Only one in five women within the developing world are getting effective cervical cancer screening, according to a study in the Public Library of Service magazine. Emmanuela Gakidou of the University of Washington, in Seattle, WA led the study.

Unfortunately, these very women are the ones most needing careful screening, as they are have a higher rate of cancer risk factors such as smoking or unsafe sex. In developing countries as a whole, screening coverage rates also decline with advancing age, when cervical cancer incidence rates are generally highest.

Cervical cancer is the second-most frequent cancer in women. Ironically, new vaccines and information have become widely available for protection against the HPV virus that sometimes leads to cervical cancer. Cervical cancer is a slow-growing cancer that may not have symptoms but can be found with regular Pap tests. In fact, within the developed world cervical cancer rates have fallen significantly, a drop attributed to public health programs.
Gakidou and her research colleagues reviewed surveys from the World Health Organization (WHO), which encompassed 57 countries in all levels of economic development. Analysis of effective coverage (a Pap smear in the previous three years) and crude coverage (a pelvic exam at some point in life) found a huge disparity in rates of cervical cancer screening-- 19% of women in the developing world have had effective coverage compared to 63% in developed countries.

The inequality in access to screening in the developing world is both between different nations and within nations. Over 80% of women receive effective screening in Austria compared to 1% or less in Ethiopia and Bangladesh. In 16 of the 57 countries studied, most women have never had a pelvic exam and in Ethiopia, Malawi and Bangladesh, of 90% of women had not had any form of screening.

Gakidou and colleagues state in the report: "Strategies for improving cervical cancer prevention must be adapted to meet the specific needs of individual countries; expanded screening may be a viable option where sufficient infrastructure and health system access exists, but novel strategies need to be considered in other settings."

More information available at: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0050132&ct=1

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