India Contributes One-Fifth of Global Cervical Cancer Burden
HPV Vaccine, The Road To Eradicate Cervical Cancer
India contributes about one-fifth of the global cervical cancer burden. Cervical cancer remains a significant health concern in India, with a high incidence that underscores the importance of prevention strategies. Despite advances in health care, cervical cancer remains the second most common cancer amongst women in India, with 1.27 lakh cases and around 80,000 deaths being reported annually. The incidence is often linked to low awareness, limited screening programs, and inadequate access to healthcare.
Dr Hrushikesh Vaidya, Medical Director and Chairman Horizon Group of Hospitals said “Several factors increase the risk of developing cervical cancer. Persistent infection with high-risk strains of human papillomavirus, a common sexually transmitted infection, is the primary cause. HPV is a primary culprit in the development of cervical cancer. In response to this pressing public health challenge, HPV vaccination emerged as a cornerstone of a comprehensive strategy for disease prevention and health promotion. Associated risk factors include early initiation of sexual activity, multiple sexual partners, smoking, a weakened immune system, and long-term unsupervised use of oral contraceptives.”
Dr Ria Vaidya, CEO, Horizon Group of Hospitals said “Protection is very important because females are the leaders of the future generation and without them, there is no world. Nearly all cervical cancers are caused by an infection from certain types of HPV. It takes 15 to 20 years for the disease to develop. The HPV vaccine has been shown to significantly reduce cases”.
Dr Ria Vaidya further said “The World Health Organization has outlined the ‘90-70-90’ targets by 2030 — for 90% of girls to be fully vaccinated with the HPV vaccine by age 15, for 70% of women to undergo cervical cancer screening tests by the age of 35 and 45, and for 90% of women with cervical cancer to be treated. These targets represent milestones in the global effort to eradicate cervical cancer and highlight the pivotal role of India’s call for HPV vaccination in achieving this goal”.
Dr Manali Shilotri, Leading Gynaecologist and Consultant Horizon Prime Hospital said “Sexually transmitted human papilloma virus infection is the most important risk factor for cervical intraepithelial neoplasia and invasive cervical cancer. The worldwide incidence of cervical cancer is approximately 510,000 new cases annually, with approximately 288,000 deaths worldwide. Unlike many other cancers, cervical cancer occurs early and strikes at the productive period of a woman’s life. The incidence rises in 30–34 years of age and peaks at 55–65 years, with a median age of 38 years. Estimates suggest that more than 80% of the sexually active women acquire genital HPV by 50 years of age”.
Dr Manali Shilotri further said “The sad part is, that there are no symptoms in precancerous conditions. Thus, regular screening for cervical cancer is crucial in identifying precancerous lesions early when they are most treatable”.
About HPV
HPV is a sexually transmitted infection and is responsible for almost all cases of cervical cancer – the fourth most common cause of cancer in women worldwide. The vaccination programme started in 2008 with girls offered the vaccine. Now all teenagers are offered this vaccine.
- There are more than 100 types of HPV
- Many women will be infected with HPV over the course of their lifetime without any ill-effect
- In the vast majority of cases, there will be no symptoms and the infection will clear on its own, but in some cases persistent infection can lead to cervical disease
- Some types of HPV are high-risk because they are linked to the development of some cancers
- Nearly all cervical cancers (99.7%) are caused by infection from a high-risk HPV
- Many types of HPV affect the mouth, throat or genital area. They are easy to catch – you can get HPV from sexual contact
Side Effects Of HPV Vaccine
The most common adverse reactions are local reactions like pain (mild to moderate) in 83%, swelling with erythema in 25% and systemic adverse effects such as fever in 4% of the people. No serious vaccine-related adverse events have been reported. The vaccine is not recommended for use in pregnant women. Although it has not been causally associated with adverse outcomes of pregnancy, data are limited. Any exposure to the vaccine during pregnancy must be immediately reported. Lactating women and immunosuppressed female patients can receive the vaccine. The efficacy and the degree of immune response could be poor in the latter group.
Tests For Screening
Screening tests can help detect cervical cancer and precancerous cells that may one day develop into cervical cancer. Screening for cervical cancer and precancerous changes is suggested at the age 21. The tests are usually repeated every few years.
Screening tests include:
- Pap test : A Pap test can detect cancer cells in the cervix. It also can detect cells that have changes that increase the risk of cervical cancer. These are sometimes called precancerous cells.
- HPV DNA Test: The HPV DNA test involves testing cells from the cervix for infection with any of the types of HPV that are most likely to lead to cervical cancer.
Increasing accessibility to these screening methods and promoting routine check-ups for women from 25 years of age to 35 years, especially in rural areas, is vital.
Treatment
If precancerous lesions are detected during screening, prompt intervention is necessary to prevent progression to invasive cancer. Timely management of precancerous conditions is instrumental in preventing the development of cervical cancer.
Treatments may include
- Cryotherapy
- Laser therapy,
- Cone biopsy depending on the severity and location of abnormalities. If you might have cervical cancer, testing is likely to start with a thorough exam of your cervix. A special magnifying instrument, called a colposcope, is used to check for signs of cancer.
If you’re diagnosed with cervical cancer, you might need other tests to find out the extent of the cancer, also called the stage. Your health care team uses the information from staging tests to plan your treatment.
Tests used for cervical cancer staging include:
- Imaging tests.Imaging tests make pictures of the body. They can show the location and size of the cancer. Tests might include X-ray, MRI, CT and positron emission tomography (PET) scan.
- Visual examination of your bladder and rectum.Your doctor may use special scopes to look for signs of cancer inside your bladder and rectum.
The stages of vaginal cancer range from 1 to 4. The lowest number means that the cancer is only in the cervix. As the numbers get higher, the cancer is more advanced. A stage 4 cervical cancer may have grown to involve nearby organs or spread to other areas of the body.
Conclusion
The Narendra Modi government’s support in encouraging the vaccination of girls from 9-14 years of age against cervical cancer stands out as a pivotal move towards safeguarding women’s well-being. Combating cervical cancer in India requires a multi-faceted approach. Comprehensive awareness campaigns, improved access to healthcare and the integration of HPV vaccination into routine immunisation programs are essential.
