A Keep Educating Yourself (KEY) Programme on prevention of cancer of the cervix and contraception was conducted by the Department of Obstetrics and Gynecology,PGIMER,Chandigarh under the aegis of Federation of Obstetrics and Gynecology Societies of India on Saturday. About 180 delegates from Chandigarh,Haryana,Punjab and Himachal Pradesh attended this meeting.
The presence of a heavy burden of disease due to cancer of the cervix among Indian women was highlighted with nearly 86% of the worldwide reported cases being contributed by India alone. Dr GRV Prasad spoke about the lack of awareness of Indian women regarding the need and availability of screening for cervical cancer which if diagnosed in its preinvasive or very early stage can be completely cured.
Screening rates for cervical cancer in India are reported to be as low as 3% in the absence of an organised screening strategy for the general population,as presently only hospital-based screening for cancer of the cervix is done.
Dr Vijay Zutchi,President,Indian Society of Colposcopy and Cervical Pathology,New Delhi stressed the need for integrating screening programmes for cervical cancer into the existing health care services. Besides the Pap test,the visual inspection of the cervix with application of acetic acid is a very simple test which can be easily taught to even paramedical staff working in rural areas.
Dr Zutchi spoke about the difficulties of implementing organised cervical cancer screening in India. She revealed that now national guidelines are available for screening programmes with allocation of funds to the state governments. The state of Tamil Nadu,she said,has brought about a 50% reduction in reported cervical cancer cases. However the incidence of the disease remains high amongst rural women.
Dr Zutchi stressed upon the need to strengthen the primary health care system along with with bringing about awareness amongst women and also the need to provide professional expertise for appropriate management of preinvasive disease once diagnosed. According to the current screening guidelines for cancer of the cervix,cytology screening ( Pap smear) is recommended every 3 years from 21 years upto 30 years of age. Subsequently HPV testing along with cytology co-testing can be done every 5 years upto 65 years of age. However if HPV testing is not available or affordable,then three-yearly cytology testing alone can be continued.
Later in the afternoon a panel discussion on the use of HPV vaccines to reduce the burden of cancer of the cervix was held with experts on the subject including Dr Maninder Ahuja,vice president of FOGSI,Dr Vanita Suri,Dr Alka Sehgal,Dr Nijhawan,Dr Yash Bala and Dr Surjeet Singh.
A scientific session on contraceptive choices was also held in which the need for an appropriate counseling for choosing an appropriate contraception for women was discussed. Dr Maninder Ahuja stressed on good counseling as an effective way to make many indecisive women choose a suitable method of contraception and which can help others in changing their existing contraception to a more agreeable one,thus increasing the coverage of a wider population of women using contraception.
Use of low dose progesterone only pills as a method of postpartum contraception was highlighted. In oral contraceptive pills,those containing desogestrel (progestagen) have been found to have better continuation rates amongst women. Dr Ahuja said that at present,according to the National Health and Family Survey III,36% women are still not using any form of contraception.