Cervical Cancer

Table of Contents

Context: The government is planning to roll out vaccines for the prevention of cervical cancer to girls aged between 9 and 14 years through schools.

What is Cervical Cancer

Cervical cancer is the second most common cancer among women in India, and the cause of a large number of deaths annually.
The disease is caused by infection with the Human Papilloma Virus (HPV), and there are vaccines to protect against cancerous HPV.
It can be prevented and cured if it is detected early and managed effectively.

What is HPV

Human Papilloma Virus (HPV) is the most common sexually transmitted infection (STI).
HPV is caused by sexual activity and age. About 75% of all sexually active adults are vulnerable to at least one HPV type.
Adolescent girls and women are more vulnerable to cancer caused by HPV infection.

What is CERVAVAC

Development: Serum Institute of India has partnered with DBT’s Biotechnology Industry Research Assistance Council (BIRAC), and the Bill and Melinda Gates Foundation to develop the vaccine.
Working: CERVAVAC is developed using recombinant DNA technology.
- It introduces Virus Like Particles (VLP) to stimulate an immune response from the body resulting in production of antibodies.
Effectiveness: The vaccine is effective against at least four variants of cancer-causing Human Papilloma Virus (HPV).
Significance: The existing vaccine for HPV are developed using the same technique but they are at least 10 times costly than CERVAVAC.

Need for the HPV Vaccine

According to a study, India accounts for the highest number of cervical cancer cases in Asia, followed by China.
More than 58% of all cervical cancer cases and deaths globally were estimated in Asia with India accounting for 21% of cases and 23% of deaths, followed by China (18% and 17%).
In India, the incidence rate of cervical cancer is 18 per 1,00,000 women, and based on WHO estimates in 2019, over 45,000 women died of the disease.
The WHO has specified that countries must reach and maintain an incidence rate of less than 4 new cases per 1,00,000 women a year by 2030.
To achieve this goal, one of the most important initiatives is that 90% of girls will have to be vaccinated with the HPV vaccine by the age of 15.

Rollout of the Vaccine

CERVAVAC, the HPV Vaccine, is likely to be rolled out by mid-2023. It has received approval of the Drugs Controller General of India.
A one-time catch-up vaccine will be provided to 9-14 year old adolescent girls, before it is introduced at nine years.
States and Union Territories have been asked by the centre to issue directives to appropriate authorities for organising HPV vaccination centres in schools.
- Girls not attending schools will be given the vaccines by community outreach and mobile health teams.
Apart from vaccination, screening programmes will have to be conducted regularly to detect early signs of the disease that will allow time for treatment.
The Ayushman Bharat Health and Wellness centres are already screening for common cancers like oral, breast and cervical, with over 5 crore women being screened for cervical cancer till November 2022.

Cervical Cancer Challenges

Social inequalities: A substantial geographical and socioeconomic inequality in cervical cancer globally has been identified, with a clear gradient of increasing rates for countries with lower levels of human development.
- In 2022, India ranked 132 out of 191 countries on the Human Development Index. It makes India one of the most vulnerable countries.

Way Forward

Once the vaccine is launched through the UIP it is expected to reach the maximum number of the targeted population.
The surveillance systems and infrastructure used for COVID-19 vaccinations may be customised to improve HPV vaccination, monitor national cervical screening programmes and improve health system capacity to deliver more efficient preventive services.