Advances in Biological Research 5 (4): 226-232, 2011
ISSN 1992-0067
© IDOSI Publications, 2011
Corresponding Author: Krishnakumar Duraisamy, Shantha Biotechnics,
Hyderabad, India. E-mail: krishnapharmacy@gmail.com.
226
Methods of Detecting Cervical Cancer
Krishnakumar Duraisamy, K.S. Jaganathan and Jagathesh Chandra Bose
Shantha Biotechnics, Hyderabad, India
Abstract: Cervical cancer is the second most common cancer in women worldwide, with more than half a million
new cases diagnosed in 2010. The disease disproportionately affects the poorest regions—more than 80% of
cases are found in developing nations, mainly in Latin America, sub-Saharan Africa and the Indian
subcontinent. Cervical cancer is an important cause of early loss of life as it affects relatively young women.
Important advances have taken place in the diagnosis and treatment of this cancer in recent years. Surgery or
chemo radiotherapy can cure 80-95% of women with early stage disease (stages I and II) and 60% with stage
III disease. An ideal screening test is one that is minimally invasive, easy to perform, acceptable to the subject,
cost-effective and efficacious in diagnosing the disease process in its preinvasive or early invasive state when
the disease process is more easily treatable and curable. A variety of screening tests have therefore been
developed in an attempt to overcome the innate limitations of conventional cytology. Screening techniques for
cervical cancer include Conventional exfoliative cervicovaginal cytology i.e. the cervical (Pap) smear, Fluid
sampling techniques with automated thin layer preparation (liquid based cytology), Automated cervical
screening techniques, Neuromedical systems, HPV testing, Polar probe, Laser induced fluorescence, Visual
inspection of cervix after applying Lugol’s iodine (VILI) or acetic acid (VIA), Speculoscopy, Cervicography.
The screening strategies mentioned above though applicable to the developed world may not be cost effective
enough for widespread application in the third world countries. Currently, cervical cytology is widely regarded
as the gold standard for cervical cancer screening in all developed countries. It is however not feasible to
implement a systematic cytology based screening programme in a country like India. This is mainly due to
severe restrictions on the availability of infrastructure, resources and funding. There is therefore a need to
develop low cost screening strategies for cervical cancer. This will necessarily involve the use of a very simple
technique that can be easily taught to and practiced by paramedical personnel in the rural areas. Such
techniques will need to be cost effective while retaining adequate sensitivity and specificity to perform as
practical screening techniques.
Key words: Cervical Cancer HPV Pap Test Cytology
INTRODUCTION between the columnar epithelium of the endocervix and
Cervical cancer is one of the most common types of continuous metaplastic change. Since maximum
cancer among women worldwide. The good news is that metaplastic activity occurs at puberty and first pregnancy
92% of the cases can be detected (Table 1) and treated if between 18-30 yrs of age, hence detected during active
a woman undergoes regular pelvic exams and Pap tests sexual life. All women are at risk of developing the
[1]. Many methods currently exist to detect cervical disease, but several factors can increase the risk. The
cancer. Cancer of the uterine cervix is a leading cause of risk factors for cervical cancer are viral infections
mortality and morbidity among women worldwide. In India (HPV, HIV, HSV), multiparity, early initiation of sexual
cervical cancer is still the most common cancer and activity, multiple sex partners, smoking, low
occupies the top rank among cancers in women in socioeconomic status, diet low in antioxidants, long term
most developing countries, constituting 34% of all use of oral contraceptives and poor hygiene etc.Since
women’s cancers. Most cervical cancers arise at the early detection predicts better prognosis, one of the most
squamo-columnar junction and transformation zone effective ways of preventing and controlling cervical
squamous epithelium of the ectocervix where there is