Editorial of the Day (16th Jan): A Jab in Time

Context: The article titled “A jab in time” emphasises the importance of a comprehensive approach to cervical cancer prevention and treatment.

About Cervical Cancer

• It is the second-most common cancer among women in India, with over 1 lakh new cases and 77,000 deaths in 2022.
• Globally, it contributes to one-fifth of the total burden.
• Cause: Primarily caused by persistent high-risk Human Papilloma Virus (HPV) infection, with co-factors like low socioeconomic status and immunity.
• Detection: Precancerous and cancerous stages can be identified through screening tests like HPV tests and visual assessments.
• Treatment: Precancerous lesions can be treated effectively with simple outpatient procedures.
• Prevention: HPV vaccination in girls aged 9-14 is highly effective in preventing infection and future cancer development.

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Necessity

• High burden: India accounts for 20% of global cervical cancer cases and deaths.
• Prevention and curability: Early detection and intervention can significantly improve outcomes, with a 93% cure rate for early-stage cases.
• Sustainable Development Goal: Eliminating cervical cancer contributes to reducing premature deaths by 2030 (SDG 3.4).

Key interventions

• HPV vaccination:
  • Recommended for girls aged 9-14.
  • Prevents infection with high-risk HPV types.
  • Most effective before sexual debut.
• Screening:
  • Regular Pap smears or HPV tests recommended for women aged 30-45.
  • Detects precancerous changes before they become cancerous.
  • Simple and easily available.
• Early diagnosis and treatment:
  • Effective treatment options exist for pre-cancerous and early-stage cancer.
  • Palliative care available for advanced stages.

Challenges

• Awareness: There is a significant lack of awareness about cervical cancer, which results in late detection and treatment.
• Vaccination: The percentage of fully vaccinated 15-year-old girls against HPV is currently low.
• Treatment Access: Access to treatment for women with cervical pre-cancer and cancer is not adequate to meet the 2030 mortality reduction target.
• Healthcare Burden: There is an anticipated increase in demand for cancer care treatments by about 20% in the next decade.
• Diagnostics: The diagnostics confirmation step in the patient journey from “screen-positive” to “treatment” is underutilised, leading to delayed or missed treatment opportunities.
• Policy Implementation: The need for robust policy frameworks and public-private partnerships to strengthen the health system has been identified as a challenge.

• Technology Use: There is a gap in testing and implementing artificial intelligence technologies for early and accurate diagnosis and treatment planning.
• Comprehensive Care: The integration of prevention, treatment, and palliative care services is still not fully realised, which is necessary for a holistic approach to managing cervical cancer.

Moving Forward

• Strengthening awareness campaigns: Educating communities about cervical cancer, its causes, prevention, and treatment options.
• Scaling up vaccination programs: Ensuring high coverage and access to HPV vaccines for eligible girls.
• Improving screening services: Expanding access to accurate and affordable screening tests.
• Building capacity for treatment: Training healthcare providers and equipping facilities for pre-cancer and cancer treatment.
• Enhancing partnerships: Collaboration between government, NGOs, healthcare professionals, and researchers is vital for effective implementation.

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