Close cervical cancer gap in India, focus on prevention, equity

A modelling study in The Lancet has estimated that India can prevent more than 10 million cervical cancer cases over the next century if it achieves the WHO’s targets on HPV vaccination — 90 per cent of girls to be vaccinated by age 15; 70 per cent of women to be screened at ages 30 and above; and 90 per cent of patients to receive treatment. The scale of that possibility is extraordinary. But so is the scale of the challenge. India accounts for one of the world’s heaviest cervical-cancer burdens, with more than 1.2 lakh new cases and roughly 80,000 deaths each year. Cervical cancer is among the most preventable forms of the disease, yet for many women — especially those in rural districts, poorer households and socially marginalised communities — access to early screening, reliable diagnosis, treatment that is not prohibitively expensive and preventive vaccination remain a distant reality.

The Human Papillomavirus (HPV) vaccine was first introduced in India in 2008, but its uptake remained limited due to safety concerns, patchy information dissemination, logistical gaps and sociocultural barriers. Nearly two decades later, in February this year, an HPV vaccination programme for adolescent girls was launched, but participation has been uneven. Screening rates, too, remain distressingly low: Only around 2 per cent of eligible women undergo regular testing. Disparities within India are stark. Tamil Nadu has achieved screening rates above 10 per cent, while Assam and West Bengal register figures as low as 0.2 per cent. The outcome is a disease that disproportionately punishes the vulnerable.