A Need of the hour: Vaccinate adolescents with HPV vaccine

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Dr Sharda Jain, Secretary General, Delhi Gynecologist Forum and Chairman, WOW India urges women in India to safeguard themselves from this fatal disease through regular screening and required vaccination

In spite of the progress that India is making in the healthcare ecosystem, low awareness levels about life-threatening diseases and their prevention amongst the majority of the population thwart its further growth. There is a greater need to comprehend the gravity of problem when it comes to cervical cancer. Regardless of cervical cancer being totally preventable, most women in India are unaware of the need for visiting a gynecologist for its prevention through screening and vaccination.

Cervical Cancer – A rising epidemic

Cervical Cancer is the second highest cancer cause of women mortality in India. With a population of 430.20 million, women aged 15 years & older who are at risk of developing cervical cancer, there is a strong need to build awareness about the disease segment and its timely prevention. Current estimates indicate that every year 1,34,420 women are diagnosed with cervical cancer and 72,825 dies from the disease. Every seven minutes, one woman dies in India due to cervical cancer. It is the second most frequent cancer amongst women between the age of 15 & 44 years, but is a number one cause of death of women in India.

Cervical cancer is a type of cancer that develops in a woman’s cervix – the entrance to the womb. The cervix is located at the entrance of the uterus & prevents infections from reaching the uterus. Cervical cancer is caused by infection with a virus – the human papilloma virus (HPV) – which infects the cervix. The virus is common and is transmitted through contact with the genital area. Today, every woman is at risk of cervical cancer, regardless of her age. Hence, timely intervention can help in keeping a woman shielded from this deadly disease. Younger women are at the highest risk of acquiring an HPV infection that might lead to cervical cancer in the future. Once a woman becomes sexually active persistent infection can lead on to precancerous changes which can turn fatal if left undetected and untreated. However, not all HPV infections cause cancer and most of them clear naturally. Only 15 odd HPV can lead to cancer.

Mitigating risks through screening and vaccination

Cervical cancer generally shows no symptoms until it has reached an advanced stage. Being aware of the disease, its causes and taking precautions, such as getting screened for cancer and HPV vaccination can help prevent or reduce the risk of developing the disease. Screening tests such as pap smear, HPV CO can detect early HPV infection that causes cervical cancer & precancerous lesions. Their treatment can prevent 100 per cent cervical cancer occurrence. However, screening alone cannot prevent the HPV infection from happening in the first place. Vaccination along with cervical cancer screening offers the best possible protection against cervical cancer.

In the pyramid of cervical cancer prevention, a vaccine is the base. Vaccination is best given as early as possible in adolescent girls as this is when the best immune response to vaccination is achieved. At this particular time, girls have a high antibody system. The higher the antibody response, the better the immunity system will be. However, since all women up to 50 years remain at risk of cervical cancer, they too need to get vaccinated. HPV vaccination is given as three shots over a six months period (0, 1, 6 or 0, 2, 6). While the WHO recommends two shots of the vaccine for girls aged 9-14 over 6 months period (0, 6). It is advisable for women in the age group of 10 – 50 years of age to take the vaccine. This base is going to contribute 50 per cent drop in the cervical cancer load in the country while the rest is going to come from cervical cancer regular screening where government action is necessary.

Unfortunately, one out of four women in the world, dying of cervical cancer is an Indian. The cervical cancer vaccine has been taken up by many countries and around 100 countries have also included this vaccine in their national immunization programme. India needs to become more serious about the screening and vaccination programme as done in the developed countries.

As a doctor and a woman, I would urge women in India to safeguard themselves from this fatal disease through regular screening and required vaccination.

Let’s pledge to make India free of cervical cancer!