This is largely due to the lack of advanced screening techniques in those areas, said Qiao Youlin, director of the Oncology Research Institute with Chinese Academy of Medical Sciences in Beijing.

Qiao, who has devoted himself to cervical cancer screening research, said that even in the cities, women's lack of awareness about the disease is worrying.

"Generally, they do not have a regular plan to receive screening and also they do not know that cervical cancer can be prevented and treated," said Qiao.

All these facts have pushed Qiao and his colleagues to call on more Chinese women aged 30 and above to get screening for cervical cancer. The call was made during a symposium on cervical cancer held in Beijing last Wednesday.

During the symposium, the medical experts highlighted the newly developed Digene hc2 High-Risk HPV DNA Test, an advanced molecular test that detects DNA of 13 high-risk viral types of HPV (Human Papillomavirus) that infect cervical cells. The sensitivity of the test is as high as 95 percent.

According to the experts, HPV is the virus that worldwide studies have shown to be the primary cause of cervical cancer.

"Five years ago, the cause of the disease was still not clear. But now much of our laboratory data points to HPV as being the primary culprit," said Qiao.

"The new screening technique available will guarantee our victory in the fight against cervical cancer, and more Chinese women will enjoy a better chance of avoiding the disease," said Qiao

In China, nearly 100,000 cases of cervical cancer are diagnosed annually, with approximately 20,000 deaths in 2001 alone, according to Qiao.

In the past, doctors used Pap smears to identify women with cervical cancer. The technique relies on visual examination of cervical cells for abnormal changes that may indicate a cancerous or pre-cancerous condition. However, its sensitivity was only 76.6 percent, so the invasive cancer often developed after an apparently normal smear.

By comparison, the newly developed test can directly detect the viruses of cervical cancer, especially the 13 high-risk viral types of HPV. By detecting the HPV types, doctors will have ample time to offer treatment, long before the virus causes cellular changes that are detected by the Pap test.

When used in conjunction with the Pap, the HPV DNA test has been shown to have a sensitivity of 98 percent. "So the combination of the two tests should prevent more cancers and an earlier detection will save more women's lives," said Lang Jinghe, director of the Department of Gynaecology and Obstetrics with Peking Union Medical College Hospital.

"HPV DNA testing is helping to usher in a new era in the battle against cervical cancer," said Qiao.

Most people might contract HPV at some point in their lives. However, the virus typically disappears on its own without causing any serious effects.

"It is only HPV infections that persist for a year or more that can cause abnormal cell changes and lead to cervical cancer," said Qiao.

An HPV infection in women aged 30 and over is more likely to be persistent and Lang suggested that these individuals should be monitored more closely.

If one has a positive result from the Digene hc2 HPV Test, Lang recommended the patient undergo further investigation to determine the extent of any pre-cancerous change. This may include repeating the HPV test in 6-12 months to determine if the infection is persistent or transient.

"Close watch over these women will ensure an early detection of pre-cancerous changes or cancer. Now there are many effective medications available for treating the disease in its early stage," said Lang.

If one has a negative Digene hc2 HPV Test result, in conjunction with a normal Pap test report, Lang said they do not need to undergo further tests for from five to eight years. "It saves women from unnecessary stress and helps give them peace of mind," he said.

(China Daily March 30, 2004)