Using vinegar to test for cervical cancer

Vinegar is known for its versatility in the kitchen. However, it is also gaining a reputation for a much more powerful benefit after results of studies conducted in India showed it is effective in detecting precancerous lesions in the cervix, which can potentially help in early diagnosis of cervical cancer. The inexpensive procedure is said to yield results similar to those of a Pap smear screening, which has been the common form of testing for cervical cancer.

Monday January 6 2014

Women line-up for free cervical cancer

Women line-up for free cervical cancer screening during an open health camp. File photo 

By Carol Nambowa

Of all home remedies available, who could have guessed vinegar could save a life, and in this case a woman’s life? Not save her life by sprinkling a bit of it on her salad before she eats it, but by providing a cheaper test for cervical cancer than was previously available.

Although using vinegar to test for cervical cancer has been around for many years now, according to DrJuliet Birungi, an obstetrician/gynaecologist at Mulago National Referral Hospital, only a handful of women in Uganda know about it, or have been tested using the procedure.

Dr Martin Origa, a gynaecologist with the Uganda Cancer Institute (UCI), at Mulago hospital insists the test is referred to as acetic acid and not vinegar test. It is commonly known as Visual Inspection with Acetic acid (VIA).

How it works
From a bottle of vinegar in the supermarket, acetic acid makes up the highest percentage of the ingredient. Both doctors Birungi and Origa caution that vinegar in supermarkets is not advisable because its purity is questionable. “In hospital settings, we use acetic acid, however vinegar is used as a substitute,” explains Dr Birungi.

Before it is used to test for cervical cancer, acetic acid is diluted with distilled water to three to five per cent. Then the woman lies in a lithotomy position (on the back with her knees bent and thighs apart).

Using a speculum to open the vaginal walls, the medical personnel apply some of the diluted acetic acid to cotton wool, which is then applied to the cervix for one minute. The medical personnel then observe the cervix for changes in the cells.
“The medical personnel should be able to differentiate between normal and abnormal changes in the cervix,” says Dr Origa.

The normal cervix colour is pink, so the doctor or nurse will know when the cells in the cervix turn white to signal a positive test or remain pink for a negative result.

Dr Origa however explains not all abnormal changes mean that one has cancer because the changes can be as a result of other factors.
“These changes simply mean we should go ahead to conduct further tests,” he says.

If the VIA test is positive, colposcopy is performed.
“A colposcopy involves using a powerful lens to observe abnormal changes in the cervix. This procedure can be carried out by a gynaecologist,” states Dr Origa.

Once a colposcopy is done and the test is positive, a cervical biopsy is taken and tested to confirm whether the patient has cervical cancer or not.

Benefits over pap smear
Using acetic acid to test for cervical cancer comes with benefits of being relatively cheap. An acetic acid test is free of charge in government hospitals and in some private facilities.

“In some private health facilities however, a patient might be charged up to Shs20,000 for the test to cater for gloves, cotton and sterilising instruments,” states Dr Origa. On the other hand according to Dr Birungi, the pap smear tests ranges from Shs40,000 to Shs100,000, depending on the hospital where it is done.

Another advantage of VIA is that it can be done by a medical practitioner at the rank lower than that of a doctor.

“The VIA test can be carried out by a nurse or a midwife in a low resource centre,” states Dr Birungi. Since this test is easily accessible to the average Ugandan, more women can be tested for cervical cancer compared to previous tests that largely relied on pap smear. There are no instruments required for a VIA, unlike the pap smear test which requires a microscope.

Yet still, with the VIA test, one can get immediate results compared the
pap smear tests whose results are received after a week or two.
“Results from a pap smear take longer because they require the interpretation of a cytologist yet we do not have many of these in Uganda,” Dr Origa explains.

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