Two physicians and a doctoral student at the Arizona Health Sciences Center at the University of Arizona have started a program in Honduras that uses ordinary vinegar to detect cervical cancer. Ilana B. Addis, MD, and Pamela S. Lotke, MD, both assistant professors of clinical obstetrics/gynecology at the UA College of Medicine, are co-directors of the Honduran Women's Health & Visual Inspection Acetic Acid Program. With Deanna Lewis, PA, MBA, who also is a doctoral student at the UA Mel and Enid Zuckerman College of Public Health, they initiated the program June 7 in collaboration with Salud Juntos in La Guacamaya, Honduras.
“Visual inspection with acetic acid,” or “VIA,” is a simple and effective method that is used to screen for and detect cervical cancer in countries where women do not have access to Pap smears. The technique involves applying acetic acid (vinegar) to the uterine cervix and examining it with the naked eye under bright light. If a well-defined white area on the cervix is observed after one minute, the test is positive. Women who are VIA-positive are offered immediate cryotherapy – a treatment that freezes surface skin lesions – to remove any cancerous lesions, or a referral for any suspected invasive cancers. Programs such as this have demonstrated a reduction in cervical cancer incidence of as much as 25 percent when compared with existing care (The Lancet, 307, 398 (2007)).
Low-cost and sustainable, this program assures “just-in-time” treatment for women who are VIA-positive. In addition, promotoras and auxiliary nurses are being trained to use the technique independently. Drs. Addis and Lotke and Deanna Lewis provided initial training to the two health workers who are employed at La Guacamaya Clinic in June. Working alongside their expert mentors, Suttyalin Caballero and Norma Murilla participated in seeing and treating a total of 80 patients over the Salud Juntos four-day “summer brigade.”
The Salud Juntos-AHSC team plans a return visit for winter 2012.