- Prelims: Current events of national importance, cervical cancer, Government policies, universal immunization programme, Human Papillomavirus (HPV) etc
- Mains GS Paper II: Government policies and interventions for development in various sectors and issues arising out of their design and implementations etc
ARTICLE HIGHLIGHTS
- January was observed as Cervical Cancer Awareness Month.
- March 4 is observed as International HPV Awareness Day.
INSIGHTS ON THE ISSUE
Context
Cervical cancer:
- It is the second-most common cancer among women in India, mostly affecting the middle-aged.
- With 1,23,907 new cases and 77,348 deaths in the year 2022, India contributed to one-fifth of the global
- Main cause: Presence of persistent high-risk type of Human Papilloma Virus (HPV) infection
- co-factors like low socioeconomic conditions, low immunity status, other genital infections, smoking etc, that facilitate initiation and progression to cancer.
- Cervical cancer is preventable and curable if detected early.
- Most cervical cancer and precancer cases can be detected in the reproductive age group.
- Cervical cancer has a long pre-invasive phase that lasts for 10–15 years.
- This provides a window of opportunity to detect and treat the neoplasia in pre-invasive stages
- Cervical cancer is detected and managed at an early stage, it is found to have over 93 percent cure rate.
- Cervical cancer can be prevented through HPV vaccination of girls.
- It is the fourth most common cancer among women worldwide
- cervical cancer claims the lives of more than 3,00,000 women every year, or one life every two minutes.
- Nine out of 10 women dying of cervical cancer live in lower- and middle-income countries.
India:
- Cervical cancer is the second most common cancer after breast cancer.
- About 500 million women above the age of 15 are at risk of cervical cancer.
- With the current population growth rate, the absolute number of new cases of cervical cancer for all ages in India in 2040 is estimated to be 1,91,347
- An increase of 54% over the number of new cases reported in 2020.
Reasons for high mortality:
- Lack of awareness
- Fear of cancer
- Early symptoms of disease not being evident
- Women not being screened
Strategies for prevention
● Knowledge of HPV epidemiology and its role in causation of cancer has resulted in the development of two major strategies for prevention and early detection:
○ HPV vaccination and screening for precancerous lesions.
● WHO’s strategy outlines a 90-70-90 triple pillar intervention to be implemented by 2030 with an additional focus on high-quality health care and equitable health care services.
○ Targets are:
■ 90% of girls must be fully vaccinated with the HPV vaccine by the age of 15
■ 70% of women must be screened using a high-performance screening test by the age of 35 and again by 45
■ 90% of women detected with cervical pre-cancer and cancer lesions must receive treatment and care.
● Accelerating global health pathways: to health equity for the G20: It highlighted the commitment of India’s G20 presidency to promoting equitable access to vaccines, particularly for lower- and middle-income countries.
● The HPV vaccine was introduced in India in 2008.
○ It is part of the Universal Immunization Programme from 2023.
Challenges:
- Research indicates that the HPV vaccine is not widely accessible to all girls across India.
- It is available in the private market at a significant out-of-pocket cost.
- Many physicians underestimate the incidence and risk of cervical cancer and the HPV infection.
- Physicians underestimate the safety and effectiveness of HPV vaccines.
- The lack of trust in vaccine safety and effectiveness leads to hesitation in recommending the HPV vaccine to parents of age-eligible adolescents.
- Physicians hesitate to recommend this cancer prevention vaccination because HPV infections are primarily transmitted through intimate skin-to-skin contact.
- Feeling that it might be time-consuming to answer parents’ questions regarding myths and misinformation about the HPV vaccine.
HPV vaccine:(Cervavac)
- It is a quadrivalent vaccines, developed by the Serum Institute of India.
- It prevents the entry of four of the most common types of HPV 16, 18, 6 and 11 thereby preventing infections, genital warts, and eventually cancer.
- It will be used in the government campaign.
- The vaccine has to be administered in adolescent girls before they are sexually active.
Way Forward.
- The Federation of Obstetric and Gynaecological Societies of India (FOGSI) and the Indian Academy of Pediatrics (IAP): It has joined hands to remind member obstetricians-gynecologists and pediatricians about the facts of HPV vaccination
- share best practices for effectively communicating with parents about this cancer-preventing vaccine.
- This safe and effective vaccine can help prevent six HPV cancers.
- Five of these occur in women: vulvar, anal, vaginal, throat, and cervical.
- Recommending the HPV vaccine to all adolescents starting at age 9 years is part of completing the IAP immunization schedule.
- The FOGSI Good Clinical Practice Recommendations: It reinforced its recommendation for HPV vaccination to the primary age group of 9-14 years as well as regular screening for every woman above the age of 30 years.
- The FOGSI and IAP seek to ensure that every girl grows up protected from cervical cancer through HPV vaccination and every woman is protected through regular cervical screening.
- They are creating at least 20,000 HPV physician champions in their cadres by mid-2024.
- The member physicians will share the importance of HPV vaccination among their peers and the community at large.
- Physicians are the most respected leaders in society and the trusted source for health-related information. Their leadership is needed to eliminate cervical cancer in India.
QUESTION FOR PRACTICE
Critically examine the role of WHO in providing global health security during the COVID-19 Pandemic.(UPSC 2020) (200 WORDS, 10 MARKS)
