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Cervical Cancer Control- A Comprehensive Approach 

“Breaking the Barriers” 

The Apex Chamber ASSOCHAM (The Associated Chambers of Commerce and Industry of India) in association with Cancer Foundation of India (CFI) organized its inaugural session of the round table web series on Cervical Cancer, Head and Neck Cancer and Lung Cancer: “Breaking the Barriers”. This was aimedat raising public and political literacy and understanding around cervical cancer, reducing fear, eliminating myths and misconceptions, and changing behaviors and attitudes.  With over 150 participants, the event highlighted the urgent need of building a healthy young India by reducing the disease burden of HPV-related cancers and disease in our country.

Moderated by Ms Sutapa Biswas, Executive Director of Cancer Foundation of India (CFI), the session opened with remarks from Smt. Upasana Arora, Co-Chair, ASSOCHAM National Empowerment Council & Chairperson, Yashoda Superspeciality Hospital highlighted that Cervical cancer is the fourth most common cancer among women worldwide.  Awareness amongst both young girls and boys for cervical health and cervical cancer prevention is need of the hour. The most important thing you can do to help prevent cervical cancer is to get vaccinated early and have regular screening tests.

Ms. Lakshmi Puri, Key Speaker, Assistant Secretary-General United Nations, Deputy Executive Director UN Women and Ambassador,

 showcased how this subject of non-communicable disease in women is neglected by society and expressed that this topic should be highlighted not only on the global level but also within India. She also highlighted the need of reaching out to all women in urban and rural areas to avail of screening services for proper prevention. 

Further she stated that “India accounts for 24% of all cervical cancer cases worldwide. In 2020, GLOBOCAN has estimated that 604000 were diagnosed with cervical cancer and 342000 women died from the disease. About 14,480 new cases of invasive cervical cancer will be diagnosed and 4,290 women will die from cervical cancer.

Over the past decades incidence and mortality rates of cervical cancer declined in most regions but the battle is not won unless we are able to prevent, immunize, diagnose, and treat all women and girls. In India we need comprehensive health and social interventional approach to combat cervical cancer.

She also shared that, when she was with UNWOMEN, she closely worked with WHO & GAVI / UNITAID to focus on women’s health issues, and this was one of the causes they supported from 2015 onwards. On 17th November 2020, WHO and other partners with 154 members including India launched a global strategy to accelerate the elimination of cervical cancer and it was considered a great milestone even amidst covid. The target is 90-70-90; 90% of girls fully vaccinated with the human papillomavirus (HPV) vaccine by age 15, 70% of women screened with a high-performance test by 35 and again by 45 years of age, and 90% of women identified with cervical disease appropriately treated. If we achieve the elimination goal by the end of this century, we will have prevented 70 million new cervical cancer cases and 62 million deaths in low-income and high burden countries alone

“Age-appropriate Sex Education for children is the need of the hour to make them more open-minded and to inform parents that vaccines for 9-13-year-old girls are available for cervical cancer,” said Ms. Suruchi Gandhi, Principal, Bal Bharati Public School, Dwarka, New Delhi. 

“She talked about adolescent health, Adolescent is very sensitive period of 10 to 19 years of age where rapid growth takes place whether it is physical or psychological. The role of educators is very momentous in dealing with the problems of adolescent. Now that life skills are part of school education, we really need to provide complete education to children and their parents”, she further added.

In her address, Ms. Poonam Kamdar, Counselling Psychologist, motivated the audience with her inspiring journey about battling cervical cancer and how she lived through it. She stressed over the fact that “Prevention is better than cure and do not ignore the signs and signals your body gives you”.  


 
Dr. Satinder Kaur, Clinical Lead & Senior Consultant Gynae- Oncology, Dharamshila Narayana Superspeciality Hospital, Delhi, 

shared that cervical cancer is caused by an infection that is called human papillomavirus.

Human papillomavirus occurs to any women who is sexually active, even if you are into a single partner relationship. In majority of the cases, it gets treated on its own, but there are some risk factors, like if you have multiple sexual partners, if you have co existing other infections, you have chronic smoking etc. In all these cases HPV infection might get converted into a pre cancer stage and then into a cancer stage, which takes almost 10-15 years.

In spite of getting vaccination, you still have to get yourself screened because there is still 30% chance that you can get infection from other cancer-causing viruses, she further added.

She also highlighted that there is a need of awareness in males too because of their dominance in the society. She stated that “cervical cancer is only one cancer where the cause is known and where prevention is possible to avert the situation”. She added that getting the correct vaccinations is a blessing in disguise during pandemic and talked about the basics of cervical cancer.  

Dr. Kirti Chadha, Chief Scientific Officer, Sr Consultant Oncopathologist, MD, PDCC (Oncopath & Oncohemat), Metropolis Healthcare Ltd. Mumbai 

talked about the WHO’s global strategy for cervical cancer elimination– endorsed in 2020 calls for 70% of women globally to be screened regularly for cervical disease with a high-performance test, and for 90% of those needing it to receive appropriate treatment alongside 90% vaccination of girls against HPV. The implementation of this global strategy could prevent more than 62 million deaths from cervical cancer in the next 100 years.

She also emphasized on self-sampling, as studies show that women often feel more comfortable taking their own samples, for instance in the comfort of their own home, especially relevant during current pandemic.

Co test with cytology in HPV positive cases further improves specificity and positive predictive value and directs specific treatment of pre-cancerous lesion

There is an important shift in approach, it recommends an HPV DNA based test as the preferred method, rather than VIA or cytology (Pap smear), currently the most used methods globally to detect pre-cancer lesions.

HPV-DNA testing detects high-risk strains of HPV which cause almost all cervical cancers. HPV-DNA testing is an objective diagnostic test with high sensitivity and negative predictive value.

Ms. Neelima Dwivedi, MSD India’s Executive Director of Public Policy, Corporate Communications, and Market Access, said

“Nano -valent Human Papillomavirus vaccine is the only USFDA approved vaccine, first launched in US in 2015 and already approved in more than 80 countries across the globe, that helps protect against 9 types (Types 6, 11, 16, 18, 31, 33, 45, 52 and 58) of HPV.
In last 10 years >25 countries included male HPV Vaccine to fight against genital warts & anal cancer. US CDC recommends HPV vaccination for both males and females. Only adolescent boys can protect themselves from certain types of HPV infections with this HPV Vaccine.

HPV does not discriminate between males and females. HPV-Gender Neutral Vaccinations facilitates a more rapid reduction in HPV prevalence as well as a greater resilience towards temporary drops in vaccination coverage. The immense value of a gender-neutral HPV vaccine reflects the ‘shared responsibility’ of reducing HPV related cancer and disease burden and is a progressive step towards building a healthy population of young girls and boys in our country”, she added.

To summarise, the panel highlighted the need and efficacy of the HPV vaccine, Smt. Upasana Arora, Co-Chair, ASSOCHAM National Empowerment Council & Chairperson, Yashoda Superspeciality Hospital thanked all the speakers and participants for their valuable insights and ended on the positive note of “’When the Lady of the home is healthy, her family is healthy”.

The second session of this roundtable web series on Head and Neck cancer awareness is scheduled in April 2022.  The information will be available on ASSOCHAM’s Website (www.assocham.org)

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