Cervical cancer an “epidemic” in poor countries

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Health agencies on Thursday called for tackling cervical cancer which has taken on epidemic proportions in developing countries from Brazil to India due to a lack of screening.

An alliance launched a manual to help authorities develop good, low-cost detection and treatment programs for the second most common cancer among women worldwide after breast cancer.

About 80 percent of the 500,000 new cases of cervical cancer each year occur in poor countries, mainly in Latin America, Sub-Saharan Africa and the Indian sub-continent. The global caseload is projected to jump to 750,000 by 2020, it warned.

“You could say it is a developing epidemic of cervix cancer,” Peter Boyle, director of the International Agency for Research on Cancer (IARC), one of five agencies forming the Alliance for Cervical Cancer Prevention, told a news briefing.

Cervical cancer, caused by a sexually transmitted virus, is both preventable and treatable as it takes many years to develop from detectable precursor cancerous lesions.

About 230,000 victims die every year, according to the manual, based on a five-year study financed by a $50 million grant from the Bill & Melinda Gates Foundation.

In rich countries, women routinely undergo examinations and pap smears in which a smear of cervical cells is taken and evaluated at a laboratory to detect any abnormality.

Such screening lowers risk by 50-90 percent, but is costly and requires a reliable laboratory for analysis, according to Sankarana Rayanan of the IARC, which is based in Lyons, France.

“Such a luxury is not possible in low-resource settings, where we would emphasize that women between 30 and 49 years be screened at least once or twice in their lifetime,” he said.

The simplest method is visual inspection, after acetic acid, basically vinegar, is applied to the cervix, turning precancerous lesions white, or iodine, which turns them yellow.

NEW OPTIONS FOR RICH WOMEN

In wealthy countries, women have access to a new technology, the HPV DNA test to detect whether types of cancerous human papillomavirus (HPV) are present.

“It is an effective test that can find women at high risk ... It is certainly something that holds out a lot of hope,” said Boyle of the IARC, which has recommended it as a screening test.

But the test, by the U.S.-based company Digene, costs $20 to $40 - out of the reach of poor countries, which also lack technicians and laboratories, according to Sankarana.

The world’s first preventive vaccines against cervical cancer are also in sight, with GlaxoSmithKline and Merck and Co. Inc conducting phase three clinical trials.

“Both have been shown to be safe and effective,” Boyle said.

On Tuesday, Merck said it plans to seek approval next year for its Gardasil vaccine, while GlaxoSmithKline said it believes it has a winner in its experimental cervical cancer vaccine Cervarix, due to be filed for regulatory approval in 2006.

GSK chief executive officer Jean-Pierre Garnier estimated that there are more than 400 milllion women in Europe and the United States who could be vaccinated, potentially making the new treatments the biggest-selling vaccines ever.

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