New “Screen and Treat” method said more effective than traditional Pap smear in Latin America and the Caribbean

 WASHINGTON, D.C. (ASRN.ORG)- Experts from the Pan American Health Organization (PAHO) briefed members of the U.S. Congress today on a new method of cervical cancer prevention that has proven in studies to be simpler and more cost-effective than the traditional Pap smear in countries of Latin America and the Caribbean.

“This method is accurate, acceptable to women, faster in providing results and treatment, and less costly,” said Silvana Luciani, a PAHO expert on cervical cancer. Following a series of successful pilot projects, “PAHO proposes to roll it out in countries with the highest burden of the disease.”

The new method, called “Screen and Treat,” uses Visual Inspection with Acetic Acid (VIA) to detect abnormal cervical cells and then provides immediate treatment with cryotherapy of patients who have precancerous cells. Studies of the method were carried out by the Alliance for Cervical Cancer Prevention, of which PAHO is a member, with support from a grant from the Pan American Health and Education Foundation through the generosity of the Bill & Melinda Gates Foundation.

Improving cervical cancer is an urgent priority in Latin America and the Caribbean, where rates are four and a half times higher than in the United States and Canada. The disease kills some 33,000 women each year in Latin America and the Caribbean, compared with about 5,000 in the United States. Rates are also higher among Hispanic women (along with African-American women) than among non-Hispanic white women in the United States.

“This is a worrying picture because of the disproportionate burden of this disease among Latin American and Caribbean women living in the United States and throughout the hemisphere,” said PAHO Director Dr. Mirta Roses. “It is even more terrible because this disease is almost entirely preventable.”

“Cervical cancer is one of the big challenges facing our region largely due to lack of information, lack of systems to distribute information to poor and disadvantaged women in our hemisphere,” said Silvestre Reyes, Democratic congressman from Texas. “The work of getting people screened and eventually treated is extremely important. I am very much supportive of the Pan American Health Organization and the work it does.”

The new "Screen and Treat" method promises to help overcome a number of problems that have plagued cervical cancer prevention programs in Latin America and the Caribbean. Many women in the region lack access to screening, particularly those in rural areas with few health clinics nearby. Even women with good access often fail to get screened due to lack of awareness, fear, or embarrassment about the procedure. Many women who do get screened fail to return to the health facility to get the results of their tests. And finally, those with positive results often fail to seek treatment to remove their cancerous cells.

“The message is that early screening, early detection are key,” said Dr. Roses. “We need to bring women into health facilities by having gender-friendly services, by helping them to overcome obstacles in their families and communities, and by not having too many steps in the treatment process. As it is, we too often get women when it is too late, too costly, too painful.”

The Alliance for Cervical Cancer sponsored pilot tests of the new Screen and Treat method in Peru, El Salvador, and Suriname. The studies showed that use of the method significantly improved follow-up rates. In Peru, for example, only 10 percent of women screened with the new method failed to get follow-up, compared with 75 percent of women screened in a previous screening program based on the Pap smear.

PAHO is now aiming to launch the method regionally, with a focus on five high-burden countries—Bolivia, Haiti, Honduras, Guyana, and Nicaragua. Already, Bolivia, Colombia, Guatemala, and Peru are employing Screen and Treat on a small scale.

The new method will be a key element in a new PAHO Regional Strategy and Plan of Action on Cervical Cancer Prevention, which will be presented to the ministers of health of the Americas at their annual meeting in Washington in September.

PAHO Deputy Director Dr. Cristina Beato said the new regional strategy “will emphasize the importance of revitalizing screening programs, in light of the availability of HPV vaccines, and will encourage the use of simpler, evidence-based approaches for screening.”

Christine Baze, who founded the advocacy group Popsmear, related her personal story as a cervical cancer survivor. Despite having normal annual Pap smears since the age of 18, Baze was diagnosed at age 31 with advanced cervical cancer. Her treatment included a radical hysterectomy, radiation and chemotherapy, removal of one ovary, and later the removal of part of her lung. “Like all cancer survivors, I know that the battle continues. It’s never over,” she said.

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