By DONALD G. McNEIL Jr.
POYAI, Thailand — Maikaew Panomyai did a little dance coming out of the examination room, switching her hips, waving her fists in the air and crowing, in her limited English: “Everything’s O.K.! Everything’s O.K.!”
Translation: The nurse just told me I do not have cervical cancer, and even the little white spot I had treated three years ago is still gone.
What allowed the nurse to render that reassuring diagnosis was a remarkably simple, brief and inexpensive procedure, one with the potential to do for poor countries what the Pap smear did for rich ones: end cervical cancer’s reign as the No. 1 cancer killer of women. The magic ingredient? Household vinegar.
Every year, more than 250,000 women die of cervical cancer, nearly 85 percent of them in poor and middle- income countries. Decades ago, it killed more American women than any other cancer; now it lags far behind cancers of the lung, breast, colon and skin.
Nurses using the new procedure, developed by experts at the Johns Hopkins medical school in the 1990s and endorsed last year by the World Health Organization, brush vinegar on a woman’s cervix. It makes precancerous spots turn white. They can then be immediately frozen off with a metal probe cooled by a tank of carbon dioxide, available from any Coca-Cola bottling plant.
The procedure is one of a wide array of inexpensive but effective medical advances being tested in developing countries. New cheap diagnostic and surgical techniques, insecticides, drug regimens and prostheses are already beginning to save lives.