How Indian Women Can Rid Themselves of Cervical Cancer

Why in News?

• Cervical cancer, the second-most common cancer among women in India, poses a significant public health challenge.
• The government's recent announcement to include the cervical cancer vaccine in the universal immunisation program for girls aged 9 to 14 is a positive step forward.

Current Situation of Cervical Cancer Burden in India

• A Formidable Challenge
  • In the year 2022 alone, the country reported a staggering 1,23,907 new cases of cervical cancer, contributing to a concerning global burden.
  • The gravity of the issue becomes even more apparent when considering the associated mortality, with 77,348 deaths recorded in the same year.
• Prevalence in Middle-Aged Women: The age-specific incidence highlights the need for targeted interventions, especially considering the long pre-invasive phase that characterises cervical cancer, providing a crucial window for early detection and intervention.

Contributing Factors of Cervical Cancer in India

• High-Risk HPV Infection
  • A primary factor contributing to the prevalence of cervical cancer in India is the persistence of high-risk types of Human Papilloma Virus (HPV) infections.
  • These infections, often coupled with other co-factors, create an environment conducive to the initiation and progression of cervical cancer.
• Co-Factors and Socio-demographic Influences
  • Co-factors such as low socioeconomic conditions, compromised immune status, presence of other genital infections, and tobacco consumption, particularly smoking, further compound the risk of developing cervical cancer.
  • The influence of these co-factors is particularly noteworthy in the context of the middle-aged female population.

Opportunities for Early Detection and Cure

• Extended Pre-Invasive Phase is a Crucial Window
  • One of the defining features of cervical cancer is its extended pre-invasive phase, lasting for 10–15 years.
  • This extended period before the development of invasive cancer provides a crucial window of opportunity for early detection and intervention.
  • During this phase, the disease is amenable to treatment through simple outpatient modalities, making early detection a powerful tool for preventing the progression to advanced stages.
• Targeting Reproductive Age Group
  • Cervical cancer primarily affects women in the reproductive age group.
  • Targeting screening and preventive interventions towards this specific demographic allows for a more focused approach.
  • Educational campaigns and screening initiatives can be strategically designed to reach and benefit women in the age range where the disease is most likely to manifest.
• High Cure Rates with Early Detection
  • Early detection of cervical cancer has been shown to result in high cure rates, with over 93 percent success when managed at the initial stages.
  • This underscores the significance of timely screening and diagnostic interventions in improving the prognosis for affected individuals.
  • Implementing robust early detection programs can substantially contribute to reducing mortality rates associated with cervical cancer.
• Screening Tools and Outpatient Treatment
  • The availability of screening tools, including visual screening tests and HPV tests, offers simple and effective means for identifying precancerous abnormalities.
  • These tools facilitate early diagnosis, allowing for timely initiation of treatment.
  • Importantly, the outpatient treatment modalities for precancerous conditions are often simple, painless, and easily administered, making them accessible to a broader population.

Government’s Initiatives

• Inclusion of Cervical Cancer Vaccine into Universal Immunisation Programme
  • A pivotal development in the government's approach to cervical cancer prevention is the decision to include the cervical cancer vaccine in the universal immunisation program.
  • This vaccine, aimed at girls in the age group of nine to 14, represents a proactive step in preventing the occurrence of high-risk HPV infections – a primary precursor to cervical cancer.
  • By incorporating the vaccine into the routine immunisation schedule, the government aims to create a robust defence against HPV infections, thereby reducing the incidence of cervical cancer in the targeted age cohort.
  • This preventive measure aligns with global best practices and has the potential to substantially impact the future burden of cervical cancer in India.
• Alignment with Sustainable Development Goals (SDGs)
  • The government's commitment to combatting cervical cancer aligns with the broader global health agenda, specifically SDG 3.4.
  • This goal aims to reduce premature deaths from non-communicable diseases, including cancer, by one third by the year 2030.
  • By targeting cervical cancer elimination, the government contributes significantly to achieving this SDG.
  • Implementation through National Health Programs
  • The execution of these initiatives is embedded within the existing National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS).
  • Integrating cervical cancer prevention into established national health programs ensures a streamlined and coordinated effort, leveraging existing infrastructure and expertise.

Way Forward

• Need a Comprehensive Approach
  • Consistent efforts are needed for screening programs, technology integration, and capacity building.
  • Collaboration with NGOs, innovators, and public health professionals are crucial for success.
  • Connecting all elements in patients' care pathways, issuing follow-up reminders, and incorporating palliative care early on are essential.
  • Also, collaboration and partnerships in research and community outreach is crucial for eliminating cervical cancer.
• Focus on Innovations and Future Potential
  • The government should focus on developing indigenous HPV test kits, HPV vaccines, single-dose vaccination, self-sampling for HPV testing.
  • Moreover, AI technologies hold promise for resource-scarce settings.
• Need for International Collaboration
  • The significant burden of cervical cancer in India necessitates international collaboration and the sharing of best practices to develop comprehensive strategies.
  • Learning from successful models implemented in other countries could provide valuable insights in the fight against this preventable disease.
• Population Awareness and Education
  • A key opportunity lies in increasing awareness among the population about the importance of cervical cancer screening.
  • Dispelling myths, educating women about the risk factors, and promoting the benefits of early detection can encourage more individuals to seek timely medical attention.
  • This can be achieved through targeted public health campaigns, community outreach programs, and educational initiatives.

Conclusion

• While the government's initiative to include the cervical cancer vaccine is a commendable step, a comprehensive approach encompassing awareness, prevention, early detection, and treatment is vital.
• By connecting the dots in patients' care pathways, leveraging technology, and fostering collaborations, India can make significant strides towards the elimination of cervical cancer.

Q1) What is cervical cancer, and what causes it?

Cervical cancer is a type of cancer that begins in the cells lining the cervix, the lower part of the uterus that connects to the vagina. The primary cause of cervical cancer is persistent infection with high-risk types of human papillomavirus (HPV). Other factors that increase the risk include smoking, a weakened immune system, long-term use of birth control pills, and having a history of sexually transmitted infections (STIs).

Q2) How can cervical cancer be prevented, and what screening methods are available?

Cervical cancer can be prevented through vaccination against HPV, practising safe sex, and avoiding smoking. Regular screenings, such as Pap smears and HPV tests, are crucial for early detection and treatment. The Pap smear detects abnormal cell changes in the cervix, while the HPV test identifies the presence of high-risk HPV. Vaccination, early detection, and adopting a healthy lifestyle play key roles in the prevention and effective management of cervical cancer.

Source: The Indian Express