TAG: GS 3: SCIENCE AND TECHNOLOGY
THE CONTEXT: Cervical cancer, the second most prevalent cancer among women in India, is primarily attributed to persistent human papillomavirus (HPV) infection. As January marks Cervical Cancer Awareness Month, understanding the significance of periodic testing for HPV becomes crucial in the battle against this preventable and treatable form of cancer.
EXPLANATION:
Cervical Cancer in India
- Cervical cancer, originating in the cervix, is a prevalent concern for women in India, where it ranks as the second most common cancer.
- The World Health Organization (WHO) reports that almost all sexually active individuals contract HPV at some point, with certain high-risk strains posing a risk for cancer development.
- Shockingly, India accounts for nearly a quarter of global cervical cancer deaths, with approximately 1.25 lakh new cases diagnosed annually, leading to around 75,000 deaths.
WHO’s 2030 Strategy: Vaccination, Screening, and Treatment:
- In 2022, the WHO unveiled a comprehensive strategy to eliminate cervical cancer globally by 2030.
- The three-pronged approach involves achieving 90% HPV vaccination coverage for girls by age 15, 70% of women undergoing high-performance screening between 35 and 45 and ensuring 90% of identified cases receive prompt treatment.
- Although India faces challenges in meeting these goals, there has been a notable decline in incidence, attributed to various factors, including sexual hygiene, pregnancy age, and contraception use.
The Crucial Role of Awareness, Vaccination, and Screening:
- The need for a multifaceted approach encompassing awareness programs, vaccination drives, and regular screening to prevent new cases and reduce fatalities have been emphasized.
- Eradicating stigma through educational initiatives is highlighted as essential. Detecting cases at the precancerous stage is emphasized, as it presents a 100% curability rate.
Evolution of Cervical Cancer Screening and the HPV Vaccine
- Historically, pap smear was the gold standard for cervical cancer screening, involving the examination of cervix cells every three years.
- However, challenges like the need for cytologists and low awareness hindered its effectiveness, especially in rural areas.
- The WHO now recommends HPV DNA testing as the preferred method for its accuracy and lower susceptibility to quality issues.
- it is suggested that self-sampling could be an additional option, backed by studies showing equivalence to physician-collected samples.
- Despite initial setbacks in India’s HPV vaccine rollout in 2010, the WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) underscores the vaccine’s effectiveness in preventing 70% of cervical cancers caused by HPV serotypes 16&18.
- SAGE’s recent recommendation supports a single-dose regimen, offering robust protection.
- Currently, India offers two vaccines, Gardasil and Cervavac, with ongoing efforts to expand vaccine coverage.
Government Initiatives and Challenges:
- Sikkim led the way in 2018 by introducing the HPV vaccine, achieving impressive coverage.
- India’s National Technical Advisory Group on Immunisation (NTAGI) recommended incorporating the vaccine into the Universal Immunisation Programme, targeting 9 to 14-year-old girls.
- Despite reports suggesting a rollout in 2023, uncertainty persists, with the Union Health Ministry yet to confirm plans.
- Globally, 100 countries have introduced the HPV vaccine, covering 30% of the target population.
- Pediatricians now advocate routine HPV vaccination for girls aged nine to 15, emphasizing early dosing for optimal efficacy and protection.
- Addressing vaccine hesitancy is crucial, with effective communication playing a key role in dispelling anxieties and misinformation.
The Way Forward: Global Collaboration and Scaling Up Initiatives
- As Cervical Cancer Awareness Month prompts reflection, the International Agency for Research on Cancer emphasizes the need for intensified screening programs, improved HPV vaccination coverage, and enhanced access to affordable treatment.
- Global collaboration is pivotal in achieving the WHO’s 2030 targets and ultimately eliminating cervical cancer as a public health concern.
- The battle against cervical cancer in India necessitates a comprehensive approach encompassing vaccination, screening, and awareness.
- Periodic testing for HPV, coupled with timely vaccination and effective communication strategies, holds the key to preventing and treating this formidable health challenge.
- As the world strives for a cervical cancer-free future, concerted efforts at the individual, community, and governmental levels are imperative.