Journal: Cancer
This opinion article reviews why cervical cancer remains a leading, yet largely preventable, cause of cancer deaths among women in India and outlines practical system-level solutions.
Key points:
- • Burden: India reports ~127,000 new cervical cancer cases and ~80,000 deaths each year, representing about 20% of the global burden.
- • Prevention gap:
- • Screening coverage is extremely low (fewer than 2% of women screened).
- • HPV vaccination coverage is even lower (less than 1% vaccinated).
- • This persists despite global advances in HPV vaccination, screening, and molecular diagnostics.
- • New opportunity – Cervavac:
- • The launch of an indigenous quadrivalent HPV vaccine (Cervavac) in 2023 has renewed interest in scaling up vaccination.
- • However, infrastructure limitations, low public awareness, and structural/programmatic barriers remain major obstacles.
- • Diagnostic and programmatic barriers:
- • Limited access to organized screening programs.
- • Inadequate laboratory capacity for HPV testing in many regions.
- • Gaps in health system coordination needed to reach WHO 2030 elimination targets.
- • Strategic proposals:
- • Repurpose COVID-era RT-PCR infrastructure: Use the extensive reverse transcriptase–polymerase chain reaction testing network developed during the COVID-19 pandemic to conduct HPV molecular testing.
- • Integrate HPV vaccination into the Universal Immunization Program: To ensure sustainable, nationwide, and equitable access for girls.
- • Include HPV NAAT in the National Essential Diagnostics List: To formalize HPV molecular testing as a standard component of essential diagnostics and facilitate funding and implementation.
Overall, the article argues that leveraging existing laboratory capacity from the COVID-19 response, combined with programmatic integration of HPV vaccination and HPV NAAT, is critical to accelerate India’s progress toward cervical cancer elimination targets by 2030.