'Cervical Cancer Kills Over 77K Women In India Each Year' — Gynaecologists' Body Wants HPV Vaccine Added To National Program

Cervical cancer can be caused by different strains of human papillomavirus. It is rapidly becoming a more common preventable cause of death and suffering among Indian women than maternal mortality.

Around 1,20,000 women in India are estimated to develop cervical cancer each year. Of these, around 77,000 women succumb to cervical cancer infection annually.

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Cervical cancer results in the death of over 77,000 women in India each year, according to the Federation of Obstetric and Gynaecological Societies of India (FOGSI), the nation's the largest body representing obstetricians and gynaecologists in the private and public sector working towards women's health. The FOGSI has urged the government of India to include the Human Papillomavirus (HPV) Vaccine in the National Program to reduce the burden of cervical cancer, a cancer that starts in the cells of the cervix, the lower end of the uterus. 

The disease can be caused by different strains of human papillomavirus. Cervical cancer is rapidly becoming a more common preventable cause of death and suffering among Indian women than maternal mortality. The HPV vaccine helps prevent cervical cancer. Despite the availability of vaccines and screening techniques, cervical cancer continues to kill thousands of Indian women each year. 

India’s indigenously developed HPV vaccine

Pune-based pharmaceutical firm Serum Institute of India (SII) will soon launch CERVAVAC, India’s first indigenously developed Quadrivalent Human Papillomavirus (qHPV) vaccine against cervical cancer. On September 1, Adar Poonawalla, CEO of the SII, said at an event in Delhi that the qHPV vaccine will be available in the country in a few months. 

FOGSI organised event to accelerate elimination of cervical cancer from India

The body of obstetricians and gynaecologists recently organised an Expert Group Meeting at All India Institute of Medical Sciences (AIIMS), New Delhi. The theme of the event was 'Accelerating Action for Cervical Cancer Mukt Bharat'. The delegates at the event spoke about the Indian government's efforts to accelerate elimination of cervical cancer from the country, a statement released by FOGSI says. 

How many Indian women develop cervical cancer each year?

Around 1,20,000 women in India are estimated to develop cervical cancer each year. Of these, around 77,000 women succumb to cervical cancer infection annually. The number of Indian women aged 15 years and above who are at risk of developing cervical cancer is 453 million. 

In the statement, Dr Shantha Kumari, President, FOGSI, said: “So much morbidity and mortality due to cervical cancer is needless. What begins as mild dysplasia takes 10 to 20 years to turn into cervical cancer. This long progression makes the disease entirely preventable. What is needed is regular screening to detect precancerous lesions for early diagnosis treated in a timely manner to prevent their progression into cancer. Yet just screening is not enough. We also require widespread immunization with the HPV vaccine. This can prevent most cases of cervical cancer, and other cancers caused by HPV, if given to women and girls before they get exposed to the virus. We at FOGSI and other like-minded associations would like to see Government of India include the HPV vaccine in the National Program.”

At the event, Dr. Neerja Bhatla, Head, Dept. of Obstetrics & Gynaecology, AIIMS, New Delhi, said: “India is now on its way to universalizing the national-level HPV vaccination program to prevent cervical cancer. Recently, a made-in-India HPV vaccine, Cervavac, was introduced after conducting a large multi-centric trial. It is considered safe, highly effective, and affordable. Efforts are also being made to develop an affordable point-of-care indigenous HPV test to ensure universal cervical-cancer screening. With this, there is new hope to make rapid progress towards elimination of cervical cancer in India.”

What Are HPV Vaccines?

HPV vaccines protect against infection caused by human papillomaviruses (HPV), which represent a group of more than 200 related viruses. Of these, more than 40 are spread through direct sexual contact. As many as two HPV types cause genital warts, and about a dozen HPV types can cause certain types of cancer, namely cervical, oropharyngeal, vulvar, vaginal, penile, and anal cancers.

According to the US National Institute of Health's (NIH's) National Cancer Institute, three vaccines that prevent infection with disease-causing HPV are currently being marketed in many countries throughout the world. These are Gardasil, Gardasil 9, and Cervarix.

Why Are HPV Vaccines Required?

HPV vaccines are important because they could reduce the impact of cervical cancer and other cancers caused by human papillomaviruses. More than 95 per cent of cervical cancer is caused by sexually transmitted HPVs. This is the fourth most common type of cancer in women globally, with 90 per cent of these women living in low-and middle-income countries.

There are different strains of HPVs which spread through sexual contact. They are associated with most cases of cervical cancer. 

How Does A Cervical Cancer Vaccine Work?

The SII's tetravalent or quadrivalent HPV vaccine includes L1 virus-like particles (VLPs) of serotypes 6, 11, 16, and 18. A quadrivalent vaccine works by stimulating an immune response against four different antigens, such as four different viruses or other microorganisms. For instance, Gardasil is a quadrivalent vaccine that protects the body against infection with four different types of HPVs. Meanwhile, Gardasil 9 is a nine-drug vaccine which provides protection against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58. 

The L1 protein is sufficient to form virus-like particles, which are molecules that mimic viruses but are not infectious. These particles are an effective way of creating vaccines against diseases caused by HPVs, hepatitis B virus, among others.