Challenges in Cervical Cancer Prevention: Real-World Scenario in India

Abstract

In spite of global falling trends, cervical cancer remains a major healthcare challenge for India, South Asia Association for Regional Cooperation region, and other low- and middle-income countries. Our survey was to document the real-world challenges that still exist in India. A total of 316 eligible and complete responses to the 21 questions were analyzed. Screening of mothers and vaccinating their daughters was considered as the most important strategy to prevent cervical cancer by 65.8% (208/316). Screening was offered to all asymptomatic eligible females by 79% (250/316). Improvement in screening rates requires promoting the national program (67.7%; 214/316), strengthening existing infrastructure (62%; 196/316), regular training of primary healthcare workers (57.6%; 182/316), and increasing awareness among schools and colleges (57.9%; 183/316). Almost all responders (93%; 294/316) wanted to have human papillomavirus (HPV) vaccination included in the national immunization schedule. Cost of vaccine was considered a major roadblock. If it became available at INR 250 per dose, 96.8% (306/316) respondents would recommend it for all eligible patients. With the impending availability of this indigenous tetravalent HPV vaccine jointly produced by Department of Biotechnology, Govt of India and Serum Institute of India, the war against cervical cancer just got easier.

The acceptability of, and informational needs related to, self‐collection cervical screening among women of Indian descent living in Victoria, Australia: A qualitative study

“…A systematic review in India exploring the implementation of self‐collection found patient‐level barriers, including lack of knowledge and misconceptions, low prioritisation to screen and poor sample quality due to a lack of self‐efficacy outweighed provider‐ and systems‐level barriers 44 . Solutions to address patient‐level barriers centred around community engagement and education strategies, including access to self‐collection swabs for women to develop familiarisation with the test and to mitigate fears and misconceptions related to self‐collection 43 . These studies provide contextualisation to our findings on barriers to women's screening participation and views of self‐collection in Australia.…”

“…[19][20][21]42 Similarly, a survey of 316 health practitioners in India found the most significant barrier to screening among their patient group was being asymptomatic, followed by embarrassment and fear of cancer diagnosis, and thus, there is a need to raise awareness to debunk myths and clarify facts related to cervical screening and HPV vaccination. 43 A systematic review in India exploring the implementation of self-collection found patient-level barriers, including lack of knowledge and misconceptions, low prioritisation to screen and poor sample quality due to a lack of self-efficacy outweighed provider-and systems-level barriers. 44 Solutions to address patient-level barriers centred around community engagement and education strategies, including access to self-collection swabs for women to develop familiarisation with the test and to mitigate fears and misconceptions related to self-collection.…”

Experience of Establishment of a Community PAP Smear Lab at Rural Community Health Center in North India

“…Awareness, screening, and early detection lead to improvement in mortality. 1,5 Our prospective study aimed to establish a community PAP smear lab as part of (demonstrable) healthcare reforms in rural India.…”

“…Cervical cancer is second commonest cancer in rural Indian females. 1 This is most preventable cancer due to long biological course, identifiable precancerous lesions, and effective vaccine. 2 3 Other risk factors are younger age at marriage, number of pregnancies, genital hygiene, and tobacco consumption.…”

“…Awareness of the community is major challenge. 1 Successful cancer screening programs need decentralization with focus on rural health centers and incentives. Use of technology in form of mobile smart phone and use of artificial intelligence technology may lead to improve outcome in resource limited setting.…”