Context:
Health is rarely one-dimensional, and it should not be perceived as such. Especially in government policy, a comprehensive understanding of the entire issue is essential, incorporating multiple facets in a field strategy to achieve the intended goal optimally. The recent announcement by Union Finance Minister during the presentation of the interim Budget, outlining the government’s plan to promote vaccination against cervical cancer for girls aged nine to 14, is undeniably a positive step.
Relevance:
GS2- Health
Mains Question:
Highlighting the statistics of cervical cancer prevalence in India, suggest an effective way forward strategy to deal with it. (15 Marks, 250 Words).
About Cervical Cancer:
- Cervical cancer, affecting the neck of the womb, stands out among cancers due to its strong association (99%, according to the World Health Organization) with the human papillomavirus (HPV), a common virus transmitted through sexual contact.
- It stands as the second leading cause of cancer-related deaths among women in India, with over 77,000 cases annually, estimated to be the second most frequent cancer among Indian women aged 15 to 44.
- Despite the availability of a vaccine, the concerning reality is that the national prevalence of cervical cancer screening remains just under 2%, with outcomes dependent on the stage of detection.
HPV Connection:
HPV, a common virus affecting almost all sexually active individuals, often presents without symptoms. While the immune system usually clears the virus, high-risk strains can lead to cancer.
India’s Alarming Statistics:
- India bears a substantial burden, representing nearly a quarter of global cervical cancer deaths.
- Annually, around 1.25 lakh women are diagnosed with cervical cancer, and tragically, approximately 75,000 lose their lives to this disease.
Detection of Cervical Cancer:
- Ironically, cervical cancer can be easily detected in a public health setting using minimal tools – the human eye, a dilution of white vinegar, and a dab of Lugol’s iodine.
- These tests, known as VIA (Visual Inspection with Acetic Acid) and VILI (Visual Inspection with Lugol’s Iodine), assist in identifying precancerous lesions and cancer at an early stage, well before advanced disease stages are detectable through cytology.
- A straightforward and brief procedure, cryotherapy, can then be performed while the patient is awake to eliminate abnormal growth.
- Considering the ease of prevention, identification, and treatment of cervical cancer, it is unacceptable that numerous women succumb to the disease.
Global Efforts and India’s Progress:
- WHO’s Elimination Strategy: In 2022, the World Health Organization (WHO) initiated a strategy to eliminate cervical cancer as a global public health concern. The strategy focuses on three pillars: vaccination, screening, and treatment.
- Positive Trends in India: Although India may not achieve the 2030 goals outlined by WHO, there is a glimmer of hope. Incidence rates are decreasing, potentially attributed to factors like sexual hygiene, pregnancy age, contraception use, and individual immune status.
- Comprehensive Approach: Experts emphasize the necessity for a multifaceted approach, including awareness programs, vaccination campaigns, regular screenings, and education to combat stigma.
Way Forward:
Necessity of Screening:
As the government initiates its vaccination program, it should also mandate screening at primary health centers. If abnormalities are identified, cryotherapy should be offered promptly. Relying solely on vaccinating young girls is unlikely to have a significant impact in the short and medium term.
Optimal Age for Vaccination:
Vaccination is recommended for girls aged 9 to 15, providing maximum protection. However, it can benefit adults up to the age of 45.
Conclusion:
The most effective approach to prevent deaths is to implement a comprehensive array of tools as part of a national cervical cancer control program, accessible to all women regardless of age, education, affordability, or social status.
