Suba Eric J
Global Cervical Cancer Prevention Project, San Francisco, California, USA.
National Center for Bioethics in Research and Health Care, Tuskegee University, Tuskegee, Alabama, USA.
Infect Agent Cancer. 2024 Apr 26;19(1):18. doi: 10.1186/s13027-024-00576-5.
A study coordinated by Groesbeck Parham and Mark Schiffman describes a novel approach to single-visit, point-of-care cervical screening and triage for low and middle income countries (LMICs) that uses an HPV screening test that is not affordable in LMICs combined with a triage test that is not available at the point of care. Pap smears are feasible, affordable, and well-suited for single-visit, point-of-care cervical screening and triage in LMICs. Research into a discredited cervical screening test, funded by the US National Cancer Institute, contributed to at least 500,000 preventable cervical cancer deaths by delaying implementation of Pap screening throughout India for 18 years. Researchers should no longer delay implementation of Pap screening in LMICs pending research into novel screening approaches. Instead, researchers should prioritize cervical screening approaches that will save as many lives as quickly as possible in LMICs. To that end, Parham et al. should implement good-quality, single-visit, point-of-care Pap smear screening in LMICs until better-quality, single-visit, point-of-care HPV screening becomes widely affordable in LMICs.
由格罗斯贝克·帕勒姆和马克·希夫曼协调开展的一项研究描述了一种针对低收入和中等收入国家（LMICs）的单次就诊即时护理宫颈筛查和分流的新方法，该方法使用了一种在低收入和中等收入国家无法负担得起的HPV筛查测试，并结合了一种在即时护理点无法获得的分流测试。巴氏涂片检查在低收入和中等收入国家是可行的、负担得起的，并且非常适合单次就诊即时护理宫颈筛查和分流。由美国国家癌症研究所资助的一项关于一种已被质疑的宫颈筛查测试的研究，通过在印度推迟18年实施巴氏涂片筛查，导致至少50万例可预防的宫颈癌死亡。在等待新型筛查方法研究的过程中，研究人员不应再推迟在低收入和中等收入国家实施巴氏涂片筛查。相反，研究人员应优先考虑在低收入和中等收入国家能够尽快挽救尽可能多生命的宫颈筛查方法。为此，帕勒姆等人应在低收入和中等收入国家实施高质量的单次就诊即时护理巴氏涂片筛查，直到更高质量的单次就诊即时护理HPV筛查在低收入和中等收入国家广泛可负担得起。
