Cervical cancer is one cancer the world can actually eliminate according to the World Health Organisation, and a global strategy to achieve this was launched in November 2020. Cervical cancer is a major public health problem, especially among women from low-and middle-income countries. India accounts for about a fifth of the global burden of cervical cancer with 1,23,907 cases and 77,348 deaths in 2020.
Now, a study by Prayas Health Group, a non-profit organisation in Pune, has demonstrated the feasibility of using a mobile screening unit (MSU) for cervical cancer screening as well as immediate ablative treatment following the WHO guidelines. The study results were published in the Asian Pacific Journal of Cancer Prevention recently this year.
The Pune study was an attempt to increase the opportunity for women to get screened and increase awareness about cervical cancer screening, “For the last five years, Prayas’ mobile screening unit has been reaching out to various communities to screen women from the low socioeconomic strata for cervical cancer – a disease that is preventable but kills one woman every eight minutes in the country.” Dr Smita Joshi, a senior scientist with Prayas Health Group, told The Indian Express.
The Prayas initiative screened 10,925 women during the study period from November 2016 to June 2019. “We conducted 290 cervical cancer screening outreach clinics in the MSU. The screening clinics were arranged in and around Pune city within 60 to 70 km distance in collaboration with the local NGOs, self-help groups, women’s organisations and groups in the community setting,” Dr Joshi said.
The mobile screening unit was donated to Prayas by BMC Software India Pvt Ltd as part of their CSR. “Prayas was introduced to BMC by Praful Chandwarkar and Suraj Repe of Live Life Love Life Charity Foundation — a non-profit organisation aimed at spreading awareness about early detection of cancer and raising funds for the financially disadvantaged — and the work that we are doing would not have been possible without them,” Dr Smita Joshi added.
Over 18,000 women have been screened so far in the mobile screening unit, which has the facility for on-site ablative treatment. Prayas has also developed two short films for cervical cancer prevention awareness with veteran actor Rohini Hattangadi playing a lead role.
“In our initiative, among the screen-positive women, 54 per cent received treatment or completed diagnostic investigations whereas 46 per cent defaulted. Therefore additional efforts are needed to improve compliance to treatment. It is also important for women to understand the importance of follow-up when they test positive and they are called to our clinic,” Dr Joshi said.
“Screening and vaccination are two powerful tools that are currently available for preventing cervical cancer and have the potential to practically eliminate cervical cancer. There is very little awareness among women for the prevention of this cancer and less than 10 per cent of Indian women get screened. All women aged 30 to 49 must get screened for cervical cancer even if they have no symptoms and get their adolescent daughters vaccinated with human papillomaviruses vaccine (HPV),” Dr Joshi added.
WHO has set specific goals towards the elimination of cervical cancer by 2030 which includes 90 per cent of girls fully vaccinated with HPV vaccine by 15 years of age, 70 per cent of women are screened with a high-performance test by 35 years of age and again by 45 years of age, 90 per cent of women identified with the cervical disease receive treatment.
Prayas is now using a similar platform of community-based clinics to expand screening for breast cancer among women as well as colorectal (large bowel cancer) in men and women above 50 years of age.