India faces a silent cervical cancer crisis: Every 8 minutes, a woman dies, but HPV vaccine and early screening could prevent it
National Academy of Medical Sciences
(NAMS) is urging the Indian government to categorise cancer as a
notifiable disease
in order to improve its monitoring, prevention, and treatment strategies. This would allow health authorities to track cases more effectively and respond swiftly to emerging trends. NAMS has also highlighted the role of indigenous
HPV tests
and vaccines as crucial tools in the fight against cervical and
breast cancer
, with plans to incorporate them into the national health programme.
Indigenous HPV tests: A game changer for early detection
On the 65th foundation day of NAMS, officials presented a comprehensive report from the task force on cervical and breast cancer in India. Dr Neerja Bhatla, a leading expert and vice president of NAMS, discussed the current state of
cervical cancer
testing, as reported by TOI. Although HPV testing is the primary method for detecting cervical cancer, its high cost has limited its widespread use. To overcome this challenge, indigenous HPV tests have been developed. These tests are more affordable, easier to use, and require less training, making them suitable for implementation in primary healthcare centres.
According to the TOI report, Dr Bhatla noted, "Positive test results shouldn't cause alarm. They only indicate a potential risk. Cervical cancer develops gradually through a precancerous phase and remains preventable and treatable when detected early." The task force anticipates that these new tests will be incorporated into India's national programme, offering a simplified, cost-effective approach to cancer screening.
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HPV Vaccination: A key to prevention
In addition to improved testing, NAMS is advocating for the inclusion of the HPV vaccine in the national immunisation programme. This vaccine is a critical tool in preventing cervical cancer, and the National Technical Advisory Group on Immunisation (NTAGI) has already recommended its inclusion. However, there are logistical challenges, particularly regarding whether a single or double dose regimen should be adopted. Experts are currently conducting trials on single-dose vaccines, with results expected in the coming years.
The HPV vaccine's potential to significantly reduce cervical cancer incidence is enormous, but logistical considerations must be addressed. The Indian government is working to ensure the capacity for nationwide implementation, which includes determining the most effective dosage and ensuring equitable distribution.
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A stark cancer reality: The need for comprehensive data
According to NAMS, comprehensive data collection is essential for effective policy formulation and cancer prevention. The task force's literature review found that
cancer screening in India
is currently insufficient, especially for cervical and breast cancers. NAMS officials stressed that all women over the age of 30 should undergo regular cancer screening, but the country's current screening rates remain low.
Cervical cancer is the second most common cancer among women in India, despite being the fourth most common globally. One woman dies from cervical cancer every eight minutes in the country, making it a significant public health concern. Similarly, breast cancer, which now accounts for 13.5% of all cancers in India, has seen a dramatic increase in incidence over the past few decades. Today, India records one breast cancer diagnosis every four minutes.
Improving infrastructure and screening for better outcomes
Prof SM Bose, a council member of NAMS, provided a detailed analysis of breast cancer care systems across India. The task force found that the country faces significant shortcomings in diagnosing and treating breast cancer. With approximately 200,000 new cases annually, the task force found that diagnostic services, particularly imaging and pathology, are inadequate. There is also a lack of access to advanced treatment options such as surgery, radiotherapy, and systemic therapies.
To address these gaps, NAMS is calling for an urgent upgrade to India's healthcare infrastructure. Strengthening diagnostic services and expanding treatment options will be crucial to improving outcomes for breast cancer patients. Furthermore, the task force advocates for a national screening programme that focuses on early detection and prevention, which is vital for reducing the cancer burden.
The 90:70:90 Target for 2030
NAMS has set an ambitious target for the next decade: to achieve a 90% vaccination rate, 70% screening rate, and 90% timely treatment for diagnosed cervical cancer cases by 2030. Reaching these targets would significantly reduce the incidence of cervical cancer in India, with the goal of bringing the rate to fewer than 4 cases per 100,000 women annually.
The need for comprehensive cancer prevention and treatment strategies in India is more urgent than ever. With innovative solutions such as indigenous HPV tests, vaccines, and improved healthcare infrastructure, there is hope for better early detection and more effective treatment. The push for cancer to be classified as a notifiable disease will further strengthen the country's ability to respond to the growing cancer crisis. By implementing these recommendations, NAMS believes that India can significantly reduce cancer mortality and ensure a healthier future for millions of women.
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