Cervical Cancer is a deadly disease caused by Human Papilloma Virus, an extremely common virus transmitted through sexual contact. Although most infections with HPV resolve spontaneously and cause no symptoms, persistent infection can cause cervical cancer in women.
Various Strains of Cervical Cancer:
• Persistent infections with certain high-risk HPV strains add-to nearly 85% of all cervical cancers.
• At least 14 HPV types have been identified as oncogenic (potential to cause cancer).
• Among these, HPV types 16 and 18, considered to be the most oncogenic, have been found to be responsible for about 70% of all cervical cancer cases globally.
Cervical cancer develops in a woman’s cervix (the entrance to the uterus from the vagina). Cervical Cancer is second most common cancer in India in women after breast Cancer. It is fourth most common cancer in women globally with 660000 new cases and 350000 deaths in 2022.
Cervical Cancer in India:
Cervical Cancer comes as challenge to India, which necessitates the need for mitigating strategies and palliative care. The Government of India envisages to initiate a three-phase vaccination drive against Human Papilloma virus for girls aged 9-14, aiming to mitigate the risk of cervical cancer
India has a population of 511.4 million women ages 15 years and older who are at risk of developing cervical cancer. Current estimates indicate that every year 123907 women are diagnosed with cervical cancer and 77348 die from the disease.
• India is home to 16-17% of the world’s population, globally 27% of total cervical cancer cases are from here.
• Further, in India about 77% cases of cervical cancer are caused by HPV 16 and 18.
• In India, bivalent and quadrivalent HPV vaccines were licensed in 2008 and a non-valent vaccine was licensed in 2018.
Who is risk of Developing Cervical Cancer:
1. Health Inequities:
Health conditions are already poor in underprivileged and marginalised sections of the society, which makes them susceptible to the disease due to limited access to healthcare facilities.
2. Co-factors and risk factors:
The high prevalence of comorbidities like HIV/ AIDS and smoking prevalence, high fertility rate, having multiple sexual partners (as it is a sexually transmitted disease) and high use hormonal contraception.
3. Genetic Risks/ Environmental Factors:
Link to contracting HPV can be linked to family history and environmental factors.
Need for Fighting Cervical Cancer for India:
1. Increase in Out of Pocket Expenditure:
The costs associated with diagnosis, treatment increase the cost incidence on the marginalised section of the society.
2. Women’s Health:
Cervical cancer causes impact on both physical and mental health of women. Cervical cancer predominantly affects women during their prime years, leading to premature deaths that impact families’ socio-economic stability and children’s well-being.
3. Human rights issue:
Access to affordable and quality healthcare services, including HPV vaccination and cervical cancer screening, is essential for fulfilling women’s right to health and well-being.
4. Achievement of Sustainable Development Goals & Long-term Benefits:
Investing in cervical cancer prevention and control efforts yields long-term benefits for public health and sustainable development, contributing to improvements in life expectancy, maternal and child health outcomes, and progress towards achieving the SDG
Challenges Faced by India:
1. Lack of sexual education: There is formal sexual education imparted at school and college level which is a major concern faced by India.
2. Lack of Awareness: Most of the people lack information regarding the prevention and care related to the cervical cancer.
3.Dearth of skilled professionals: Shortage of skilled professionals trained in cervical cancer mitigation, screening and treatment.
4. Stigma associated with Vaccine: There is hesitation among people for taking vaccinations, there lies mistrust which affects vaccination coverage.
5.Accessibility: It is a major hindrance as it is not easily available as well economic constraints particularly for the low-income families.
Government Schemes & Intervention:
1. India Launched its own indigenously developed vaccine called as Cervavac developed by Serum Institute of India
2. it is India’s first Quadrivalent Human Papillomavirus Vaccination(HPV) (type 6, type 11, type 16, type18) designed to protect women from cervical cancer.
3. National Cancer Grid
4. National Cancer Awareness Day
5. National Program for Prevention & control of cancer
Way Forward:
1. Increasing awareness and accessibility of the CERVAVAC and,through timely screening and treatment.
2. Funding in more research and development by increasing the share of health sector in GDP.
3. Following the WHO targets 90-70-90: Targets by WHO: The WHO has targets aiming for 90% of girls to be fully vaccinated with the HPV vaccine by age 15, 70% of women to undergo cervical cancer screening tests by the ages of 35 and 45, and for 90% of women with cervical cancer to receive treatment by 2030.
4. Following the WHO cervical cancer elimination initiative.
5. Taking lessons from the other nations which we can adopt.
Apart from all these there is need for various social media platforms to come together while increasing the awareness and knowledge about the disease. There should be a multi-pronged strategy which addresses about the mitigation as well as the treatment.