India's Silent Crisis: Cervical Cancer And The Urgent Need For Awareness
Dr. Arun H N, Surgical Oncologist & Associate professor, Department of Surgical Oncology. Kidwai Memorial Institute of Oncology- Bengaluru and Braja Kishore Pradhan, Founder of the Aahwahan Foundation shares the urgent need of awareness for cervical cancer.
Even though it is one of the most preventable of cancers, it still kills thousands because of a deficiency in timely screening and information. Cultural taboo keeps women from talking about reproductive health openly, which means barriers for early detection. Healthcare infrastructure in rural enclaves remains skeletal and even where it does exist, awareness is shockingly low. Myths surrounding the HPV vaccine also exacerbate the issue, discouraging families from being proactive. This silent epidemic is more than a health problem, it's a social one that indicates profound gender disparities and institutional failure.
A Disease Without a Voice
Cervical cancer progresses gradually. It begins as a chronic infection with some high-risk types of Human Papillomavirus (HPV), a virus that is often spread through sexual activity. Though it may take years. In some cases, decades to become cancer, it usually doesn't make its presence known until relatively late. That's the first tragedy. Since early cervical cancer is often silent, women will go on with their daily activities unaware of what's going on inside their bodies. It is when symptoms such as abnormal vaginal bleeding, watery or smelly discharge, pelvic pain, or pain during sex manifest that the cancer has reached an advanced stage.
The Life-Saving Potential of Screening
The following is the good news: cervical cancer is one of the cancers that can be identified before developing into cancer.
Regular screening using Pap smears or HPV DNA testing can identify pre-cancerous cervical changes. These tests are cheap, relatively painless, and can be lifesavers, but only if the resources are made available and accessible.
Fewer than 20% of eligible Indian women have ever been screened for cervical cancer. In cities, private clinics and hospitals provide the service, but in rural or slum settings, a woman might never even be aware of the term "cervix", much less what a Pap smear is.
HPV Vaccine: Prevention in a Syringe
The second lifesaver is the HPV vaccine. Given before exposure to the virus, and preferably between the ages of 9 and 14, it can protect against more than 90% of cases of cervical cancer. Even adults up to age 45 can use it, depending on their medical history.
India's addition of the HPV vaccine to its Universal Immunisation Programme is a milestone, but roll-out is patchy. Most parents are still not aware of the vaccine. Others are misled, thinking it impacts fertility or promotes early sex, both baseless concerns. The actual barrier isn't medical — it's social.
The Real Epidemic: Ignorance
Rural, tribal, and slum populations in India have a triple burden: poverty, illiteracy, and weak health infrastructure. In most of these locations, women are instructed to keep quiet and bear the pain. Reproductive health is not discussed. Illusory beliefs galore: cancer is either a curse or a punishment.
This silence is fatal.
Field workers and community health volunteers usually describe the challenges of even initiating discussions regarding cervical cancer. In the absence of credible voices from among the community members, social workers, teachers, or local women leaders, misinformation fills the gap.
What Needs to Change Cervical cancer is not the inevitable consequence that many believe it to be. It is not an untreatable disease. And it is definitely not a death sentence if caught early.
India has to move, not only by policy but by people.
1. Initiate village-level campaigns of education in the local language, with culturally appropriate images and messages. 2. Mobilize screening camps, particularly in tribal tracts and urban slums. 3. Engage schools and parents in HPV vaccine awareness; make it as normal as giving polio drops.
4. Train more women health workers to carry out screenings and establish trust within communities.
Cervical cancer is not only a health problem; it's a matter of social justice. Every woman, no matter where she lives or how much money she makes, should have the chance to live a life free from avoidable disease.
Shattering the silence on cervical cancer is providing a voice to those who have never been heard. It is extending beyond hospital walls, into classrooms, kitchens, and community centres, to shift attitudes and, in doing so, save lives.
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