Cervical Cancer Awareness Month: With 3,546 deaths in 5 yrs, HPV vaccine most crucial now

Cervical cancer occurs in the cells of the cervix, the lower part of the uterus that connects to the vagina. The data on death toll was compiled by the state health department.

In 2017, as many as 546 women died due to cervical cancer. (Representational/Getty Images)

4 min readMumbaiJan 24, 2023 02:20 PM IST First published on: Jan 24, 2023 at 04:27 AM IST

A total of 3,546 women in the state have lost their lives to preventable cervical cancer in the five years between 2017-2021. With an average of over 700 deaths each year, doctors are stressing the need to introduce human papillomavirus (HPV)—a vaccine for cervical cancer—in the national immunisation programme to save more women from succumbing to the disease.

Cervical cancer occurs in the cells of the cervix, the lower part of the uterus that connects to the vagina. The data on death toll was compiled by the state health department. The most important risk factor for cervical cancer is human papillomavirus virus (HPV)—a common infection. Most infections occur after people become sexually active, and most people clear the virus without problems. There are over 100 types of HPV, and not all are linked to cancer. The HPV types, or strains, most frequently associated with cervical cancer, are HPV16 and HPV18. HPV infections are more commonly seen in people who have multiple sexual partners.

In 2017, as many as 546 women died due to cervical cancer. The number jumped to 1,073 with a 96 percent rise in 2018. In the next year, it dropped to 673 and further plunged to 532 in 2020, amid the Covid-19 pandemic. Doctors attribute it to lack of detection of undiagnosed cancer due to the national lockdown when accessibility to health care was restricted. In 2021, the number rose slightly to 722, which counts as 32 percent rise in fatality associated with cervical cancer among women in 2021, as compared with 2017. The data of 2022 is unavailable.

An analysis of age-wise data showed that cervical cancer death is most frequently reported from the age of 35. Of 1,325 deaths, a -third of the women who died were between 55 and 64 years. Death is rarely reported in women younger than 20. However, doctors believe that many of these lives could have been saved if they had been inoculated with the HPV vaccine. As per Centre for Disease Control and Prevention(CDCP), up to 93 percent of cervical cancers are preventable with HPV vaccine.

“The most important thing you can do to help prevent cervical cancer is to get vaccinated against HPV at a young age preferably before any sexual contact has happened,” said Dr Sewanti Limaye, director of oncology and precision medicine, Sir HN Reliance Foundation Hospital.

Currently, two vaccines licenced globally are available in India — a quadrivalent vaccine (Gardasil from Merck) and a bivalent vaccine (Cervarix from GlaxoSmithKline), one dose of which costs Rs 2,800 and Rs 3,299 respectively. The high cost deters women from taking the jab at private centres cited doctors.

“The incidence of cervical cancer is already high in India. Existing vaccines have proven helpful in preventing cervical cancer globally. So, of course if it is included in the national immunisation programme which it would give free-of-cost to girls, it would help to reduce the fatalities,” said Dr Nikhil Datar, senior gynaecologist and medical director, Cloudnine Group of Hospitals.

As of 2022, more than 125 countries have included HPV vaccine in their routine vaccinations for girls. It is on World Health Organization’s list of essential medicines and prequalified vaccines. “Averting the development of cervical cancer by increasing access to effective vaccines is a highly significant step in alleviating unnecessary illness and death,” stated the WHO in 2022.

National Technical Advisory Group for Immunization (NTAGI) has recommended introduction of HPV Vaccine in the Universal Immunization Programme (UIP). “I strongly believe that the HPV vaccine would be of great help to society. Currently, the plan is to vaccinate young girls,” added Dr Limaye. Along with that, doctors stress the need for sensitisation, as often women especially from rural parts of the state, ignore symptoms like vaginal bleeding after sex, vaginal bleeding after menopause, vaginal discharge that is watery and has a strong odor or that contains blood.

“The biggest challenges in diagnosing cervical cancer are the lack of awareness, lack of health care facility, cost of screening, low socio economic strata, lack of education,” said Dr Limaye. “Also, women should regularly undergo screening with cervical PAP smears… In some cases, the HPV test may be done instead of a Pap smear,” he added.