Context:

• Cervical Cancer is the second most common Cancer in India with more than 1 lakh new cases and more than 75,000 deaths in 2022. 
• High death numbers is a concern as Cervical Cancer is easily preventable, curable and the only non-communicable disease which can be eliminated.
• Presence of Human Papillomavirus(HPV) is the main cause of this type of Cancer.
• In January 2023, the Central Government announced that the HPV vaccine drive is to be started to eliminate Cervical cancer.

Causes for high incidence of the disease:

• Lack of awareness, fear of cancer, and late diagnosis lead to high mortality.
• Low HPV vaccination uptake as low as only 3% in a study conducted in 5 districts of Andhra pradesh state.
• Leakages in patient care pathway: Follow up treatment of patients to complete the course from screening to diagnosis and treatment is incomplete. In a study in Telangana, 70%-90% of the cases had incomplete treatment.

Elimination Strategy:

• The World Health Organisation(WHO) has given a simple, feasible, scalable three pillared strategy with clear targets and accountability mechanisms.
  • Pillar 1: Widespread HPV vaccination.
  • Pillar 2: Screening
  • Pillar 3: Diagnosis and Treatment of Cervical cancer and pre-cancer.
• The National Programme for Prevention and Control of Cancer, Diabetics, Cardiovascular devices and Stroke(NPCDCS) of Government of India is screening for Cervical cancer from the Primary Health Centre(PHC) level.
  • Simple, easy and affordable screening tests are available through this programme.
  • HPV vaccination is to be provided for girls between 14 to 15 years of age through from this year.

Steps needed:

• Urgent need to increase awareness about cervical cancer causes and prevention.
• Encourage HPV vaccination uptake and address vaccine hesitancy.
• Promote age-appropriate screening, especially with HPV testing.
• Strengthen capacity for pre-cancer treatment, referral networks, and quality care.
• Build partnerships with NGOs, innovators, and public health professionals.
• Ensure continuous efforts in screening programs, integrating latest technology for early diagnosis.
• Strengthen cancer registries and referral linkages.
• Implement mechanisms to reduce financial burden for care.
• Connect all aspects of patient care: swift diagnosis, referral, quality improvement, digital tools, and communication.
• Issue follow-up reminders and integrate palliative care early on.
• Collaborate on research and adopt successful community outreach models.

Elimination of Cervical cancer can contribute to the attainment of Sustainable Development Goal 3.4 of reducing premature deaths by one third by 2030. With the new vaccination drive and the measures available, this goal can be achieved.