A Nation's Priority - Its About Time!
Manoj Jagathmohan, Director & Head, Commercial Operations India, QIAGEN lndia, 0
Above all, be the heroine of your life, not the victim- Nora Ephron “The story of two journeys separated by time and space but connected through something even stronger something that can save the lives of millions of women around the world.”- the opening lines of the touching and inspiring documentary “Lady Ganga”. The protagonist Michelle was diagnosed with cervical cancer and had few months to live. She decided to do something extraordinary before her death: Break a world paddle boarding record on the Ganges River-She made a difference by paddle boarding more than 700 miles down the Ganges River to raise awareness of cervical cancer.
Women constitute for 48.5 percent per cent of the India’s population. As per International Agency for Research in Cancer Information Centre on HPV and Cancer, India has a population of 453.02 million women between 15 to 65 years who are at risk of developing cervical cancer. Current estimates indicate that every year 96922 women are diagnosed with cervical cancer and 60078 die from the disease. Cervical cancer ranks as the 2nd most frequent cancer among women in India.
As we celebrated International Women’s Day on the 08th of March 2021 amidst the pandemic our priorities have shifted enormously over the last 12 months but the silver lining is that there is absolute focus on healthcare and various aspect of this paradigm and secondly where there is a will there is a way, which means India has shown if we take up a fight we would come out winners. It is this radical shift that augurs well for our fight against human diseases. And it is this zeal we need to show towards managing cervical cancer.
Cervical Cancer is preventable. The strong link between high-risk persistent Human PapillomaVirus (HPV) infections and the occurrence of cervical cancer is well established and documented. While the numbers are daunting, morbidity and mortality due to cervical cancer is preventable. The paradox is we know the cause, we know it is preventable, there are screening options and vaccines available, but the death rates are the highest- One Indian woman dies of cervical cancer every 8 minutes.
For over a decade multiple screening and treatment methods have been researched, proven effective and demonstrated including in India. Visual inspection tests, cytology test and HPV DNA are some screening options which can facilitate early diagnosis and prompt treatment of cervical cancer cases. Guidelines for population-based screening programmes for cervical cancer in India have been established for more than 10 years and are based on visual inspection tests.
Community based cervical cancer screening program has been implemented on pilot basis in various parts of the country especially the Barshi Study published in New England Journal of Medicine wherein it concludes that with HPV DNA test the mortality rates can be lowered by 50 percent even with once in a lifetime screening. However, despite the introduction of the national guidelines, screening coverage is still very low.
In India the screening coverage for cervical cancer is only 3 percent of women aged between 25-64. As in other
Understanding and addressing these challenges is the key to facilitating primary and secondary prevention of cervical cancer in India. The first big step forward is to create awareness. In spite of pandemic we need to focus on other preventable diseases like cervical cancer which are a ticking time bomb.
The pandemic has taught us how we can come together to provide end to end solutions to fight the scourge in a short time and when it becomes a Nation’s priority on a mission mode, we deliver the results collectively.
As per international agency for research in cancer information centre on HPV and cancer, India has a population of 453.02 million women between 15 to 65 years who are at risk of developing cervical cancer
The following lessons learnt from the COVID-19 pandemic can be deployed in the fight against cervical cancer
• First to make it a Priority
• the power of awareness
• break the barrier of stigma
• pivotal role of healthcare providers at all levelsand
• capability to rapidly ramp up systems for delivery of services and look at prevention
We need to adapt best practices from the successful screening programmes being implemented by Regional Cancer Centres at grass root level like the community-based screening under the aegis of Adyar Cancer Institute-Chennai, Tata Memorial Hospital Mumbai, Tata Medical Centre& CNCI - Kolkata, AIIMS- New Delhi & Cachar Hospital- Assam. Each of them has been successful and unique in spearheading to drive the cause of cervical cancer elimination. In a sustainable manner they have engaged with health care workers, community volunteers, integrating newer methods like HPV DNA test for early diagnosis and other new tools for treatment.
With only 12 percent of the urban and 13 percent of the rural population under any kind of health insurance coverage and around 3/4th of the health care expenditure being borne by the families in India, diagnosis of cancer becomes a devastating news for the household because of the constant financial and psychological hardships caused by its costly treatment. Women play a crucial role in the growth of the economy.
Today, India boasts nearly 1.4 million women panchayat leaders – a number that is an indicator of the leadership roles women are increasingly taking up. Women’s Health must be a top priority in the well-being of a family and in our Indian Society. This also impacts our Nation’s health and economy as NCDs poses a renewed threat to the financial protection of the population, which is related not only to the high costs of treatment, but also compounded by the long duration of treatment for what are often chronic illnesses or long-term disabilities.
This pandemic fight ready mode should extend to cervical cancer. The need is now more than ever before, and the time is NOW to make this our priority as a Nation to swiftly paddle many miles on a mission mode to eliminate cervical cancer in the Land of Ganges. This is “A Nations priority – It’s about time!