Cervical Cancer Elimination

According to the world cancer report 2020, India has an estimated cancer burden in 2018 of 1.16 Million new cases, 7,84,800 deaths and 2.26 million 5 year prevalent cases. 1 in 10 Indians will develop cancer during their lifetime and 1 in 15 will die of the disease.

Cervical Cancer is the fourth most commonly occurring cancer in women in the world and the eighth most commonly occurring cancer overall. There were over 500,000 new cases in 2018. India accounts for about 1/5th of the global burden of cervical cancer. Despite decreasing incidence rates in several regions of the country.  

Cervix cancer accounts for 97,000 in cases and 60,000 deaths in India which contributes to 25% and 27% of the global burden of cervical cancer cases and mortality, respectively. Cervical cancer is the second most prevalent cancer among women aged 15-44 years in India. The age adjusted incidence rate of cervical cancer varies widely among registries; highest is 23.07/100,000 in Mizoram state and the lowest is 4.91/100,000 in Dibrugarh state.  

The 5-year relative survival rate for cancer cervix in India has been reported to be approximately 46%, which is much lower than survival rates reported from other Asian countries such as China, South Korea, Singapore, and Thailand. Thus, elimination of cervical cancer in India is urgently needed. 

Cervical cancer disproportionately affects women with lower socio-economic status, who are at a considerable disadvantage in the availability of and access to public health services for prevention and early detection, and therefore this is an equity issue. 

More than 50% cancer patients visit a doctor for the first time, at or past the third stage of cancer, thereby requiring multi-modal therapy, spread over 2-3 years and finally succumb to the disease. Cancer puts a massive personal and financial burden on not only the patient, but also on the patient's entire family with the out-of-pocket expenses being as high as 70% of the total treatment cost. More than 85% of patients with cervical cancer are in the age group of 40 years and above. The maximum numbers of cases were reported in 50–59 years of age group amounting to 27.37% of all cervical carcinoma cases. (Three-Year Report of Population Based Cancer Registries 2012-2014. Bengaluru: National Centre for Disease Informatics and Research National Cancer Registry Program (ICMR); 2016. Mar, Incidence, Distribution, Trends in Incidence Rates and Projections of Burden of Cancer; pp. 1–15.) The age-adjusted incidence rates of cancer cervix reported by majority of Indian cancer registries are much higher than the world age-adjusted incidence rate of 7.9/100,000 population but is lower or similar to cervical cancer incidence rates of 19.2/100,000 population seen in the South-East Asian region. The high burden of cervical cancer in India and Southeast Asian countries is due to poor to moderate living standards, a high prevalence of HPV (more than 10% in women aged more than 30 years) and due to lack of screening.

90% of girls of the age 14/15 will be HPV vaccinated, 70% of women above the age 30 will be screened and 90% of the positive patients will be treated.

• To reduce the incidence of cervical cancer to less than 4 per lakh by 2030
• To educate 90% of families on the symptoms of cervical cancer, its screening methods and use of HPV vaccination for the prevention
• 90% of women in the age group 25 to 65 years shall at least be tested once for cervical cancer screening