In designing effective solutions for combating cervical cancer, there are several parameters that must be considered.
The pap smear test, while highly effective in detecting the presence of HPV (the viral infection blamed for causing cervical cancer), still requires patients to return to the hospital after an irregular diagnosis. In the US, about 40% of women with an irregular diagnosis do not return for treatment. “We have a problem with follow-up,” says Elektra Paskett, a gynecological cancer expert from Ohio State University. [1]
In developing nations, the problems are compounded:
The cultural stigma associated with submitting themselves to such an exposing procedure to male doctors and staff put women off.
The cost to maintain the many specialists and laboratory to administer and analyze the pap smear makes the cost untenable for most women.
The belief that cancer, if detected, is anyway untreatable made women not even bother.
In India, where a third of the world’s cervical cancer cases exist, these parameters were considered and human-centric solutions designed for effect. Today, mortality rates in India have fallen from 28 in 100,000 to 11, saving over 22,000 lives per year. [2]
Cultural stigma: All female staff and doctors operated the clinics. Women were allowed to come with their husbands. Women were encouraged to come in a group of their friends for all to be tested simultaneously. In addition to cervical health, the clinic screened for high blood-pressure, diabetes, dental problems, and other medical concerns to make the appointment for time-valuable.
Cost: Scientists at Johns Hopkins University and other institutions developed a procedure that involves rubbing ascetic acid, i.e. vinegar, on the cervix. Any present HPV would react with the vinegar after a minute or two making it easily detectable. Since only vinegar and a cotton swab were needed, the clinics offered this procedure for free.
Follow-up and Belief: If detected, the HPV can be easily removed with a squirt of liquid nitrogen. No follow-up needed. Simple cancer prevention.
[1] Retrieved from: https://www.thestar.com.my/lifestyle/health/2013/06/03/simple-vinegar-test-cuts-cervical-cancer-deaths/
[3] Retrieved from: https://www.pbs.org/newshour/health/in-india-a-secret-weapon-against-cancer-vinegar
Image retrieved from: https://www.healthywomen.org/content/article/9-warning-signs-cervical-cancer-you-shouldnt-ignore