The many limitations of pap smear screenings have posed obstacles to implementing organized screening programs in developing countries. Of the 250,000 each year caused by cervical cancer, 80 percent occur in developing countries. Latin America, Brazil and the Nordic countries are in need of effective screening programs to help reduce cervical cancer incidence and mortality rates.
Researchers proposed a new screening procedure that addresses the complex setting and sensitivity of cervical cancer and precursor lesion detection. A cohort study of over 12,000 Latin American women from Brazil and Argentina was designed to examine diagnostic tools that would address these limitations, as to develop effective means of providing an affordable and feasible setting for early detection. These women were evaluated by specialists in gynecology that performed pap test evaluations, HPV testing, visual inspection with acetic acid, cervicography, screening and referral colposcopies and cervical biopsies.
High risk human papilloma virus assays were the most sensitive in detecting cervical cancer and precursor lesions. Visual inspection with acetic acid and Iodine, as well as cervicography, resulted in poor sensitivity. The pap test and high risk human papilloma virus assays in conjunction increased sensitivity to 86 percent, making it the more realistic test. This data was used to test the implementation of similar screening programs in Argentina and Brazil where incidences and mortality rates of cervical cancer are much higher.