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Government initiative shines a spotlight on cervical cancer, experts hope it is a possible turning point

Finance Minister Nirmala Sitharaman said in her speech last week that the government will encourage vaccination against human papillomavirus (HPV), which causes cervical cancer, among girls between the ages of 9 and 14. A day later, model and actress Poonam Pandey attracted social media attention (and some headlines) with claims that she had died from the disease. It was a hoax, a stunt supposedly attributed to raising awareness about cervical cancer.

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The false claim sparked some rumors about cervical cancer. But it is the government’s proactive stance to promote vaccines that will raise awareness, encourage early immunization practices and mark a significant step towards preventing unnecessary deaths, scientists said.

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The battle is complex and hard, they admitted, but government intervention will make a difference.

Vaccines against cervical cancer, the second most common cancer among women in India after breast cancer, have not increased due to the costs involved: approx. $4,000 per injection and two or three doses.

“Another concern has been that infections due to certain strains may not be covered by the vaccine. Screening would remain essential,” Dr Gayatri Gogoi, associate professor of pathology and cancer researcher at Assam Medical College, Dibrugarh, told PTI.

“Vaccines to prevent cervical cancer are likely to become cheaper if the government includes the HPV vaccine in the country’s immunization programme,” added Dr Shuchin Bajaj, founder and director of Ujala Cygnus Group of Hospitals. .

The recent announcement is a commendable step towards preventing this deadly disease in young women, Bajaj said.

An estimated 1,23,907 women (over 1.2 lakh) are diagnosed with cervical cancer every year in India and 77,348 of them die from the disease, according to the WHO HPV Information Centre.

India bears a significant share of the global cervical cancer burden and contributed substantially to the 604,000 (over 6 lakh) new cases reported worldwide in 2020.

Although it is not yet clear whether cervical cancer vaccines will be part of the national immunization program or if prices will fall, public health experts said it could well be a turning point.

Dr Atul Mohan Kochhar, executive director of the National Accreditation Board for Hospitals and Healthcare Providers (NABH), agreed with Bajaj and said the move will encourage vaccination of girls for the prevention of cervical cancer. .

“This will be a big step in tackling this disease, which is the fourth most common cancer worldwide and the second most common cancer among women in India,” Kochhar told PTI.

There will be many fewer cases if the vaccine is part of the national immunization programme, Gogoi added.

“This will reduce suffering and associated costs and prevent long-term deaths from cervical cancer,” he said.

According to a report from the American medical center NYU Langone Health, of the more than 150 strains of HPV, 40 affect the genital area but most do not pose a serious health risk. There are at least 12 high-risk strains of HPV, but only two (types 16 and 18) cause most HPV-related cancers, including those affecting the cervix.

In India there are two globally authorized vaccines; a quadrivalent vaccine, Gardasil, marketed by Merck, and a bivalent Cervarix vaccine marketed by Glaxo Smith Kline. While Gardasil covers four strains, including types 16 and 18, Cervarix only targets the two main strains.

A Lancet study last year found that the Cervavac vaccine, which covers four strains and is marketed by the Pune-based Serum Institute of India (SII), is as effective as global vaccines. The estimated cost of the vaccine is around $2,000 for two doses.

About 5 percent of women in the general population are estimated to harbor cervical HPV 16 and 18 at any given time, and 83.2 percent of invasive cervical cancers are attributed to these types, the Center said. of HPV Information.

The figures reveal India’s alarming contribution to about a third of the world’s cervical cancer deaths, Kochhar said.

“Furthermore, more than 365 million women above 15 years of age in India are at risk of developing cervical cancer. “This data certainly reflects the alarming stage at which cervical cancer is becoming one of the most prevalent cancers.”

The reasons behind the high incidence of cervical cancer in India are multifaceted.

“Limited knowledge and delayed screening contribute to the problem, particularly in rural areas with limited access to health care. Cultural taboos also affect screening rates, and socioeconomic challenges, including poverty and low education, impede prevention efforts,” Bajaj said.

“HPV screening and HPV vaccine are the measures available for patients to prevent and fight against the growing cervical cancer,” Kochhar added.

Gogoi noted that the current status of cancer screening attendance is negligible irrespective of various schemes, programs and facilities.

One of the optimistic aspects of cervical cancer is that both prevention and early detection strategies are well established.

“The screening approaches for cervical cancer are visual inspection with chemicals such as acetic acid or Lugol’s iodine, Pap test, and HPV DNA testing at an interval of three to five years,” he said.

A Pap test, also called a Pap test, involves collecting cells from the cervix, the lower, narrow end of the uterus. It can detect changes in cells that suggest cancer may develop in the future.

The HPV DNA test is a laboratory test in which cells from possible infected sites are analyzed for genetic material from the virus.

Experts say treatment options for cervical cancer in India include surgery, radiotherapy, chemotherapy and palliative care.

“Vaccines, although considered cost-effective in the long term, can still pose financial challenges for some people and governments,” said Dr Chinnababu Sunkavalli, senior consultant, surgical oncology and robotic surgical oncology, Yashoda Hospitals, Hyderabad.

He said the cost of cervical cancer treatment can vary significantly, influenced by factors such as cancer stage, geographic location and healthcare infrastructure.

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