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Cervical cancer is a devastating disease that afflicts nearly 500,000 women each year and kills close to 270,000. Globally, it is the second most common cancer among women. It is also a disease of striking inequality: about 80 per cent of all deaths occur in developing counties (1). Yet cervical cancer is almost entirely preventable. Few diseases reflect global healthcare disparities as clearly as this one.
Over the past fifty years, the introduction of cervical cancer screening programmes has significantly reduced advanced-stage disease and deaths in many developed countries. But as tests used in these countries require skilled technicians, sophisticated laboratory infrastructures, and a relatively long time to produce results, they are impractical for use in low-resource settings where cervical cancer rates continue to soar. As a result, women in these regions rarely receive early diagnosis and seek care only when they develop the advanced, untreatable disease. The World Health Organization estimates that only five per cent of women in developing countries have been screened for cervical disease in the past five years, compared to between 40 and 50 per cent of women in developed countries (2). Consequently, there is a dire need for cervical cancer prevention programmes and corresponding technologies that are appropriate for use in developing countries.
To reduce the disease burden in the developing world, the cervical cancer screening technologies available and widely deployed in developed nations today are now being adapted for low-resource settings. Human papillomavirus (HPV) DNA testing utilises advanced molecular technology to accurately identify high-risk strains of HPV, the primary cause of cervical cancer. Based on the success of HPV DNA testing in developed countries, and evidence from hundreds of randomised controlled trials around the world, there is an opportunity to use the investment in this current technology and create a modified version that both detects high-risk HPV and is appropriate for the training and infrastructure constraints of low-resource settings. As a result, this adapted HPV DNA test can help address the cervical cancer burden in areas with the greatest epidemiological need. |
