title: Alternative approaches to cervical cancer screening for developing countries.
abstract: Cervical cancer remains the most common cancer among women living in developing countries, largely because of the failure either to initiate or sustain effective cervical-cancer screening programmes. This potentially preventable and curable cancer continues to cause high mortality among relatively young women residing in low-resource countries. Cytology as a screening test, linked with a robust healthcare infrastructure, has significantly affected cervical cancer prevention in countries that have had sufficient resources to establish and sustain well-conducted programmes. The failure to establish such programmes has stimulated a large body of research into alternative screening tests and approaches to cervical-cancer prevention. Two of the most recent research methods have been visual inspection with acetic acid and molecular testing for high-risk types of human papillomavirus deoxyribonucleic acid. Visual inspection with acetic acid has shown a great deal of promise in cross-sectional studies; however, in randomised-controlled trials, it has been shown to be significantly less effective in reducing cervical cancer or its precursors. The development of point-of-care human papillomavirus or other highly sensitive tests for the prevention of cervical cancer is imperative. It has also been clearly shown that linking testing or screening to treatment (so-called 'screen and treat') without the intervention of colposcopy or the need for sophisticated laboratories may potentially prevent cervical cancer in large numbers of women.
authors.affiliation: Department of Pathology, College of Physicians and Surgeons of Columbia University, Room 16-404, P&S Building, 630 W. 168th Street, New York, NY 10032, USA. tcw1@columbia.edu
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Wright
authors.forename: Louise
authors.initials: L
authors.lastname: Kuhn
mesh_terms: D000085:Acetates; D000328:Adult; D003127:Colposcopy; D003906:Developing Countries; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control / Q000821:virology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000517:prevention & control / Q000821:virology
chemical_list: D000085:Acetates