The simple screening method that uses vinegar, cotton swab and bright light to detect cervical cancer was designed by Indian doctor R Sankarnaryanan. And it was Sankarnaryanan, now the Screening Group Head at International Agency for Research on Cancer (IARC) in France, who brought the research project from France to the little Tamil Nadu town of Dindigul, about 450 km south of Chennai. In 1997, a few oncologists did a community health study and found an alarming incidence of cancer, nearly 42 per cent, in Dindigul, while it was only 37 per cent in Chennai. Dr Sankarnarayanan, then based in Thiruvananthapuram, tied up with the group and got ICAR interested in the project. The Bill and Melinda Gates Foundation agreed to fund it. After the Rs 1-crore programme, called “Cluster-randomised controlled intervention trial for cervical screening” started in 2001, he flew down once every two months to personally monitor it. The programme began with the research team selecting 113 villages in the district, some for intervention (creating awareness) and some for actual screening and control. Of the 31,343 women in 56 villages screened using “vinegar-cotton swab-bright light”, 3088 tested positive. All that a core team of 15 health workers, including oncologists associated with the Christian Fellowship Community Health Centre (CFCHC) did was to use the cheap acetic acid (or vinegar), a cotton swab and bright light to detect pre-malignant lesions indicating cervical cancer in women. “It took a lot of persuasion and counseling to convince the villagers. We used village heads and elders to rope in the women,” said P O Esmy, the 49-year-old Radiation Oncologist, attached to the CFCHC. She said Dr Sankarnarayanan had been frequently discussing the project with Union Health Minister Anbumani Ramadoss and a proposal to extend it to other parts of India.
