Cervical cancer prevention: Cervical cancer remains a significant global health concern, with an estimated 6,04,000 new cases and 3,42,000 deaths worldwide in 2020 alone (WHO, 2020). However, taking control of our health can significantly improve our well-being. With effective prevention strategies such as screening and vaccination, a substantial portion of cervical cancer cases can be prevented. To answer the frequently asked question – Should we screen, vaccinate, or do both? It is crucial for everyone to understand that cervical cancer can be prevented.
‘Regular screening’ helps in early detection and better prognosis. Parallelly ‘vaccinations within the age group of 9yrs to 15yrs’ can-do wonders in eradicating the same. We have seen that vaccines have been instrumental in defeating deadly diseases like measles, mumps, polio, and tuberculosis, ensuring a healthier future for generations to come.
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The scenario
Early diagnosis is crucial in battling cervical cancer, prevalent in India and globally. Cervical cancer screening programs, utilizing Pap smears and HPV tests, significantly reduce incidence, with organized screening reducing cases by 60-70% (Ronco et al., 2018). Raising awareness among men and women is vital for prevention efforts.
Current screening rate in India
Despite the advantages of screening and vaccination, challenges such as limited healthcare access and vaccine hesitancy persist. Despite international recommendations, the current screening rate in India remains dismally low, standing at approximately 1.2%. This low uptake significantly contributes to the high incidence and mortality rates of cervical cancer nationwide. Late-stage diagnoses, often due to limited screening, result in fewer treatment options and poorer outcomes. Several factors contribute to this low rate, including lack of awareness, cultural barriers, accessibility issues, and inadequate healthcare infrastructure, especially in rural and underserved regions. Increasing screening rates is imperative for early detection and effective treatment, ultimately leading to improved outcomes and reduced mortality rates.
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Balancing short- and long-range approaches in combating cervical cancer
Balancing immediate and long-term strategies in cervical cancer prevention is essential. Both vaccination and screening play crucial roles, with vaccination impacting long-term outcomes and screening offering immediate and long-term benefits. While vaccination prevents cancer in the future, screening detects precancerous lesions promptly. Resource allocation is key; with ample resources, both vaccination and screening should be prioritized. However, India’s low screening rate poses challenges, and focusing solely on vaccination could lead to dire outcomes, as thousands of women die from cervical cancer annually. Urgent efforts to increase screening rates are imperative to prevent future deaths alongside vaccination initiatives.
Navigating the challenges
Public health organizations advocate for comprehensive strategies, combining screening and vaccination to prioritize underserved populations. Cost-effectiveness analyses support integrating these approaches, improving outcomes, and reducing costs. Future efforts should focus on innovative screening technologies and optimized vaccination strategies to further reduce cervical cancer’s global burden.
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The Way Forward
Union Finance Minister Nirmala Sitharaman announced government’s plans to focus on vaccination against cervical cancer for girls aged 9 to 14 as a part of her Interim Budget 2024. To progress, the national immunization campaign must ensure states commit resources to screening before introducing the HPV vaccine. The announcement about the funds from the government gives a hope to first expand screening cervical cancer, this looks like prevention is taking a multifaceted approach, combining screening, vaccination, and targeted interventions to address barriers to access and uptake. By leveraging both screening and vaccination, we can make significant strides towards eliminating cervical cancer, potentially eradicating it altogether. Increased awareness and preventive measures are crucial for tackling HPV prevalence through regular screenings.
By Dr. Sravani Reddy G, Global COO and Director of Board, Ojaska
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