India has come out as the major contributor to cervical cancer in Asia, a study published in The Lancet journal on Wednesday revealed.
According to the study, more than 58 percent of all cases of cervical cancer globally were estimated in Asia, with India accounting for the highest number of cases at 21 percent followed by China at 18 percent.
“Cervical cancer is a major cause of morbidity and mortality in India . The study in Lancet does well to talk about the immense disease burden in India which is a public health concern , though over last three decades there has been a decline in the prevalence as well as mortality due to cervical cancer in our country,” Dr Prashant Mehta, Senior Consultant, Department of Medical Oncology/Hematoncology/BMT, Amrita Hospital, Faridabad told Financial Express.com.
The study also revealed that out of the 40 percent of total deaths from cervical cancer 23 percent occur in India followed by 17 percent in China.
“We have indeed come a long way in controlling the menace of Cervical Cancer in India. We used to see nearly 38/1,00,000 Indian women affected with cervical cancer in 1980s. We see it less commonly now, affecting about 18/1,00,000 our women-years annually, thanks to increasing awareness and timely access to health care, but it still continues to be a major health concern for us, especially in the under-developed parts of our country,” Dr. Shubham Jain, HOD & Consultant of Surgical Oncology at HCMCT Manipal Hospitals, Dwarka, New Delhi told Financial Express.com.
There were over 6,00,000 estimated new cervical cancer cases and over 3,40,000 deaths in 2020.
It is noteworthy that the incidence was much more than the World Health Organization’s threshold of 4 per 100,000 women to consider cervical cancer eliminated as a public health problem in populous countries including China (10.7 cases per 100,000 women), India (18.0 cases), Indonesia (24.4 cases), Russia (14.1 cases), and Brazil (12.7 cases).
According to the study, targets to reach the WHO elimination threshold by 2030 will be missed unless countries scale up screening programmes, improve coverage of human papillomavirus or HPV vaccination and improve access to affordable treatment.
The study also found that in 2020 rates of cervical cancer cases were 13 per 100,000 women per year and there were seven deaths per 100,000 women per year. Incidence rates in 172 out of 185 countries exceeded the four cases per 100,000 women per year, it said.
In 2020, the global health agency announced a target to accelerate the elimination of cervical cancer as a public health problem, aiming to reduce incidence below a threshold of four cases per 100,000 women per year in every country by 2030.
“Nearly 1 out of every 5 women getting diagnosed and dying of cervical cancer globally is an Indian. There are substantial geographical and socioeconomic disparities seen in the numbers and care of patients affected with cervical cancer globally, which is what Close the Care Gap campaign is all about. With the Global Cervical Cancer Elimination Initiative, we are striving to bring this public health problem down to 4/1,00,000 women years,” Dr. Jain told Financial Express.com.
The study was conducted to track progress and provide timely evidence to remain aligned with the targets set by WHO for eliminating cervical cancer as a public health problem.
“We need to strictly adhere to the “90-70-90″ principle laid down, which means ensuring 90% coverage of vaccination of girls between the ages of 9-14 against HPV (the major causative reason for cervical cancer); providing for adequate cervical cancer screening opportunities to 70% of our women between the ages of 35-45 and assuring access to quality medical care for 90% of women diagnosed with cervical cancer,” he added.
Cervical Cancer Vaccine in India
Human papillomavirus vaccines are vaccines that prevent infection by certain types of human papillomavirus which is one of the leading causes of cervical cancer.
In September this year, Union Minister Dr. Jitendra Singh had announced the launch of India’s first indigenously developed vaccine, ‘CERVAVAC’. According to reports, the vaccine will be roll out next year for girls aged 9-14 years.
“With Cervavac , the Indian grown vaccine developed by Serum Institute becoming available possiblly at a cost of 400 Rs per dose and intensified screening at the primary health and rural health care level , we will be able to overcome this challenge sooner than anticipated. Present vaccines costing 3500 to 6000 INR have not been able to penetrate the population although these are commercially available,” Dr. Mehta told Financial Express.com.
Screening and vaccination are the two best strategies to reduce the cervical cancer incidence and mortality by more than 90 percent, he added.
