How to deal with cervical cancer in time

Cervical cancer is a cancer that has been neglected in India despite having highly effective screening methods that can not only prevent cervical cancer but also eliminate it through early diagnosis and treatment.

Cervical cancer remains the second most common malignancy in women, affecting 530,000 women and causing nearly 2,70,000 deaths annually worldwide. It is geographically unevenly distributed, the highest global disease burden is confined to developing countries, and facilities to combat the disease are ineffective.

In India, it is estimated that 1,25,000 new cases are detected each year and nearly 70,000 people die prematurely from undiagnosed and untreated cervical cancer. It is a common cause of premature death in women of reproductive age, with devastating effects on families and increasing social inequalities. Meanwhile, the implementation of effective and systematic screening programs in developed countries has reduced the incidence of cervical cancer by 70%.

Cancer treatment affects three main areas. First, there is a huge financial burden on patients and families. Second, human time is lost for the country, both for patients and their families who are immersed in cancer treatment and take time and effort. And third, it has a social and psychological impact on families that is largely unmeasured and addressed.

The most successful strategy for cervical cancer prevention is to screen women with cervical cytology, a routine test called cervical cancer screening. It is a well-established and organized population-based screening program that has been implemented in developed countries for the last 50 years. Early diagnosis and treatment have resulted in significant reductions in cervical cancer incidence and mortality in these countries.

There are many problems with cervical cancer screening in India, but above all it is the large population. The second most common factor is the lack of awareness and acceptance that the simple HPV virus can cause devastating cancers. India is also a country of diversity, with differences in socio-cultural practices, differences in medical infrastructure such as state-of-the-art equipped tertiary hospitals, unequipped public and community health centres, and uniformized screening available. For example, there is no screening strategy. There is also no uniformity of resources.

There is also a lack of government strategies to mandate various cervical screening programs at the national and state levels. A major reason is the lack of priority given to health issues that affect women, especially those related to cervical cancer. There is also the issue of the funding and resources required to screen a large population of eligible women. Whatever the reason, cervical cancer screening in India is opportunistic and women can decide whether or not to get screened.

The link between human papillomavirus (HPV) infection and cervical cancer was established in the early 1980s, and it is now proven that HPV infection causes cervical cancer. There are many types of HPV viruses, of which HPV types 16 and 18 are responsible for 70% of cervical cancers worldwide. As such, they have been designated as a high-risk type of HPV virus and are known to be carcinogenic. It’s a virus that causes cancer.

Most HPV infections are transient, asymptomatic, and resolve spontaneously in immune-compromised women. Her 80% of infections clear within her 3 years. Infection with her high-risk type of HPV that persists for at least 6 months is the first step in the progression of HPV infection to cervical cancer.

Various other predisposing factors associated with the development of cervical cancer include early marriage, multiple pregnancies, multiple sexual partners, smoking, poor hygiene, HIV infection, substance abuse, and multiple sexual partners. I have.

HPV infection is spread primarily by skin-to-skin contact, usually sexual contact, but can also be spread by fomites. Because HPV infection is asymptomatic, it is difficult to identify infected women and the initial damage caused by the virus. The best way to detect infection is to have her HPV tested, a new technique developed to screen for cervical cancer.

There are now new guidelines to replace the HPV test instead of doing a Pap smear for cervical cancer screening. Also, if a woman is infected with her HPV virus at high risk, triage for cervical cancer screening and colposcopy to detect precancerous conditions of the cervix. At this stage, if a woman is diagnosed and treated on time, she is 100% cured. The advantage of the HPV test is the high negative predictive value and the near zero risk for her to develop cervical precancerous conditions at 5-6 years. This feature of her HPV test allows for longer screening intervals and fewer screening visits in a woman’s lifetime compared to Pap smear testing, which must be done every two to three years.

The establishment of the central role of HPV infection in cervical cancer has opened new horizons for primary prevention by combating infection and developing vaccines against HPV infection.

Therefore, HPV testing and HPV vaccination are the most effective ways to prevent HPV infection. Australia has a highly effective national cervical screening programme, with his HPV vaccination in both boys and girls for the past 15 years. This is expected to eradicate cervical cancer by 2025. His HPV vaccination in the program and country has reduced cervical cancer cases.

This has prompted the World Health Organization (WHO) to call for action to globally eradicate cervical cancer, a preventable cancer. Countries recommend screening at least 70% of women aged 35 and her 45 with a high performance HPV test by 2030 to eradicate cervical cancer.

WHO’s vision: A world without cervical cancer – The goal by 2030 is to have fewer than 4 cervical cancer cases per 100,000 women. This can only be achieved by:

• 90% of girls fully HPV vaccinated by age 15
• 70% of women were tested for HPV at ages 35 and 45 and all were adequately managed
• 90% of women are diagnosed with cervical disease and treated for precancerous lesions and invasive cancer. Currently, only 5-6% of cervical screening is done in India, and HPV vaccination is negligible. India therefore faces a huge challenge to reach her WHO vision goals.

Today, a woman dies every eight minutes in India from cervical cancer, a completely preventable cancer.

Fighting this disease is not the responsibility of governments alone. Businesses and NGOs must join us to fight this silent killer.