(Graphic: Kim Ducharme. Originally posted at theworld.org/cancer
How Vinegar Could Save 73,000 Women A Year From Cancer
Almost two decades ago, a doctor named Surendra S. Shastri was put in charge of preventative oncology at Tata Memorial Hospital in Mumbai, India. One of his biggest jobs: to figure out how to cut the toll from cervical cancer, which kills 200,000 women a year in the developing world but is rare in developed countries.
In the United States, that death toll is just 4,000, the result of the most successful story of early detection preventing cancer death. Unlike most other cancers, cervical cancer starts as a pre-cancerous lesion that accumulates mutations. The Pap smear, a technique invented in the 1920s by George Papanicolau, a Greek pathologist at Cornell University, involves a doctor taking cells from the lining of the cervix and sending them to a lab to be analyzed under a microscope. Annual pap smears mean most cases of cervical cancer that would happen in the U.S. are caught before they become deadly tumors. In India, which has the world’s worst cervical cancer burden, the introduction of annual Pap smears for all women seems impossible.
“We don’t have the kind of laboratories or the kind of trained manpower needed for having a Pap smear. The Pap smear has succeeded in the countries where it has because of good quality control and frequency of screening,” Shastri says. He needed something far cheaper. The idea that he and others hit upon was to steal a step from from the procedure that follows a suspicious Pap smear. Doctors pour acetic acid – basically a sterile vinegar solution – onto the cervix and look at it under a magnifier. Cancer and precancer cells have less of the gooey cytoplasm than healthy cervix, and the acetic acid makes them actually turn white after just a minute. The normal cells remain a healthy pink.
Shastri skipped the magnifier and the doctor, and decided to train the same health care workers who give immunizations and other basic preventative measures to apply an acetic acid solution in the field. In 1998, he obtained funding from the National Cancer Institute, one of the U.S. National Institutes of Health, to conduct a fifteen-year clinical trial comparing using the vinegar screen once every two years to not screening in 150,000 women. The results are being presented today here at the annual meeting of the American Society for Clinical Oncology. The vinegar test reduced the rate of cervical cancer death from 16.2 women per 100,000 to 11.1 women per 100,000, a 31% reduction.