Cervical cancer is preventable
Cervical cancer is preventable
Cervical cancer is a major cause of cancer mortality in women and more than a quarter of its global burden is contributed by developing countries. In India, in spite of alarmingly high figures, there is no nationwide government-sponsored screening program
In the 70s and 80s, scientists and clinicians had a single goal of detecting cervical cancer at an early stage. As there was no successful treatment for the late-stage of cervical cancer and prevention was not possible because the cause of cervical cancer was unknown. Disease patterns looked like the spread of a sexually transmitted disease. Researchers focused on the association between disease and women’s sexual activity.
Pap smears screened for early-stage cancers and precancers.
Then between 1980 to 1900s we came to know that cause of cervical cancer was HPV (Human papilloma virus). Today, most screening laboratories use molecular tests on cells collected from the cervix during Pap tests to look for high-risk HPV types that can lead to cervical cancer. Automated HPV DNA testing is now the standard of practice in developed cpuntries.
In 2006 HPV vaccine was introduced and slowly vaccination was started world wide. With vaccination, cervical cancer incidence started decreasing.
HPV vaccine effect on cancer rates and trends in the United States population was obvious. Cervical cancer screening is a success story. This cancer is now rare in the United States and other developed countries. The old screening model of annual Pap smears prevented many cervical cancer deaths. Technology allows for more precise, less frequent screening that can catch HPV infection before cancer starts.
In today's era, in spite of the availability of HPV vaccines and affordable and effective methods for early detection and treatment of cervical cancer precursor lesions, cervical cancer still continues to be a public health problem in India. The age-adjusted incidence rates of cancer cervix reported by majority of Indian cancer registries are much higher than the world age-adjusted incidence rate of 7.9/100,000 population but is lower or similar to cervical cancer incidence rates of 19.2/100,000 population seen in the South-East Asian region. The high burden of cervical cancer in India and Southeast Asian countries is due to poor to moderate living standards, a high prevalence of HPV (more than 10% in women aged more than 30 years) and due to lack of screening.
In India, despite such alarming statistics, there has been no synchronized initiative from public health authorities for prevention and control of cervical cancer.
However, for any cervical screening program to be successful in addition to the use of a reliable and accurate screening test, high rates of coverage and the ability to effectively provide treatment to test positive women are very important. Hence, the development of health services and the generation of community involvement are keys to the initiative in reducing the burden of cervical cancer.
Dr. Rakesh Rai. MS, FRCS, MD, CCT, ASTS Fellow.