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Cosmopolitan Safer Screening Campaign,
Cosmopolitan, National Magazine House, 72 Broadwick Street, London W1V 2BP
Money or your life?
While American technology makes cancer detection virtually foolproof, the British cervical screening system is still stuck in the Sixties. And all because it's cheaper. NICOLA GILL reports.
In November 1995, Sara Jones, 26, was called for a routine smear and a month later had a letter from her GP describing the result as 'unsatisfactory'. Concerned, she asked her GP what it meant but was told there was nothing to worry about. A second test in April 1996 produced similar results, as did a third one shortly afterwards. By now she was really worried, "My doctor kept saying it was quite normal, but I felt sick with the anxiety of not knowing." she recalls.
A year later Sara went back for a forth test. This time the result showed pre-cancerous (CIN1) cells. "In January 1997 I had laser treatment to destroy the abnormal cells. I had repeat smears at three and six months and will now pay to have smears done privately every year for peace of mind."
"I feel angry I lost a whole year before learning that I was ill. The worry of not knowing whether I had cancer for 12 months was nearly as bad as discovering that I did have abnormal cells. With more efficient diagnosis. I could have started		 treatment a year earlier and escaped the hell of wondering all that time."

WHAT PRICE NEW TECHNOLOGY?
What id Sara had had a more efficient diagnosis, what if she'd known that there was a computer that could detect abnormal smears with almost 100 percent accuracy? A machine that could virtually eliminate inexact smear results and prevent countless women from developing cancer. The catch? It would cost slightly more for each test. Chances are, she'd think it was worth it.
In the US, this technology exists, has been approved by the FDA (who license new medical procedures and drugs) for two years and is routinely used in cervical cancer screening. PapNet (the commercial name for the technology) evolved from the high-tech military Star Wars project (see below). US trials have proved it to be 30 percent more effective than a human at spotting abnormal smears.
Finding abnormal cells in an average smear test is comparable to looking for a dozen spelling mistakes in a book the size of War and Peace. Human testers get tired, make mistakes and habitually decide that a smear is clear because more than 90 percent of the smears they look at will be negative. PapNet never gets tired and doesn't have off days.
Life saving technology - how PapNet works
The cervix is a constantly changing environment affected by hormones and infection, no single smear looks exactly like another. Abnormal cells don't all look the same and although some look very different to normal cells, others are very similar.
Because of these subtle differences, until recently no computer could cope with the millions of variations.		 It would need to be able to recognise an abnormal smear. PapNet uses neural networking, which means the computer 'learns', like a human, from examples. PapNet was shown thousands of smears over a two year period before it had compiled the information necessary to make accurate analysis.

 

Future perfect?
How your smear could be screened in the next millennium

Cervical cancer kills 450,000 women world-wide every year. In Britain there are 4000 new cases a year and 1500 deaths. Better detection using processes such as these would save many lives, and thousands of women could be spared treatment for a disease that leaves them traumatised or infertile.

HPV (HUMAN PAPILLOMA VIRUS) TESTING 98% of women with cervical cancer also carry certain strains of the HPV virus (which causes genital warts). The Hybrid Capture II DNA/HPV test has been in development for eight years. By detecting the virus it can predict who is likely to have pre-cancerous cells.

THINPREP Developed by a US company called CYTYC, ThinPrep is designed to make smears easier for the human eye to read by taking out blood, mucus and other material, which often causes inadequate results. The cells from the smear are put in a vial with alcohol and gently rotated to isolate the cervical cells, which are then examined as normal. This technology is already used in the US.
THE POLAR PROBE Now under trial at London's Whittington Hospital, it gives instant results using a vaginal probe which emits electrical energy and lightwaves to detect pre-cancerous changes and cancer.

FLI (FLUORESCENCE LIFETIME IMAGING)
A laser chip, similar to that in a CD player, sends out a light probe which detects changes in cervical tissue before they can even be seen under a microscope - simply by passing the device across your stomach.

BLOOD VESSEL FORMATION Scientists at Cancer Research Campaign found that extra blood are made in the cervix before signs of cancer appear on a smear test. At the moment a tissue sample must be given before the extra vessels can be detected. Scientist are now working on a way to detect biological signals including such an increase in a conventional test.