India among nations with most cervical cancer cases: Study

According to the study, there were at least 600,000 new cases of cervical cancer and 340,000 deaths worldwide in 2020, of which 123,907 cases and 77,348 deaths were reported from India.

India is one of the high disease burden countries for cervical cancer, accounting for 21% of cases and 23% deaths globally, according to an observational study published in The Lancet Global Health journal on Wednesday, adding that the country has still seen a sharp decline in cases.

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According to the study, there were at least 600,000 new cases of cervical cancer and 340,000 deaths worldwide in 2020, of which 123,907 cases and 77,348 deaths were reported from India.

Although cervical cancer has decreased in many regions over the past three decades—Latin America, Asia, Western Europe and North America, for instance—the burden remains high in many low- and middle-income countries, said researchers .

The development of effective HPV vaccination and screening programmes has made cervical cancer a largely preventable disease, they added.

India started community cancer screening programme a few years ago, wherein those above 30 years of age are screened for common cancers such as oral, breast and cervix at its Ayushman Bharat- Health and Wellness Centres, to ensure early detection and treatment.

“Millions of cancer cases have been identified and put on treatment since the time community screening began, who otherwise would have been missed. A robust screening programme helps significantly in early diagnosis and treatment. Earlier a patient of cancer gets treatment, better is their treatment outcome,” said a senior central government official, requesting anonymity.

Dr GK Rath, head, National Cancer Institute, and former head of cancer division, All India Institute of Medical Sciences, Delhi, said, “Cancer of breast and cervix uteri are the most common cancers among women in India. If you look at the national cancer registry, cervical cancer is estimated to contribute at least 5% of the total cancer burden in the country.”

In 2020, the World Health Organisation (WHO) announced elimination of cervical cancer as a public health problem, aiming to reduce incidence below a threshold of four cases per 100,000 women per year in every country by 2030.

“HPV vaccination and screening technologies mean that cervical cancer is now largely preventable. Our study finds encouraging decreases in some high-income countries following successful implementation of HPV vaccination programmes and screening—such as in Sweden, Australia, and the UK—but globally the burden remains high. All over the world, women should be free from the risk of preventable cancer, and with development of effective vaccines and screening over the past 20 years, we have the tools to make this a reality,” said Dr Deependra Singh, International Agency for Research on Cancer (IARC), WHO, France, one of the authors of the study.

The study used IARC’s GLOBOCAN 2020 database to estimate the burden of cervical cancer incidence and mortality rates in 185 countries.

In 2020, rates of cervical cancer cases were 13 per 100,000 women per year and there were seven deaths per 100,000 women . Incidence rates in 172 out of 185 countries, still exceeded the four cases per 100,000 women per year threshold for elimination set by WHO.

The authors observed major declines in cases in some Latin American countries, including Brazil, Colombia, and Costa Rica. A similar pattern was observed in Asia in India, Thailand, and South Korea, as well as in Eastern Europe in Poland, Slovenia, and Czechia.

However, there were increases in cases in Eastern Europe, in Latvia, Lithuania, and Bulgaria, and Eastern Africa in the past decade, as well as in The Netherlands and Italy. The reasons for recent increases might include increased prevalence of HPV among the younger generations of women and lack of effective screening programmes.

“Cervical cancer cases are much higher than the threshold agreed by the WHO initiative on cervical cancer elimination in most countries, indicating that there is still much work to be done before 2030,” said Dr Valentina Lorenzoni, Scuola Superiore Sant’Anna, Italy,co-author of the study.