Tamil Nadu   

Low-cost method to detect cervical cancer on trial

CHENNAI: The Tamil Nadu Government has put on trial a low-cost, effective method to detect pre-cancerous stages in the cervical cancer among rural women.

The project will be implemented in Thanjavur and Theni.

The VIA method was touted by the Lancet as the model for cancer cervix detection in resource poor settings after the results of a study in Ambillikai, Dindigul district showed it to be of immense utility in detecting pre-cancerous stages in women.

The measure of success in these two districts will determine whether the programme can be extended to other districts, according to PWC Davidar, Project Director, Tamil Nadu Health Services Project, which is the implementing agency.

An experiment in the Chennai Corporation limit has proved the efficacy of the method in detecting cancer of the cervix, with eight per cent of the women testing positive and receiving treatment.

“It is very significant that the Tamil Nadu Government is examining VIA, especially considering that a study [in 2000] established that 67 out of every 1,00,000 women in rural Tamil Nadu had cervical cancer,” said R. Rajkumar, assistant professor of community medicine, PSG Institute of Medical Sciences and Research, Coimbatore.

Dr. Rajkumar, who initiated and worked on the Ambillikai project for nine years, said it was imperative to act fast as rural Tamil Nadu has the third highest incidence of cervical cancer in the world.

R. Sankaranayanan of the International Agency for Research on Cancer (IARC) and principal author in the Ambillikai study, said: “We estimate that 132,000 new cervical cancer cases occurred in India in 2002 and 1,88,000 women will develop it in 2030 if the current trends in occurrence continue, and there is no screening.” However if screening was introduced effectively, the Ambillikai study indicates, an estimated 60,000 cases could be prevented every year by 2030.

The cost factor, besides the apparent simplicity of the procedure, would be the key to establishing VIA as an important tool for cancer detection, Dr.Rajkumar said. The entire process — inclusive of a cryosurgery in case a woman tests positive — costs Rs.100. Without the surgery, the cost may be as low as Rs. 30, setting it at an advantage over the traditional Pap Smear test which costs Rs.200 and is not so efficient in detecting pre-cancerous stages.

However, experts cautioned that effective and appropriate implementation was essential right from the beginning.

The IARC has also recommended training nursing assistants in VIA, and doctors and nurses in treatment of cervical precancerous lesions.

Other suggestions that come from the Ambillikai success include concealing the sexual nature of transmission of the Human Papilloma Virus that causes cancer cervix in order to bring women to the clinics for testing.

“The moment you indicate it could be sexually contracted, you begin to stigmatise the woman. It simply won’t do in rural Tamil Nadu to stress on the sexual nature of the infection. We should rather stress on poor hygiene and nutritional status,” Dr. Rajkumar said.

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