the future in terms of the potential duration of the effect of the vaccine, which will be key for this product" (Hirschler, Reuters, 11/1).