Comments on: Part III: An Ounce of Prevention

By: Mohammed Lardi

Mohammed Lardi — Tue, 11 Dec 2012 11:35:00 +0000

we at UNFPA support early detection of cervical cancer in moroco using visual inspection , we can share our experience if some one is intersted
Dr Mohammed Lardi represetative Assistant health UNFPA

By: Joanne Silberner

Joanne Silberner — Fri, 07 Dec 2012 21:36:00 +0000

Thank you too for the helpful information. I’d love to keep up-to-date with the status of the new guidelines, and if you want to message me via facebook that would be great. One thing that fascinates me is the geographical disparity in cervical cancer deaths in this country. Looking at an incidence map in the US http://www.cdc.gov/cancer/cervical/statistics/state.htm it looks like there’s a belt across the south. I wonder what that is about.

By: grisberg2000

grisberg2000 — Thu, 06 Dec 2012 18:12:00 +0000

Thank you so much for your prompt reply, Joanne. I really appreciate it. I also understand that you were reporting on a test that can give health care professionals immediate visualization of precancerous lesions which can be treated on the spot. Certainly this will save many lives. You reported on a really effective screening and treatment tool in areas where getting women to show up for a Pap is difficult, or the expense of running the cytology is prohibitive. Again, your focus on developing countries was really clear and thanks for your work. I wonder if you would be interested, for a future piece, in the new guidelines which are increasing the time intervals between screening and the age of screening in developed countries (namely Pap smears in the U.S and U.K., probably elsewhere too). The 70% reduction in cervical cancer deaths in the US is the result of 50 years of early detection and screening. Sadly, the deaths continue and new guidelines which appear to significantly roll back the screening seems risky. AGOG disagrees and thinks there will be little additional risk, but I worry. Finally, and thank your for your patience, part of the reason that deaths from cervical cancers are “unheard of”, is so many women, even in this modern century, in this modern world that I live in, are afraid to speak up. Thank you for bringing the issue of cervical cancer, in general, into the public eye and for replying to my post.

By: joanne silberner

joanne silberner — Thu, 06 Dec 2012 16:36:00 +0000

As the author of “near zero,” I take your point — 4,000 is not, on its own, near zero. And my characterization seems insensitive. I was trying to make the point that screening saves many many lives. Cervical cancer rates have gone done dramatically since the introduction of the Pap smear – cervical cancer used to be the number one cause of cancer death among women, it’s now about 14th. In retrospect, I should have just left it at that — that rates have gone down dramatically. As for your second point, that one check is enough – one check will, at least theoretically, get precancerous changes that have occurred, but of course there is a false-negative rate and some growths will be missed. And new cancers could grow after the test. In the U.S., testing is customarily repeated over time. For financial reasons, developing countries are wrestling with the issue of when and how often to test.–Joanne Silberner

By: grisberg2000

grisberg2000 — Thu, 06 Dec 2012 00:00:00 +0000

I listened to the full report on the acetic acid test used for cervical cancer screening in India, but I could not get over the initial comment that deaths from cervical cancer were “near zero” in the US. Around 4,000 women die annually from cervical cancer in the US. Around 11 per day, one every few hours. Acetic acid is used in the US for screening as well, and last time I checked to tell someone that one treatment takes care of the problem for life is not accurate either.This report was full of the type of inaccurate information that is rampant about cervical cancer.