Indian Women’s Guide to Cervical Cancer Prevention

Cervical cancer, the second-most common cancer among Indian women, has claimed several lives. With a staggering 1,23,907 new cases and 77,348 deaths in 2022, India bears a significant burden of this disease (1). However, recent developments, including the government’s plan to include the cervical cancer vaccine in the universal immunization program, bring a ray of hope.

What is Cervical Cancer?

Cervical cancer primarily targets middle-aged women, and its prevalence is influenced by factors like persistent high-risk HPV infection, low socioeconomic conditions, compromised immunity, and smoking. Despite its severity, cervical cancer is preventable and highly curable when detected early (2). A crucial aspect is the extended pre-invasive phase, lasting 10–15 years, providing a unique opportunity for early detection and intervention.

Cervical Cancer Vaccine

The imminent inclusion of the cervical cancer vaccine in the universal immunization program is a monumental step. HPV vaccination for girls in the nine to 14 age group is projected to commence this year. Early vaccination not only prevents the initiation and progression of cervical cancer but also contributes to a reduction in mortality rates.

The Government of India has also implemented cancer screening through the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS). Screening tools like visual tests and HPV tests are simple, yet there’s a need for robust awareness campaigns. Indigenous HPV test kits and vaccines, coupled with innovative developments like single-dose vaccination and AI technologies, offer hope for scaling up preventive measures.

Challenges in Detection and Treatment of Cervical Cancer

Despite the promising developments, challenges persist in the detection and treatment of cervical cancer. A significant gap lies in awareness, evidenced by a population-based study showing that 68% of patients initially sought help from traditional healers. Additionally, only 3% had received the HPV vaccine. The projected increase in cancer cases and the leakage from screening to treatment steps highlight the urgency for comprehensive solutions.

WHO’s Three-Pronged Approach to Eliminate Cervical Cancer

The World Health Organization (WHO) advocates a clear strategy to eliminate cervical cancer globally. Widespread HPV vaccination, efficient screening, and early diagnosis and treatment constitute the three pillars. The proposed targets, including 90% of girls fully vaccinated, 70% of women screened at crucial ages, and 90% of women with cervical pre-cancer receiving treatment, underscore the urgency and ambition of the global campaign.

To truly eliminate cervical cancer, a multifaceted approach is imperative. Strengthening population-level awareness, overcoming vaccine hesitancy, promoting age-appropriate screening, and enhancing pre-cancer treatment processes are vital. Additionally, partnerships at various levels, digital interventions, and efficient communication can bridge gaps in care pathways and contribute to a cohesive strategy.

As India strides toward eliminating cervical cancer, consistency in screening programs, technological advancements, and financial support for cancer care are essential. Strengthening cancer registries, reducing the financial burden on patients, and early integration of palliative care services form key components of this journey. Collaborations with NGOs, innovators, and public health professionals can amplify the impact of these initiatives.

Connecting all aspects of patient care pathways, ensuring swift and accurate diagnosis, and leveraging digital technologies are paramount. Follow-up reminders, palliative care integration, and collaborative research efforts further fortify the fight against cervical cancer. It’s through collective efforts and unwavering partnerships that India can envision and realize a future free from the burden of cervical cancer.

References:

1. Secular trends in incidence and mortality of cervical cancer in India and its states, 1990-2019: data from the Global Burden of Disease 2019 Study
   
   Singh M, Jha RP, Shri N, Bhattacharyya K, Patel P, Dhamnetiya D. Secular trends in incidence and mortality of cervical cancer in India and its states, 1990-2019: data from the Global Burden of Disease 2019 Study. BMC Cancer. 2022 Feb 7;22(1):149. doi: 10.1186/s12885-022-09232-w. PMID: 35130853; PMCID: PMC8819855.




2. Cervical Cancer
   
   Fowler JR, Maani EV, Dunton CJ, Gasalberti DP, Jack BW. Cervical Cancer. 2023 Nov 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 28613745.

Source-Medindia