Cervical Cancer Awareness and the HPV Vaccine

January is Cervical Cancer Awareness Month, a time when doctors urge women to get screened for cervical cancer, an important health issue, especially in India. Let's break down why this disease is a concern and what can be done to prevent it.

What is Cervical Cancer?

• Cervical cancer develops in the cervix, the lower part of the uterus (womb) that connects to the vagina.
• It is one of the leading causes of cancer among women in India. The primary cause of cervical cancer is Human Papillomavirus (HPV)
• Around 7% of cervical cancers worldwide are caused by certain types of HPV.
• Cervical Cancer Burden in India: Cervical cancer is the third most common cancer among women in India, with an incidence rate of 18.3%, translating to around 123,907 cases It is also the second-leading cause of cancer-related deaths among women in the country.
• Key statistics:
• Cervical cancer accounts for 6-29% of all cancers in Indian women.
• The highest incidence of cervical cancer is found in Papumpare district, Arunachal Pradesh (27.7 cases per 100,000 people).

HPV Vaccine:

• The HPV vaccine is a powerful tool in preventing cervical cancer. It works by stimulating the body’s immune system to produce antibodies that fight against HPV infections, the leading cause of cervical cancer. Vaccination is most effective when given before a person is exposed to the virus, ideally in pre-teens or teenagers.
• Vaccine Availability in India
• The HPV vaccine has been available in India since 2008, but its high cost has made it less accessible.
• Currently, HPV vaccines can only be obtained through private practitioners in India.
• Some states like Punjab and Sikkim have already included the HPV vaccine in their immunization programs.
• The National Technical Advisory Group on Immunization (NTAGI) has recommended the inclusion of the vaccine in India’s national immunization program, particularly for girls aged 9-14.
• The Indian government announced its plans to focus on cervical cancer prevention in its Interim Budget 2024. This marks a significant step toward making the vaccine more accessible to the public.
• Importance of HPV Vaccination for Both Genders: The HPV vaccine is not only recommended for women but also for men and boys. It helps prevent genital warts, and certain cancers related to HPV, including anal, throat, and penile cancers. Boys and young men aged 9–26 should get vaccinated, as well as unvaccinated adults up to 45 years.

HPV Vaccine Options in India

India has authorized several HPV vaccines:

• Gardasil (a quadrivalent vaccine) – Protects against HPV types 6, 11, 16, and 18.
• Cervarix (a bivalent vaccine) – Protects against HPV types 16 and 18.
• Cervavac – An India-made vaccine developed by the Serum Institute of India, which also protects against HPV types 16 and 18, and is approved for ages 9 to 26.
• Cervavac is priced at around Rs 2,000 per dose, making it more affordable than imported options like Gardasil.
• Gardasil 9 costs around Rs 10,850 per dose, while Gardasil 4 is priced between Rs 2,000 and Rs 4,000 per dose.

Challenges to HPV Vaccination in India

Despite the proven effectiveness of the HPV vaccine, there are several challenges that affect its uptake in India:

• High Cost: Vaccines like Gardasil are expensive, making it unaffordable for many.
• Lack of Awareness: Many people are unaware of the vaccine and its importance in preventing cervical cancer.
• Cultural Barriers: Cultural perceptions around reproductive health and vaccination prevent many women from getting vaccinated.