Study roots for urine tests in war on cervical cancer

Cervical cancer is the leading cause of terminal illness among women in Kenya.

As with other types of cancer, screening for the disease is of utmost importance for prevention as well as early diagnosis of cancer.

This leads to improved treatment outcomes and allays the suffering and pain associated with advanced or late stage cancer.

For cervical cancer, the three tests recommended include pap smears, DNA tests for HPV — the virus that causes the disease — as well as visual inspection using acetic acid (VIA).

All these tests are invasive, as they require health workers to inspect or collect samples inside the cervix.

Even though they are life-saving, some women find these medical procedures uncomfortable or embarrassing and hence shun them.

Cultural dictates may also dissuade women from embracing existing cervical cancer tests. For instance, some communities believe that it is a taboo for strangers to assess women’s private parts.

To address these challenges, researchers have been racking their brains for many years, trying to come up with less invasive innovations or alternative tests for use in cervical cancer screening.

There is light at the end of the tunnel for this initiative.

A new study published in the BMJ Open Journal has found that urine tests may be as effective as the Pap smear in preventing cervical cancer.

The research, which was steered by the University of Manchester scientists in the United States, showed that urine testing is just as good as the Pap smear at picking up the high-risk human papillomavirus (HPV) that causes cervical cancer.

“We’re really very excited by this study, which we think has the potential to significantly increase participation rates for cervical cancer screening,” said Dr Emma Crosbie, lead author of the study from the University of Manchester.

She stated that many young women avoid conventional cervical cancer screening tests as they find them embarrassing or uncomfortable, particularly if they have gynaecological conditions like endometriosis.

These inconveniences undermine the impact that awareness campaigns have made in enhancing awareness about cervical cancer and encouraging women to embrace early screening.

“The effects aren’t long lasting and participation rates tend to fall back after a while. That’s why we clearly need a more sustainable solution.”

According to the researchers, the new urine test can help increase the number of women screened for the disease globally.

This would go a long way in reducing the estimated 570,000 cervical cancer cases recorded annually, based on the World Health Organisation statistics.

In Kenya, recent statistics released by the International Agency for Research on Cancer in GLOBOCAN 2018 indicate that cervical cancer is the second most prevalent type of cancer in the country after its breast variety. Of the about 5,250 diagnosed with the disease each year, more than 3,000 will die from it.

Health experts are hopeful that comfortable and easy to use screening methods such as the urine test will encourage women to undergo tests early to reduce the burden of cervical cancer in Kenya.

According to the researchers, the urine test could also play a significant role in the developing world — especially in rural areas — where Pap smear testing may be largely non-existent.

PERNICIOUS DISEASE

“Urine is very simple to collect and most hospitals in the developed and developing world have access to the lab equipment to process and test the samples,” said Dr Crosbie.

“Let us hope this is a new chapter in our fight against cervical cancer, a devastating and pernicious disease.”

Over a hundred (104) women participated in the study and were screened for HPV in the United Kingdom.

From the total, eighteen women had precancerous changes to the cervix caused by HPV that needed treatment.

The Pap smear and urine test picked up 16 and 15 of these cases respectively.

“These results provide exciting proof of principle that urine HPV testing can pick up cervical pre-cancer cells. However, we need to try it on a greater number of women before it can be used. We hope that is going to happen soon,” noted Dr Crosbie.

Cervical cancer occurs when abnormal cells develop and spread in the cervix, the lower part of the uterus. When these cells first become abnormal, there are rarely any warning signs. However, as cancer progresses, symptoms may include unusual vaginal discharge, vaginal bleeding between periods, bleeding after menopause and bleeding or pain during sex.