Cervical cancer screening at home? US FDA approves kit. Why is this significant?
The Pap smear detects abnormal cells in the cervix (narrow end of the uterus connected to the vagina), which can indicate cervical cancer or precancerous changes. However, many women find this test uncomfortable or painful due to the insertion of a metal speculum and the scraping of cells.. The US device comes with a brush. So no need to put off pelvic examinations.
A US study showed that the at-home cervical cancer screening test is as accurate as a clinical test (96 per cent accuracy) and is preferred by 94 per cent of women.
According to Dr Smita Joshi, a senior scientist at Prayas Health Group, 'Worldwide two out of three women have never been screened in their lifetime and hence improving the screening coverage is important. Self-sampling can help reach the never screened or hard to reach population.' This gap is the reason why women in low-and middle- income countries have the highest cervical cancer burden.
In India, such home collection of samples is still rife with challenges. 'For instance, the logistics of shipping the samplers to the women, ensuring that they understand why this screening is important, correctly following the instructions and collecting the sample are still complex tasks for rural women,' Dr Joshi observed. However, this can also be done with the help of healthcare personnel in remote areas till the women become aware and capable of doing this by themselves, she feels.
Dr Joshi and her team have evaluated if the self-sample collected by the home-grown CERVICHECK kit yields the same test report as that of the clinician-collected cervical sample. The study was conducted in Pune and Baroda with 156 women participants and showed almost similar accuracy results as the clinician's test.
The kit contains an instruction manual, a biohazard bag for keeping the sample and the device itself. It comes as a tube encasing a cytobrush with a piston. Once the tube is inserted in the vagina, one has to rotate the knob clockwise. This pushes the brush deeper inside to collect tissue samples. Once done, the brush is dropped into the collection bag. The women participants rated the self-sampling kit and found its convenience, ease-of-use, comfort and painlessness at 90 per cent and above.
The World Health Organisation's (WHO) envisages cervical cancer screening of 70% of women at least twice in their lifetime, once at 35 and again at 45. 'Although HPV vaccination of adolescent girls will help in reducing cervical cancer incidence in low- and middle-income countries by more than 85 per cent over the next century, adult women, who do not benefit from preventive HPV vaccines, need immediate cervical cancer screening and appropriate management of pre-cancers,' Dr Joshi said.
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