News Feed | 19 Jan 2024

The Hindu | 19 Jan 2024

Summary

• Cervical cancer is the second-most common cancer among women in India and is caused
by persistent human papillomavirus (HPV) infections. A substantial proportion of HPV
infections occur without symptoms but in some cases, high-risk strains of the virus may
persist and lead to cancer. India accounts for nearly a quarter of all global cervical cancer
deaths.
• In 2022, the World Health Organization (WHO) formulated a strategy to eliminate cervical
cancer as a global public health concern. The strategy involves the complete vaccination of
90% of girls by 2030 with the HPV vaccine, ensuring 70% of women aged 35-45 receive a
high-performance early treatment pre-cancerous lesion test, and 90% of women with
cervical disease receive treatment. Despite India being unlikely to meet these 2030 goals,
experts note a decline in incidence rates.
• The role of awareness programs, vaccination programs, and regular screening to prevent
new cases and deaths are stressed. Importantly, the aim is to detect at the precancerous
stage as cervical cancer is 100% curable at that stage.
• Previously, the pap smear, which involves the scraping and brushing of cells from the
cervix for examination, was the standard testing for cervical cancer. However, issues with
this method lie in its reliance on specialist cytologists to study the smear and low levels of
awareness and follow-up screening, particularly in rural India.
• The recommended method for screening for cervical cancer is now HPV DNA testing, which
tests cells from the cervix for infections with any of the HPV types that could cause cancer.
The WHO recommends this method as the first-choice for cervical cancer prevention.
• There is some history to the rollout of the HPV vaccine in India. In 2010, a trial of the
vaccine by a US-based international non-profit faced backlash after the deaths of seven
girls. The Indian government examined this and criticized the trial's monopolistic nature
and its potential for commercial exploitation.
• Currently, two vaccines are available in India to protect against HPV: Merck's Gardasil and
Serum Institute of India's Cervavac. Plans are in place to expand vaccine production
capacities. Sikkim was the first State in the country to introduce the vaccine in 2018.
• Initial reports indicated that the Central government would start a vaccination programme
in six states in June 2023, targeting girls aged nine to fourteen. However, this did not
materialize, with current reports suggesting rollouts in the second quarter of this year
across three phases over three years.
• Globally, 100 countries have included the HPV vaccine in their national schedules but this
covers only 30% of the global target population. Doctors in India are recommending the
vaccine for girls aged nine to fifteen, emphasizing its greatest efficacy and protection when
administered early.

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