Women in the developing world are not getting cervical screening

Emmanuela Gakidou (University of Washington, Seattle, USA) and colleagues report that although women in the developing world have the highest risk of developing cervical cancer, few are effectively screened. Additionally, there exist severe inequalities between and within countries concerning the access to cervical cancer screening.

As the second-most common cancer in women (after breast cancer), cervical cancer is a leading cause of death all around the world. During the last 40 years, both the number of new cases of cervical cancer and the death rate due to the disease have fallen in the developed world. Medical and health professionals point to widespread screening programs as the reason for this public health success. The developing world, however, has a higher prevalence of cervical cancer but very little information about rates of screening.

Researchers used data from World Health Organisation (WHO) reports from 57 countries at all levels of economic development. They used two measures of cover: effective cover - the number of women who had a PAP smear and a pelvic examination in the preceeding three years, and ineffective cover - the numbers of women who did not have these procedures. The difference was striking - 63% to 19% respectively.

Those women who have the highest exposure to smoking, unsafe sex, and other cervical cancer risk factors are poor women; this group is also less likely to receive effective screening. As women get older, screening rates in developing countries decline even though older women are more prone to cervical cancer.

Read the full article here http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050132