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March 15, 2006

Prevention of Cervical Cancer in Low-Resource Settings

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;295(11):1248-1249. doi:10.1001/jama.295.11.1248-b

To the Editor: Dr Denny and colleagues1 studied screen-and-treat approaches to cervical cancer screening in low-resource settings. We question whether these approaches should be characterized as safe, effective, or resource-appropriate in a real-world setting.

Supply, equipment, salary, space, and overhead costs for Papanicolaou tests in developing countries such as Vietnam total less than $0.50 per test.2 Supply costs alone for the human papillomavirus (HPV) test total $20 to $30 per test2; when analyzed in developing-country laboratories there is difficulty with reproducibility and accuracy that is comparable to cytology.3