Cervical Cancer in India: A Comprehensive Guide on Risk Factors, Symptoms, Prevention and Treatment

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Cervical Cancer in India

Cervical cancer is the second most common cancer among women in India, with over 96,000 new cases and 60,000 deaths reported each year. This preventable disease continues to take a huge toll on the health and lives of women across the country. In this comprehensive guide, we will dive deep into all key aspects of cervical cancer in India – from risk factors and symptoms to prevention, screening, and treatment options available.

An Overview of Cervical Cancer in India

  • Cervical cancer ranks as the 2nd most frequent cancer among women aged 15 to 44 years in India.
  • India accounts for about one-fifth of the global burden with 1,23,907 new cases and 67,477 deaths from cervical cancer in 2024.
  • Cervical cancer is the 2nd most common cancer in women aged 15 to 44 years.
  • About 6.6% of women in the general population are estimated to harbor cervical HPV infection at a given time.
  • Rural areas report a higher incidence rate (14.7 per 100,000 women) compared to urban areas (11.3 per 100,000 women).
  • The mortality rate is estimated to be 8.8 per 100,000 women in India compared to 6.9 per 100,000 globally.
  • Northeast states like Mizoram (29.8 per 100,000) have the highest age-adjusted incidence rates.
  • Lack of screening and early detection facilities leads to more late-stage diagnosis and higher mortality.

What Causes Cervical Cancer?

  • HPV infection: Persistent infection with high-risk strains of the human papillomavirus (HPV) is responsible for over 99% of cervical cancer cases. HPV 16 and 18 account for about 83% of all cervical cancers in India.
  • Early sexual activity: Having multiple sexual partners or becoming sexually active at an early age below 18 increases the risk of HPV infection and cervical cancer.
  • Smoking: Smoking cigarettes is associated with a higher risk as chemicals in smoke can damage cervical cells and make them more vulnerable to HPV infection.
  • Weakened immunity: Women living with HIV have a 6 times higher risk of contracting cervical cancer than the general population.
  • Multiple pregnancies: Having many full-term pregnancies is linked to a higher risk of cervical cancer.
  • Oral contraceptives: Long-term use of oral contraceptives may contribute slightly to cervical cancer risk.
  • Chlamydia infection: This sexually transmitted infection can cause cervical cell changes and inflammation that may lead to cancer.

Symptoms of Cervical Cancer

Early cervical cancers usually don’t show any symptoms. As cancer progresses, women may experience:

  • Abnormal vaginal bleeding between periods, after menopause or after intercourse
  • Heavier, prolonged menstrual bleeding
  • Increased or foul-smelling vaginal discharge
  • Pain during sexual intercourse
  • Bleeding after douching or after a pelvic exam
  • Unexplained, persistent pelvic and back pain
  • Painful urination
  • Blood spots or light bleeding other than period
  • Loss of bladder and bowel control

If you notice any of these cervical cancer signs, consult your gynaecologist right away for further evaluation.

Who is at Risk of Cervical Cancer in India?

Certain factors can increase a woman’s risk of developing cervical cancer:

  • HPV infection – Contracting HPV is the biggest risk factor. Women get infected through sexual contact.
  • Multiple sexual partners – Having many partners or a partner who has had multiple partners expands HPV exposure.
  • Early sexual activity – Becoming sexually active before 18 years old raises vulnerability.
  • Weakened immunity – Women with HIV, transplant recipients, and those on steroids or chemotherapy have a higher risk.
  • Smoking – Chemicals from smoking can damage cervical cells and make them prone to cancer.
  • Multiple pregnancies – Having many full-term pregnancies is linked to greater cervical cancer risk.
  • Long-term oral contraceptive use – May contribute slightly to cervical cancer risk.
  • Chlamydia infection – This STI can trigger cervical cell changes that may lead to cancer.
  • Low socioeconomic status – Poor genital hygiene and lack of access to healthcare services also contribute.

Effective Ways to Prevent Cervical Cancer in India

Cervical Cancer in India is highly preventable through a combination of key strategies:

1. HPV Vaccination

  • Getting vaccinated against HPV is the most effective prevention method.
  • The HPV vaccine is recommended for girls and boys starting from age 9 before sexual debut.
  • It provides nearly 100% protection against HPV infection and cervical precancers.
  • Three HPV vaccines available in India are Cervarix, Gardasil, and the low-cost Cervavac.
  • HPV vaccination is safe with minimal side effects like pain/swelling at the injection site, fever, headache, and nausea.
  • India aims to vaccinate 300 million girls under the universal immunization program by 2030.

2. Cervical Cancer Screening

  • Regular screening helps detect precancerous changes so they can be treated early before progressing to cancer.
  • Screening methods:
    • Pap smear – Checks for abnormal cervical cells
    • HPV DNA test – Identifies high-risk HPV strains
    • Visual inspection with acetic acid (VIA) – Low-cost effective test
  • Women should get screened every 3-5 years starting from age 25 to 49. HPV testing may start at age 30.
  • Screening is available at primary health centres, government hospitals, and health and wellness centres.
  • Treatment of precancerous lesions is quick, effective, and prevents cervical cancer.

3. Safe Sexual Practices

  • Practising safe sex lowers HPV transmission risk. Using condoms protects against contracting new HPV infections.
  • Limiting the number of sexual partners reduces exposure to the virus.
  • Seeking treatment for STIs like chlamydia reduces cervical inflammation and precancerous changes.

4. Stop Smoking

Quitting smoking reduces the chance of cervical cell damage and cancer risk significantly. Avoiding secondhand smoke is also advised.

5. Maintain Good Gynecologic Care

Get regular gynecologic exams, and pap smears according to guidelines. Seek prompt treatment for any cervical abnormalities or suspicious symptoms.

Cervical Cancer in India: Cervical Cancer Screening in India

Despite being highly preventable, cervical cancer screening rates remain very low in India. Key statistics:

  • Only about 5% of women in India have undergone cervical cancer screening.
  • 50% of states have screening rates below 1%.
  • In NFHS-5 (2019-20), just 1.97% of women aged 30-49 years reported getting screened.

Barriers to improving screening coverage include:

  • Lack of awareness – Most women don’t know about available screening programs.
  • Limited access – Screening facilities are inadequate in rural, remote areas.
  • Social taboos – Many avoid gynecologic exams due to embarrassment or the gender of the health worker.
  • Financial constraints – Women can’t afford the time off work or transportation costs.
  • Lack of symptoms – Since early cancer shows no symptoms, screening seems unnecessary.

To enhance screening rates, India is taking steps like:

  • Expanding screening infrastructure and health worker training.
  • Leveraging Ayushman Bharat wellness centres to offer cervical cancer screening.
  • Raising community awareness through health camps and door-to-door education.
  • Utilizing ASHAs and ANMs for personalized counselling at the village level.
  • Offering VIA screening by ANMs at sub-centres and wellness centres.
  • Making screening available to women accessing health facilities for any service.

Diagnosis of Cervical Cancer in India

Diagnostic tests used for confirming cervical cancer are:

  • Medical history and physical exam – Looking for symptoms, pelvic exam
  • Colposcopy – Visual exam of the cervix using a microscope. Identifies abnormalities.
  • Biopsy – Takes a cervical tissue sample to test for cancer cells. Confirms diagnosis.
  • MRI/CT/PET scans – Create images of organs and tissues. Helps see tumour size and spread.
  • Cystoscopy/proctoscopy – Examines bladder and rectum if impacted by cancer.
  • Blood tests – Check for liver/kidney function, blood cell counts, and markers like SCC for prognosis.
Cervical Cancer in India

Cervical Cancer in India: Different Treatments

Based on the stage, These different therapies can cure cervical cancer:

Early-Stage Cervical Cancer Treatment

1. Surgery

  • Hysterectomy – Removal of the uterus and cervix.
  • Radical hysterectomy – Removes uterus, cervix, surrounding tissue and lymph nodes.
  • Trachelectomy – Removes cervix only, preserving fertility in young women.

2. Radiation Therapy

  • Uses high-energy X-rays to kill cancer cells and shrink tumour size.
  • External beam radiation targets the pelvis to destroy cancer cells in early-stage cervical tumours.
  • Brachytherapy implants placed inside the cervix deliver concentrated radiation to the tumour while sparing surrounding tissues.
  • Chemoradiation combines radiation therapy with chemotherapy for improved cancer cell killing.

3. Chemotherapy

  • Uses drugs like cisplatin, carboplatin, and paclitaxel to kill cancer cells.
  • Often administered alongside radiation to make it more effective.
  • Helps eliminate remaining cancer cells after surgery.
  • Manages symptoms and slows cancer growth in advanced stages.

Locally Advanced Cervical Cancer Treatment

1. Radiation Therapy

  • External beam radiation to the pelvis destroys cancerous cells
  • Brachytherapy – Radiation implants placed inside the cervix to target the tumour directly
  • Chemoradiation – Combining radiation with chemotherapy for better results

2. Chemotherapy

  • Uses anticancer drugs like cisplatin, paclitaxel, etc. to kill cancer cells
  • Often given along with radiation to enhance effectiveness
  • Helps control advanced cancers and manage symptoms
Cervical Cancer in India

Advanced/Recurrent Cervical Cancer Treatment

If cancer returns after initial treatment or spreads to other organs, options include:

  • More radiation to target new tumor sites
  • Stronger doses of chemotherapy
  • Immunotherapy drugs to boost the immune system to fight cancer
  • Targeted therapy drugs attacking specific cancer cell features
  • Palliative care to relieve pain and manage symptoms

Where Can You Get Cervical Cancer Treatment in India?

Cervical cancer treatment is available at:

  • District hospitals
  • Government medical colleges
  • Regional cancer centers
  • All India Institute of Medical Sciences (AIIMS)
  • Top cancer hospitals like Tata Memorial Hospital

Under Ayushman Bharat, poor patients can avail of free cervical cancer treatment at empanelled hospitals.

Prognosis and Survival Rates for Cervical Cancer

When detected early, cervical cancer has an excellent prognosis and high survival rates:

  • Stage 0 – Nearly 100% 5-year relative survival rate
  • Stage I – Over 90% 5-year survival
  • Stage II – Around 60% 5-year survival
  • Stage III – 30-35% 5-year survival
  • Stage IV – 15-16% 5-year survival

In India, overall 5-year survival rate is about 50%. Early detection through screening and HPV vaccination gives women the best chances of survival.

Watch the Web Story on Cervical Cancer in India

FAQs About Cervical Cancer in India

1. Who is at high risk of cervical cancer in India?

  • Women with HPV infection
  • Those with early sexual debut <18 years
  • Having multiple sexual partners
  • Smokers
  • HIV-positive women
  • Multiple pregnancies
  • Using oral contraceptives long-term
  • Low socioeconomic status

2. What are the most common symptoms of cervical cancer?

Abnormal vaginal bleeding, foul discharge, pelvic/back pain, painful sexual intercourse, bleeding between periods or after menopause are common cervical cancer symptoms.

3. Should women get the HPV vaccine in India? At what age?

Yes, HPV vaccination is strongly recommended for girls aged 9-14, before becoming sexually active. Catch-up vaccination can be done for women up to 26. Three doses are given over 6 months.

4. What screening tests detect cervical cancer early?

Pap smear, HPV DNA test, and VIA (visual inspection with acetic acid) are the standard screening tests used to detect precancerous changes.

5. How much does cervical cancer treatment cost in India?

Early-stage cancer treatment may cost ₹2-5 lakhs ($2500-$6500 USD). Advanced cancer treatment can cost ₹6-10 lakhs+ ($8000-$13,000+ USD).

6. What is the cervical cancer survival rate in India?

Overall 5-year survival rate is about 50%. When detected very early in stage 1, the survival rate is over 90%. The advanced stage 4 survival rate is 15-16%.

7. How can we create awareness about cervical cancer prevention in India?

Strategies include TV, radio and social media campaigns, free community health talks, health worker counselling at the village level, promoting HPV vaccination, screening camps, and advocating for policy change.

The Road Ahead: Eliminating Cervical Cancer in India

India bears 25% of the global cervical cancer burden. To change this by 2050:

  • Prevention is key – Increased HPV vaccination and screening coverage offers the best promise. School-based immunization and utilizing PHCs/ASHAs for screening outreach must be prioritized.
  • Generate awareness – Utilize mass media, social media, and community networks for education about risk factors, symptoms and prevention. Curb stigma about sexual health.
  • Train more healthcare workers on VIA screening, sample collection, and HPV vaccination to expand service access.
  • Upgrade infrastructure – Expand diagnostic and cancer treatment facilities, especially in rural areas and smaller towns.
  • Leverage global partnerships – Benefit from initiatives like WHO’s global cervical cancer elimination strategy.

While cervical cancer continues to take a toll on women’s health in India, the tools exist to dramatically curb new cases and deaths. Through concerted prevention efforts and early detection, India has the potential to meet the WHO target of reducing cervical cancer incidence to below 4 per 100,000 women by 2050. Women’s lives hang in the balance. The time to act decisively is now.

Conclusions for Cervical Cancer in India

Cervical cancer continues to impact the lives of hundreds of thousands of women in India each year. While incidence and mortality rates remain high, cervical cancer is also one of the most preventable and treatable cancers if detected early. Through a concentrated effort on increasing HPV vaccination, improving screening coverage, generating awareness, upgrading infrastructure, and training healthcare workers, India has the opportunity to dramatically reduce the cervical cancer burden and work towards the WHO target of elimination by 2050. Women’s health and lives hang in the balance. By taking action today across all levels of society, we can create a future where our mothers, daughters, and sisters no longer have to suffer and die from this preventable disease

Disclaimer for Cervical Cancer in India

This health article is for informational purposes only. It is not intended to provide medical advice or to take the place of a licensed healthcare professional’s advice. Consult your doctor before making any decisions about medical tests, treatment, or lifestyle choices related to any health condition. Do not rely on this article as your sole source of information on the topic it covers. Always consult multiple credible sources when making medical decisions. Information provided here is accurate to the best of the publisher’s knowledge but comes without any express or implied warranty or guarantee.

This article is published by Wini Media. For other useful health content, visit our website regularly.

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Cervical Cancer in India: Take these steps to protect yourself
Cervical Cancer in India: Take these steps to protect yourself