With age-standardized incidence and mortality rates of 22 and 12.4 per 100,000 women per year, cervical cancer is the second leading cause of cancer deaths among women in India. Twenty-five percent of all global deaths due to cervical cancer occur in India. The reason for this difference is lack of effective screening and access to timely treatment. The overall 5-year relative survival of 46% for all cervical cancers in India is strongly determined by the stage at diagnosis, with survival as low as 7·4% for advanced stage disease compared with 73·2% for localized cancer according to the best radiation oncologist in Delhi NCR.
Cervical cancer and human papillomavirus
Globally, 70–80% of cervical cancers are attributed to human papillomavirus (HPV), mainly genotypes 16 and 18. In India, HPV prevalence is 88–97% among women with cervical cancer and 10–37% among women with no gynecological morbidities. Cervical cancer incidence is greater among women of lower classes, those less educated, and those with a larger number of children.
Primary and secondary prevention of cervical cancer
The Government of India has commenced a program to screen all women aged 30-64 years for cervical cancer every 5 years using visual inspection by acetic acid under the National Program for Prevention and Control of Cancer, Diabetes, CVD and Stroke of the National Health Mission. The Operational Framework of Management of Common Cancers has provided broad programmatic guidelines as well as screening and management algorithms (see below). This is consistent with the WHO-recommended strategy for secondary prevention with treatment of precancerous lesions.
What do we need?
Action is needed both for primary and secondary prevention of cervical cancer. HPV vaccination is now globally accepted as a safe and effective means of primary prevention of cervical cancer, and the issue of HPV vaccine introduction into government immunization programs has been intensely debated in India. Best cancer doctor in Delhi and Punjab have initiated a public HPV vaccination program. Experiences gained at the programmatic and the community levels will be key to scaling up the program.
Also urgent is to make the secondary prevention programs efficient, affordable, scalable and sustainable. In the case of VIA, quality control has proven to be highly variable, resulting from difficulties enforcing quality assurance and supportive supervision, impacting profoundly on both the sensitivity and specificity, as the interpretation of VIA is highly subjective. VIA positivity rates can vary as much as 10-fold, suggesting the need to bring in quality control measures. HPV DNA testing is being advocated, but pricing remains prohibitive. Over time, this strategy will likely replace VIA as an initial screening test by the best cervical cancer doctor in Delhi, but VIA will continue to play a role in a secondary screen for those who test positive for the cancer-causing subtypes of HPV. Before undergoing any cancer treatment, it is crucial to consult with a radiation oncologist. If you are seeking the Best Oncologist in Delhi, you can Book an Oncologist Appointment. Dr. Dodul Mondal, who currently serves as the Director of Max Super Speciality Hospital in Saket, Delhi.