At the Annual Meeting of the American Society of Clinical Oncologists, scientists presented study results indicating that a cheap test using vinegar could effectively screen for early signs of cervical cancer.

The study was conducted in Indian slums, where women are unable to access Pap smears.  The researchers recruited 150,000 study participants.  Approximately half of the women were given the test with vinegar every two years.  The other half of the participants, the control group, were given cancer education and a voucher for a free Pap test at the local hospital.  In either group, if cancer was found, the study paid for treatment.

By swabbing the cervix with diluted vinegar, it was possible to visually check for signs of cancer. Abnormal cells may briefly change color after contact with the vinegar solution. With only two weeks of training, others can be trained to perform this test.

Researchers found that this low-cost alternative to a Pap smear could cut the cervical cancer death rate by 31 percent. While the Pap smear is able to cut the death rate by 80 percent in developed nations where it is widely available, women in India, especially poor women, are not able to access this test.

According to the Journal of Obstetrics and Gynecology, cervical cancer is the second most common cancer by incidence and mortality in the world.  India accounts for an estimated 20 to 30 percent of the global burden of cervical cancer.  There are more than 140,000 cases of cervical cancer in India every year.

India presents a unique environment of challenges for screening and treatment of cervical cancer.  The male-dominated society expects women to get permission from men for routine health decisions.  Moreover, modesty leaves some women unwilling to disrobe even for a medical exam.  Communities may even turn on health workers.  In this study, a health worker was beaten by a group from the neighborhood after it became public knowledge that women were being asked to take their clothes off.

Poverty also reduces access to treatment.  While developed nations offer safety net programs that treat individuals with cancer, India does not have such programs. Beyond the study, if the low-cost vinegar test is used, there may be no recourse for women found to have cervical cancer. Without medical treatment, their fate is likely the same as it would be without knowing that they have cancer.