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Cervical Cancer Screening with Vinegar in Less Developed Countries

Posted Jun 20 2013 12:00am

In an earlier note about two years ago, I discussed how vinegar applied to the uterine cervix could be used as a simple test in developing countries to detect dysplasia (see:  Replacing the Pathologist and Gynecologist with Vinegar and CO2 ). Here's a quote from that note:

Nurses using the new procedure, developed by experts at the Johns Hopkins medical school in the 1990s and endorsed last year by the World Health Organization, brush vinegar on a woman’s cervix. It makes precancerous spots turn white. They can then be immediately frozen off with a metal probe cooled by a tank of carbon dioxide, available from any Coca-Cola bottling plant. 

I have just come across another reference indicating that this technique can reduce mortality from the disease (see: Cervical Cancer Screening With Vinegar Reduces Mortality ). Below is an excerpt from it:

A simple screening technique using an inexpensive agent dramatically reduced deaths related to cervical cancer in a population of Indian women. Visual inspection with acetic acid or vinegar (VIA), conducted by nonmedical personnel trained to deliver basic healthcare, cut the death rate by 31% [according to a recent study]. This strategy is effective and can be implemented on a broad scale in low-income countries...."There is no cervical cancer screening program in India because it is not feasible," explained [an Indian physician working with the technique]. "There is inadequate infrastructure, a lack of trained human resources, logistic difficulties, and a relatively high cost." Therefore, the researchers looked at VIA, which is a simple visual test that can be done without laboratory support....[Another physician in the study] pointed out that there are several take-home messages from this study; namely, that the VIA method has been validated, has been accepted, is inexpensive, can be use in low-resource areas, and can save lives.....Compliance was high, with 89% participation in screening and 79% compliance with postscreening diagnostic confirmation. The researchers note that the quality of screening performed by the primary health workers was comparable to that of an experienced gynecologist....On the basis of these results, the Indian health officials in Maharashtra state, where the trial was conducted, are preparing to train primary health care workers to provide VIA screening to all women 35 to 64 years of age at 24-month intervals. In addition, the Indian government is working to implement nationwide VIA screening, and is planning to reach out to other low- to moderate-income countries to share these results and offer assistance with training.

An interesting follow-up study for a developed country would be to correlate the exact histologic changes that cause the cervical mucosa to turn white. Here's some more information about the science behind the test (see: Using Vinegar to Thwart Cervical Cancer in the Developing World ):

Dr. Bandit Chumworathayi, a gynecologist at Khon Kaen University who helped run the first Thai study of VIA/cryo, explains that vinegar highlights the tumors because they have more DNA, and thus more protein and less water, than other tissue. It reveals pre-tumors with more accuracy than a typical Pap smear. But it also has more false positives — spots that turn pale but are not malignant. As a result, some women get unnecessary cryotherapy. But freezing is about 90 percent effective, and the main side effect is a burning sensation that fades in a day or two.

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