The second most common cancer among women in developing countries is cervical cancer. It is silent, asymptomatic and a killer if not diagnosed in time. Cervical cancer is the first cancer declared for elimination by the World Health Organization (WHO), which recently launched a new campaign, ‘Global Strategy to Accelerate Elimination of Cervical Cancer.’
At a webinar organised recently, a number of experts from leading health organizations like the Harvard T.H. Chan School of Public Health — India Research Center, Project SANCHAR, the American Cancer Society and the Cancer Foundation of India partnered with WHO to discuss the disease in the Indian context. Dr. Rati Godrej, M.D., Internal Medicine and Advisor, Harvard School of Public Health, India Research Center moderated the webinar.
An important takeaway from the webinar was that cervical cancer is preventable and treatable. But, despite being preventable, it is still a serious problem in India. Dr Neerja Bhatla, Unit Head, Department of Obstetrics and Gynaecology at AIIMS, New Delhi and a member of the WHO Director General’s Technical Advisory Group on Cervical Cancer Elimination warned that cervical cancer is likely to affect 80% of women at some point of their lives.
Clarifying that genetics is not a major causal factor, she said that girls who start sexual activity early, multiple partners, large number of pregnancies and teenage pregnancies are High Risk factors. Most cervical cancer cases are caused by the sexually transmitted human papillomavirus (HPV) that also causes genital warts. Other factors that can also increase risk include birth control pills.
Professor Maqsood Siddiqi, Founder Chairman, Cancer Foundation of India said the lack of knowledge about the disease, in both urban as well as rural areas, is a major barrier to women accessing cervical cancer screening, testing, vaccination and treatment. Given the lack of infrastructure, facilities and equipment, Bihar has only one radiotherapy machine for a population of 124 million. Dr Rengaswamy Sankaranarayanan, senior visiting scientist, International Agency for Research on Cancer (WHO), said self-collection of samples can increase participation of women in screening programs since both hospital and community-based screening programs have been affected by COVID-19.
Vaccines are a critical measure for cervical cancer prevention, but often plagued by deliberate misinformation. Dr Bhatla noted the global shortage of vaccines adding that a single dose may suffice for three years. As things stand, American vaccines are expensive, Chinese are way cheaper.
On the possibility of an Indian vaccine, Dr Sankaranarayanan said a promising low-cost and highly efficacious Indian cervical cancer vaccine candidate is in the process of being launched by the end of 2021.
Dr Bakul Parekh, President, Indian Academy of Pediatrics (IAP) regretted that despite cervical cancer vaccine being recommended by IAP for inclusion in India’s national immunization programme, it is yet to be included in the national programme.