Cervical Cancer in SAARC Countries

Abstract

In the year 2020, a total of 342 000 women were estimated to die of cervical cancer, of which 90%) were expected amongst low- and middle-income countries (LMIC). Globally incidence of cervical cancer has reduced as a result of improved personal hygiene, better living conditions and higher application of opportunistic screening programs. Yet GLOBOCAN shows that absolute number of cases are still increasing.We therefore conducted a 21 question multiple choice questionnaire online survey in Jan 2023 amongst 9 SAARC countries. A total of 367 replies were received and the representative answers for each country are being reported in this manuscript.A good possibility of achieving World Health Assembly target (Nov 17, 2020) was felt only by Bhutan and Nepal. For screening, most countries (Bhutan, India, Myanmar, Nepal, Pakistan and Sri Lanka) recommend for all asymptomatic eligible patients. Public health experts have suggested VIA / VILI as the best solution for LMICs. However, a dual screening strategy (HPV DNA plus) cytology was preferred by doctors in Afghanistan, Bhutan, India, Myanmar, Pakistan and Sri Lanka.Screening, triage and then treatment was the preferred by Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, Sri Lanka.HPV vaccination was recommended in all girls between ages 10 to 26 years in Bangladesh, India, Myanmar, Nepal, Pakistan and Sri Lanka. All the 9 countries would use HPV vaccination to all eligible patients if the cost of the vaccine was reasonably low.Our survey clearly outlines challenges faced in tackling cervical cancer in SAARC countries. We also provide consensus regarding several potential solutions that can be used in both public and private cervical cancer control programs.

Practical Consensus Guidelines for the Use of S-1 in GI Malignancies

“…12 Due to cultural and social differences, Indian older cancer patients and those from other low-and middle-income countries (LMIC) are best evaluated by using screening tools developed and validated locally. [13][14][15] Since sociocultural features are similar among South Asian Association for Regional Countries (SAARC) countries, the SCOPE-C Ver2 questionnaire is recommended as the ideal screening tool for older patients with cancer in SAARC. 16 Colorectal Cancer S-1 has been studied extensively, received first approval in Japan in 1999, approved by European Marketing Agency (EMEA) in 2011 and is currently approved in 30 countries (including India) for seven indications.…”

“… 12 Due to cultural and social differences, Indian older cancer patients and those from other low- and middle-income countries (LMIC) are best evaluated by using screening tools developed and validated locally. 13 14 15 Since sociocultural features are similar among South Asian Association for Regional Countries (SAARC) countries, the SCOPE-C Ver2 questionnaire is recommended as the ideal screening tool for older patients with cancer in SAARC. 16 …”

Awareness of Cervical Cancer, Risk Perception, and Practice of Pap Smear Test among Young Adult Women of Dhulikhel Municipality, Nepal

“…Globally, cervical cancer is the 4th most frequent malignancy in women, with an estimated 604,000 new cases and 342,000 deaths in 2020 [ 1 ]. It is the second most common cancer in women in the South-East Asia Region (SEAR) and becoming a major cause of cancer deaths among women in low and middle-income countries (LMICs) including Nepal [ 2 ].…”

Nurses and doctors ‘s awareness and knowledge towards treatment and care of cervical cancer patients: a cross-sectional study

“…Cervical cancer remains a significant public health issue worldwide, particularly in India and the SAARC nations (Afghanistan, Bangladesh, Bhutan, India, Maldives, Myanmar, Nepal, Pakistan, and Sri Lanka) [ 6 , 19 ]. Cervical cancer burden estimate for Pakistan has been limited and regional.…”