How often have you come across a patient of cervical cancer around you? Chances are, rarely. But reality begs to differ. According to the World Health Organisation (WHO), over six per cent women around the world (including 570,000 new cases) suffered from cervical cancer in 2018. Sadly, the statistics of both the developed and developing countries tell a similar horrifying story. Every day, nine women in the UK are diagnosed with cervical cancer and three lose their battles to life. In the US, nearly 13,000 women are diagnosed with cervical cancer every year, which amounts to an appalling 36 women falling prey every day! Developing countries like India have morbid statistics too. As per a study by National Center for Biotechnology Information, India alone accounts for a quarter of cervical cancer cases globally. Approximately 270,000 women across the world die from cervical cancer yearly, with 85 per cent deaths occurring in low-to-middle income countries. Owing to the gigantic figures, the United States Congress designated January as the Cervical Health Awareness Month.
Most common among women aged around 35 years, cervical cancer has remained, through times, an ignominious reality. However, even more lamentable is the fact that 75 per cent of such cases are actually prevented by cervical screening (or smear tests) and vaccination. Yet, one in four women does not attend this potentially life-saving test because of embarrassment. Some time back as part of the Pink Chain campaign, a study among schoolteachers in India was conducted. It revealed that cervical cancer was the second most common cancer in India. It also identified and assessed the level and impact of awareness programmes in the adoption of safe practices in prevention and early detection. Uneasiness around discussing the topic with friends, family and peers emerged as the main reason behind women not coming forward for tests and treatment.
While cervical cancer rates have dropped significantly within the United States over the past few decades, it still remains a critical global health issue. The high mortality rate for cervical cancer in the developing world is driven by limited access to cervical cancer screening and treatment. Laboratory-based methods used to detect cervical cancer, and the personnel required to perform and analyse them may be unavailable in developing nations. In an alarming finding, it was identified that approximately 90 per cent of deaths from cervical cancer occurred in low- and middle-income countries. Likewise, the ability to treat cervical cancer is highly dependent on access to surgical facilities, chemotherapy agents and radiation equipment.
The high global mortality rate despite having mechanisms to diagnose and treat this cancer is a matter of great concern. Doctors and researchers have time and again emphasised that more awareness programmes need to be run and sustained in order to literate people, especially women, to combat this cancer. Women must be encouraged to speak, walk up to a doctor and get her diagnosed. Reduction in mortality could be induced through a comprehensive approach which includes preventive care, early diagnosis, effective screening and treatment, and follow-ups. Particularly, in countries where screening programmes are not available, identifying cervical cancer at an early stage and providing effective treatment can improve the likelihood of survival. Presently, in many low-income nations, the disease is often not identified until in advanced stages.
Widespread training and awareness programmes run by state governments in partnership with CSR divisions of private firms can also be a way forward in combating cervical cancer. They must be made educated on the initial symptoms of the cancer. WHO Package of Essential non-communicable (PEN) disease interventions for primary healthcare in low-resource settings has guidance on the approach to assessing and referring affected women in the primary care setting. This must be widely publicised through various broadcast channels. In one of its studies, the WHO has concluded that “… screening should be performed at least once for every woman in the target age group (30-49 years) when it is most beneficial; HPV testing, cytology and visual inspection with acetic acid (VIA) are all recommended screening tests; cryotherapy or loop electrosurgical excision procedure (LEEP) can provide effective and appropriate treatment for the majority of women who screen positive for cervical pre-cancer; “screen-and-treat” and “screen, diagnose and treat” are both valuable approaches.”
Irrespective of the approach being deployed in educating women, the key to an effective programme is reaching the largest proportion of women at risk. Organised screening programmes, comprehensive cervical cancer prevention and control, community education, social mobilisation, vaccination, etc. can go a long way in improving cervical cancer control. Cervical Health Awareness Month is an opportunity to dedicatedly work, for a whole month, towards ensuring that our women remain safe and prevented from this deadly cancer. Let us spread the word around, not only among our female friends but also among our male friends, peers and family so that in case of such diagnosis, every person around must be aware of the next critical steps involved in treating the patient. Let us all be well-equipped for a better tomorrow because prevention is certainly better than cure.