Archivos de Patología Clínica

Economics of implementing international standard effective population based cervical cancer screening in India: A pan India study

Manu Noatay

To develop an effective population based screening programme for cervical cancer detection as there is a lack of effective organised screening programs for cervical cancer. Cervical Cancer (Cervix Uteri) is the most common form of Cancer among women in India. India has a population of 366.58 million women ages 15 years and older who are at risk of developing cervical cancer. Cervical cancer ranks as the 1st most frequent cancer among women in India. Current estimates indicate that every year 134,420 women are diagnosed with cervical cancer and 72,825 die from the disease. Cervical cancer has the highest rate of cancer incidence & mortality among Indian women. Cancer starts with infection with HPV and then persistence of infection leads onto preinvasive lesion and after 10-15 years into invasive cervical cancer. The development of cervical cancer is typically slow, and occurs over a period of years. The progression to cervical cancer begins with the development of precancerous changes in normal cells. Most of these changes, even if left untreated, will not progress to cancer. There are several risk factors for the development of cervical cancer, both genetic and environmental. These include: Human Papillomavirus (HPV) Infection, Family History of Cervical Cancer, Age, Sexual and Reproductive History, Socioeconomic Status, Smoking, HIV Infection, long-term use of oral contraceptives, >99% of Cervical Cancer cases are attributed to HPV infection - World Cancer Congress 2012. Although cancer of the cervix can develop in women of all ages, it usually develops in women aged 35-55 years, with the peak age for incidence varying with populations (Zeller et al, 2007). In India, the peak age for cervical cancer incidence is 45-54 years, which is similar to the rest of South Asia [WHO/ICO Information Centre on HPV and Cervical Cancer.