Cervical cancer has long been one of the most significant health threats to women globally. According to Global Cancer Today (GLOBOCAN), over 600,000 new cases are reported annually, making this disease a major concern for women's health. Despite numerous efforts in prevention and treatment, cervical cancer remains a complex challenge, particularly because it is often detected only at advanced stages.

Nevertheless, the extensive journey to combat cervical cancer through screening deserves recognition. Contributions from scientists, doctors, and global health organizations have united toward a common goal: saving as many women as possible. The history of cervical cancer screening reflects continuous innovation to address this pressing issue.
 

The First Breakthrough: Pap Smear by Dr. George Papanicolaou

The 1940s marked a significant milestone in cervical cancer screening with the invention of the Pap smear by Dr. George Papanicolaou. This test allowed doctors to detect abnormal cells in the cervix before they developed into cancer, significantly reducing mortality rates in many countries. However, as the first method of its kind, Pap smear had several limitations, including low sensitivity and high false-negative rates. The results often varied depending on the examiner's interpretation, leading to inconsistent detection outcomes.
 

A Cost-Effective Alternative: IVA by Dr. Johan Petrovich

In 1986, Dr. Johan Petrovich introduced Visual Inspection with Acetic Acid (VIA), a more affordable cervical cancer screening method compared to Pap smears. VIA involves applying acetic acid to the cervix and visually inspecting for abnormalities. While this method improved accessibility, its accuracy depended heavily on the examiner's expertise, and it was less effective at detecting microinvasive lesions.
 

Identifying HPV: Harald zur Hausen's Revolutionary Discovery

In 1983, Dr. Harald zur Hausen made a groundbreaking discovery by identifying the Human Papillomavirus (HPV) as the primary cause of cervical cancer, particularly HPV types 16 and 18. This finding transformed the approach to cervical cancer prevention worldwide. In 2008, Dr. zur Hausen was awarded the Nobel Prize in Medicine for his discovery, which paved the way for the development of HPV DNA-based screening methods.

HPV DNA testing, introduced in recent decades, represents a major advancement in screening techniques. It offers higher sensitivity and the ability to detect the virus before any cellular abnormalities appear, allowing for earlier and more effective prevention strategies.
 

Current Cervical Cancer Management Strategies

In 2010, the World Health Organization (WHO) recommended HPV DNA testing as the primary method for cervical cancer screening. Through its "90-70-90" strategy, WHO aims to eliminate cervical cancer by 2030 by achieving the following:
 

• 90% of girls vaccinated against HPV by age 15,
   

• 70% of women screened with high-performance tests at ages 35 and 45, and
   

• 90% of women diagnosed with cervical disease receive appropriate treatment.

Indonesia has embraced these goals in its National Cervical Cancer Elimination Plan (2023–2030), with a focus on increasing screening coverage using HPV DNA testing. In the first phase (2023–2027), the country aims for 70% of women aged 30–69 to be screened, increasing to 75% in the second phase (2028–2030).
 

The Role of Technology in Modern Screening

Achieving these ambitious goals requires collaboration and innovation. Biotechnology companies play a crucial role in this effort, providing accurate, accessible, and user-friendly technologies.

One such contribution comes from Nusantics, an Indonesian biotechnology company that has developed the PathoScan hrHPV qPCR Kit. This tool detects high-risk HPV types, including HPV-16 and HPV-18, with high accuracy. Additionally, Nusantics offers urine-based HPV testing, a less invasive and more convenient alternative for women who may feel uncomfortable with conventional cervical swab methods.

Cervical cancer screening plays a critical role in preventing and managing the disease. Innovations like those from Nusantics are expected to enhance early detection and reduce cervical cancer cases in Indonesia. With support from the government and various stakeholders, Indonesian women now have broader access to accurate and comfortable screening technologies, making cervical cancer management more effective and accessible for all.

 

References:

1. American Association for Cancer Research. (2021). The past, present, and future of HPV: Can vaccination help eliminate cervical cancer? Retrieved from https://www.aacr.org/blog/2021/09/28/the-past-present-and-future-of-hpv-can-vaccination-help-eliminate-cervical-cancer/
2. Kementerian Kesehatan Republik Indonesia. (2023). Rencana Eliminasi Kanker Leher Rahim Nasional Indonesia (2023-2030). Retrieved from https://gco.iarc.fr/en
3. Nusantics. (n.d.). HPV Test Kit. Retrieved from https://nusantics.com/products/human-diagnostics/reproductive-health
4. World Health Organization. (2021). WHO Recommends DNA Testing as a First Choice Screening Method for Cervical Cancer Prevention. Retrieved from https://www.who.int/europe/news/item/11-09-2021-who-recommends-dna-testing-as-a-first-choice-screening-method-for-cervical-cancer-prevention
5. World Health Organization. (2022). Comprehensive Cervical Cancer Control: A Guide to Essential Practice. Retrieved from https://www.who.int/publications/i/item/9789240030961
6. Hidayat, B., & Listiani, P. (2016). Acetic Acid Visual Inspection Method for Early Detection of Cervical Cancer: A Review. Journal of Cancer Education, 31(2), 223-229. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC7376483/
7. Jang, T. W., et al. (2012). Human papillomavirus testing as a primary cervical cancer screening method. Journal of Gynecologic Oncology, 23(4), 282-286.  Retrieved from https://doi.org/10.3802/jgo.2012.23.4.282 
8. Lestari, A. I., & Hidayat, B. (2019). The Efficiency of Cervical Pap and Comparison of Conventional Pap Smear and Liquid Based Cytology: A Review. Cureus, 11(5), e19834. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC5385241/