India

About cervical cancer in India

In India, cancer of the cervix uteri is the 3rd most common cancer with an Incidence rate of 18.3% (123,907 cases) and the second leading cause of death with a mortality rate of 9.1% as per GLOBOCAN 2020. The Age standardized incidence rate per 100 000 population was 18 while the 5 year prevalence rate across all ages was 42.82 per 1 lakh population. As per the National Cancer Registry Programme, cancer of breast and cervix uteri was the most common cancers among females. Cervical cancer accounted for 6-29% of all cancers among women in India. Papumpare district in the state of Arunachal Pradesh, India had the highest incidence rate of cervical cancer (27.7) in Asia. The majority of the patients with cancer were diagnosed at the locally advanced stage for breast (57.0%), cervix uteri (60.0%), head and neck (66.6%), and stomach (50.8%) cancer, whereas in lung cancer, distant metastasis was predominant among males (44.0%) and females (47.6%).

Healthcare governance in India

Health is primarily a State Responsibility as per the Constitution of India. The Ministry of Health and Family Welfare, Government of India is the Central Governing body that looks after the Health sector in the country. Apart from the State and Central Governments, there are various other Private sector institutes, NGOs, CBOs, philanthropic organisations etc who are also actively involved in various healthcare activities providing preventive, promotive and curative services to the people.

National health policy

The National health Policy of India which was first drawn up in 1983 and subsequently revised in 2002 and 2017 provides the overall guidelines for the health sector in the country. Its primary aim is to inform, clarify, strengthen and prioritize the role of the Government in shaping health systems in all its dimensions- investments in health, organization of healthcare services, prevention of diseases and promotion of good health.

National cancer registry program

Cancer registry is an organization of systematic collection, storage, analysis, interpretation and reporting of data on patients with cancer (IARC). A proper analysis and interpretation of data provides insights with inputs for its prevention, control and management.

Cervical cancer policy/strategy

At present, there does not appear to be a single comprehensive cervical cancer program at the national level in India. Some provisions for cervical cancer prevention and treatment are included within the documents related to the aforementioned policies and strategies.

Cervical cancer screening policy/strategy

There is no comprehensive national screening program in India at present. A lifetime screening prevalence of 29.8% among women aged 30-49 has been reported from a nationally representative survey. The Ministry of Health and Family Welfare has 4 recommended the Visual Inspection with Acetic Acid (VIA) screening method for women aged 30-65 with a 5-year interval since 2016 as per the operational framework.

HPV immunization policy/strategy

Although there is no national human papillomavirus (HPV) immunization program in India, there are several efforts, including one state- wide program in Sikkim, another program in two districts of Punjab and an opportunistic program based in Delhi.

Services provided by the consortium members

Manipal Academy of Higher Education (MAHE): MAHE has applied research efforts with an emphasis on interdisciplinary research and engagement with the wider research community. MAHE has relevant infrastructure required for the project, including an HPV testing facility (Roche-COBAS), VIA-AI and a cryocautery unit. The MAHE team has designed the ECO-Easy Cervical Optimiser device for cancer cervix screening by VIA-AI, which will be used for PRESCRIP-TEC project.
St. John’s Medical College, a unit of CBCI Society of Medical Education Bengaluru: The department is actively involved in preventive oncology work. Its role is to perform screening and field research handling gynaecological malignancies by radiation therapy and palliative care for management of cancer pain and terminal care.

Dharmasthala Manjunatheshwara Educational Society Ujire, Department of Obstetrics and Gynaecology: The Department has organised free rural breast and cervical cancer screening camps and has established good rapport with the general public and NGOs to ensure better communication and outreach. Within PRESCRIP-TEC, the Department will perform screening and field research in cervical cancer.
Tata Medical Centre: is a private cancer care centre, established in May 2011 and committed to delivering comprehensive cancer care, including prevention, diagnosis and treatment, rehabilitation and palliation, and research. The activities of the Centre within the PRESCRIP -TEC project will be coordinated by the preventive oncology unit after the formation of a core team.

Impact areas where we are working

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Epidemiology SummaryCountry data
Population (million)1360
Female population aged 20-29 (million)137.8
Female population aged 30-59 (million)230.5
HPV prevalence (%)2.3% – 36.9%
Cervical cancer incidence rate (crude, per 100 000)18.7
Cervical cancer incidence rate (age-standardized, per 100 000)18.0
Cervical cancer mortality (crude, per 100 000)11.7
Cervical cancer mortality (age- standardized, per 100 000)11.4
Available/recommended method of screeningVIA
Type of screeningOpportunistic
Is there a national strategy/program dedicated to cancer?Yes – National Cancer Cancer Control Programme + separate program for NCDs
Is there a national strategy/program dedicated to cervical cancer?Yes
2017-2022
Target age group in the project (years)35-55

National guidelines for cervical cancer screening

Cervical Cancer can be prevented by screening women systematically through organized population based programmes. Under the National Cancer Control Programme and the National Cancer Registry Programme, different screening strategies have been adopted in India since 1975. Various screening techniques such as visual inspection with acetic acid, visual inspection with Lugol’s iodine, visual inspection with magnification devices-magnavisualizer, Pap smear and HPV-DNA testing are being used either on a camp approach or as opportunistic screening in the different health and wellness centres, PHCs/CHCs/FRUs etc. The current programme mainly targets women in the 30 – 65 years age group.

News from India

Cervical Cancer Screening Awareness Programme in Innanje village, Udupi district (India)
Cervical Cancer Screening Awareness Programme in Innanje village, Udupi district (India)

A successful Cervical Cancer Awareness Programme and screening camp was held in Innanje to promote the elimination of cervical cancer…

One year of the Cervical Cancer Elimination movement. What is PRESCRIP-TEC doing?
One year of the Cervical Cancer Elimination movement. What is PRESCRIP-TEC doing?

On 17th November 2021 we are celebrating the Cervical Cancer Elimination movement. Know what PRESCRIP-TEC is doing.

PRESCRIP-TEC Nominated for Computable Awards 2021 in the Care Project Category
PRESCRIP-TEC Nominated for Computable Awards 2021 in the Care Project Category

Cervical cancer is a leading cause of death among women in resource-poor or hard-to-reach settings in the world, especially sub-Saharan…

Towards elimination of cervical cancer
Towards elimination of cervical cancer

Jaap Koot, coordinator of PRESCRIP-TEC, talked about cervical cancer at the International Student Congress of (bio)Medical Sciences (ISCOMS)

New WHO recomendations for screening and treatment of cervical cancer.
New WHO recomendations for screening and treatment of cervical cancer.

In order to reach the 2030 targets for cervical cancer elimination, the World Health Organization is launching two new products:…

New initiative launched to fight cervical cancer through prevention and early diagnosis
New initiative launched to fight cervical cancer through prevention and early diagnosis

Prevention and Screening Innovation Project Towards Elimination of Cervical Cancer" (PRESCRIP-TEC) is a 3-year project funded by the Horizon 2020…

The world glows teal for cervical cancer elimination
The world glows teal for cervical cancer elimination

Cancer of the cervix of the uterus is preventable and curable. Yet it is the fourth most common form of…