28/01/2023
Increasing access to services to prevent and lower the likelihood of cervical cancer during Cervical Health Awareness Month
Dr Vishal Sehgal, President of Portea Medical, emphasises that while a cheap and widely available vaccination can reduce the incidence of cervical cancer in India, other obstacles must also be removed. This can be accomplished by enhancing screening programmes and conducting widespread awareness campaigns to dispel vaccine-related fallacies.
Gynecological malignancies are becoming more prevalent in India, and cervical cancer is still the second most common malignancy among women there. 9.4% of all cancer cases and 18.3% (123,907) of all new cases in India in 2020 were related to it. With an anticipated 604,000 new cases in 2020, cervical cancer will rank as the fourth most frequent malignancy in women worldwide. In 2020, the predicted 342,000 fatalities from cervical cancer took place in low- and middle-income nations, accounting for almost 90% of the total.
Human papillomavirus (HPV), a common sexually transmitted infection, is responsible for almost 95% of occurrences of cervical cancer (STI). Low literacy and awareness, poor screening, social inequity, stigma, and poverty are some of the main causes of the increase in cases.
A pap test, which helps identify any abnormalities in the cervix's cells, is used to detect cervical cancer. Once this is completed, it will be feasible to initiate therapy quickly and stop the cancer from spreading.
How far have we come in India in terms of treatment and prevention?
The HPV vaccine and screening are two proven methods to lower cervical cancer. The condition can be prevented with vaccination, and early diagnosis through screening results in a better prognosis. The WHO unveiled a global plan to hasten cervical cancer eradication. It suggested that 70% of women be examined twice in their lifetime, 90% of women with cervical cancer receive the necessary treatment, and 90% of girls should receive the HPV vaccine by the time they are 15 years old. The situation is drastically different in India, where the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke only recommends opportunistic screening (NPCDCS).
Given the limited resources, mandatory screening for HPV and vaccination are not even close to being possible. The HPV vaccination was first made available in 2008, although it is still not a part of the National Immunization Program. A vaccination that is at least ten times less expensive than the prior ones was just introduced. In addition to resolving the issue of pricing, it is hoped that this would result in more women receiving vaccinations. However, this is only a small portion of the issue. Before we get to the immunisation stage, there are still a few obstacles. The Indian community has very little knowledge regarding cervical cancer. Add to this the stigma attached to the illness, which prevents immunisation. This is because sexual activity is linked to cervical cancer, which further decreases people's willingness to act or speak out about it.
The function of at-home care
Cervical cancer can be prevented in part through vaccination and in part through screening. However, numerous studies have found that the readiness of facilities for cervical cancer screening varies greatly across India. This is made worse by the infrastructural and staffing gaps at the primary and secondary care levels, which pose a significant obstacle to the screening and immunisation processes. Studies imply that healthcare system quality and health policies have an impact on how people screen for cervical cancer. Public-private cooperation are crucial in this situation. It is possible to reach out to more women across all age groups by enhancing primary care through home-based screening and vaccination. Today's top outpatient care organisations in India have the ability to lead in this area.
The next step
While a cheap and widely available vaccine can reduce the incidence of cervical cancer in India, other obstacles must also be removed. This can be accomplished by boosting screening programmes and running widespread awareness campaigns to dispel vaccine-related fallacies. In this context, home healthcare plays a crucial role. In terms of a long-term, sustainable solution to India's rising cervical cancer burden, this is the only path ahead.