Review of Cervical Cancer Preventive and Screening Strategies in India (original) (raw)

Burden of cervical cancer and role of screening in India

Indian journal of medical and paediatric oncology : official journal of Indian Society of Medical & Paediatric Oncology

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. This study was conducted to assess the burden of cervical cancer in India and review the performance characteristics of available cervical cancer screening tools, so as to provide evidence-based recommendations for application of most practically suited screening test to be used in resource-poor field settings. MEDLINE and Web of Science electronic database were searched from January 1990 to December 2015, using the keywords such as "cervical cancer", "screening", "early detection", "cervical cytology" and "visual inspection", and their corresponding MeSH terms in combination with Boolean operators "OR, AND." Two authors independently selected studies that are published i...

Cervical Cancer: Formulation and Implementation of Govt of India Guidelines for Screening and Management

Indian Journal of Gynecologic Oncology, 2021

Purpose Cervical cancer is the second most common cancers of women in India, despite being largely preventable. This review traces the journey of formulation of the Operational Guidelines for the management of common cancers and its implementation. Methods A literature review was done to document the process of formulation of the guidelines, in addition to inputs from the officials involved in the process of developing them. Results The review covers the pre-existing challenges in the National cancer control program and helps in providing recommendations for the future of cervical cancer screening, considering the COVID pandemic and the limitations of the public health system in India. Conclusion The implementation of early diagnosis of cervical cancer on a national scale as envisaged in the Operational Guidelines for the management of common cancers is a herculean task. A concerted approach for the implementation of cervical cancer control and HPV vaccination will hopefully bring fruitful results going forward.

Cervical cancer screening in India: Strategies revisited

Indian Journal of Medical Sciences, 2007

With the change in the life styles and demographic profiles of developing countries, noncommunicable diseases are emerging to be important health problems that demand appropriate control program before they assume epidemic proportion. One of these is the problem of cancer. In India, cervical cancer is a significant problem in terms of incidence, mortality and morbidity. Cervical cancer is a disease that can be prevented through both primary prevention and early detection using screening techniques. Several screening modalities are now available for early detection of cervical cancer and its precursor lesions. They all differ with regard to their test characteristics, feasibility and economic considerations. This communication reviews different aspects of these screening modalities and provides different options considering mass application.

Epidemiology of cervical cancer with special focus on India

International Journal of Women's Health, 2015

Cervical cancer is on the declining trend in India according to the population-based registries; yet it continues to be a major public health problem for women in India. Multifactorial causation, potential for prevention, and the sheer threat it poses make cervical cancer an important disease for in-depth studies, as has been attempted by this paper. This paper attempts to review the available knowledge regarding the epidemiology and pattern of cervical cancer; types of HPV (human papilloma virus) prevalent among cervical cancer patients and among women in general, high-risk groups such as commercial sex workers, and HIV (human immunodeficiency virus)-positive women; and the role of the national program on cancer in control efforts. The peak age of incidence of cervical cancer is 55-59 years, and a considerable proportion of women report in the late stages of disease. Specific types of oncogenic HPV-16, 18 have been identified in patients with cervical cancer. Other epidemiological risk factors are early age at marriage, multiple sexual partners, multiple pregnancies, poor genital hygiene, malnutrition, use of oral contraceptives, and lack of awareness. A multipronged approach is necessary which can target areas of high prevalence identified by registries with a combination of behavior change communication exercises and routine early screening with VIA. Sensitizing the people of the area, including menfolk, is necessary to increase uptake levels. Vaccination against types 16 and 18 can also be undertaken after taking into confidence all stakeholders, including the parents of adolescent girls. Preventing and treating cervical cancer and reducing the burden are possible by targeting resources to the areas with high prevalence.

Cervical Cancer Prevention Efforts in India

Indian Journal of Gynecologic Oncology

Purpose Cervical cancer is one of the leading cancers among women in India. Its prevention and control require a concerted effort to improve awareness among women regarding primary and secondary prevention strategies as well as access to care for treatment and palliation. A focused strategy is important to reach the World Health Organization's targets for cervical cancer elimination, due to be completed by 2030. Methods Currently available literature was reviewed regarding cervical cancer prevention strategies in India including various national programmes and other initiatives on the part of government, non-governmental organizations and professional organizations. Their applicability to the present situation was assessed. Results National programmes need to build on success stories of various states and neighbouring countries as well as to audit the performance. Strengthening of cancer registries and improvement of linkages between different healthcare levels with incorporation of task-shifting, adding digital technology and supporting programmes that promote women's welfare and health will also provide synergy to cancer control programmes. In the current pandemic era, HPV self-sampling can be an ideal method for screening. The development of an affordable, point-of-care HPV test is urgently needed to facilitate its introduction in low-and middle-income countries. HPV vaccination efforts need to be speeded up. Conclusion Scaling up of cervical cancer prevention with inclusion of widespread HPV vaccination and primary HPV test should be the new standard of care.

Challenges in Cervical Cancer Prevention: Real-World Scenario in India

South Asian Journal of Cancer

In spite of global falling trends, cervical cancer remains a major healthcare challenge for India, South Asia Association for Regional Cooperation region, and other low- and middle-income countries. Our survey was to document the real-world challenges that still exist in India. A total of 316 eligible and complete responses to the 21 questions were analyzed. Screening of mothers and vaccinating their daughters was considered as the most important strategy to prevent cervical cancer by 65.8% (208/316). Screening was offered to all asymptomatic eligible females by 79% (250/316). Improvement in screening rates requires promoting the national program (67.7%; 214/316), strengthening existing infrastructure (62%; 196/316), regular training of primary healthcare workers (57.6%; 182/316), and increasing awareness among schools and colleges (57.9%; 183/316). Almost all responders (93%; 294/316) wanted to have human papillomavirus (HPV) vaccination included in the national immunization schedu...

Cervical cancer screening and prevention: how aware is the Indian woman?

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018

Background: Carcinoma of the cervix is the second most common cancer in women worldwide. It is the commonest cancer among Indian women. Awareness regarding cervical cancer and its prevention is quite low amongst Indian women. The Pap test is a simple and cost-effective technique for early diagnosis of cervical cancer.Methods: It was a cross sectional study conducted in the months of September and October 2018. We included 200 women between 30 and 60 years of age.Results: In present study, out of 200 respondents, 160 (80%) respondents got married after 21 years of age while 40 (20%) respondents got married below 21 years of age. 148 (74%) respondents had 2 children, 30 (15%) respondents had one child while 22 (11%) respondents had 3 children. 166 (83%) had heard about cervical cancer, 24 (12%) knew that cervical cancer can be cured if detected in early stage while only 10 (5%) knew that it can be prevented. 54 (27%) respondents knew that pap smear test should be done as screening tes...

Awareness of cervical cancer risk factors and screening methods among women attending a tertiary hospital in Lucknow, India

International journal of reproduction, contraception, obstetrics and gynecology, 2017

Cancer cervix is the second most common cancer among women after breast cancer worldwide. According to WHO, cancer cervix comprises 12% of all cancers in women and is the leading gynaecological malignancy in the world. In contrast to developed countries, cancer cervix is a major public health problem in developing countries like India. India alone accounts for one-quarter of the worldwide burden of cervical cancers. 1,2 It is one of the leading cause of cancer related deaths, accounting for 17% of all cancer deaths among women aged between 30 and 69 years. It is estimated that cancer cervix will occur in approximately 1 in 53 Indian women during their lifetime compared with 1 in 100 women in more developed regions of the world.

An overview of prevention and early detection of cervical cancers

Indian Journal of Medical and Paediatric Oncology, 2011

Cervical cancer still remains the most common cancer affecting the Indian women. India alone contributes 25.41% and 26.48% of the global burden of cervical cancer cases and mortality, respectively. Ironically, unlike most other cancers, cervical cancer can be prevented through screening by identifying and treating the precancerous lesions, any time during the course of its long natural history, thus preventing the potential progression to cervical carcinoma. Several screening methods, both traditional and newer technologies, are available to screen women for cervical precancers and cancers. No screening test is perfect and hence the choice of screening test will depend on the setting where it is to be used. Similarly, various methods are available for treatment of cervical precancers and the selection will depend on the cost, morbidity, requirement of reliable biopsy specimens, resources available, etc. The recommendations of screening for cervical cancer in the Indian scenario are ...