Cervical Cancer: Experts call for vaccination under national immunisation programme


A recent statewide health screening programme revealed that for every 100 women examined, one was detected with undiagnosed cervical cancer in Maharashtra. Despite this, the long-pending demand to include Human papillomavirus (HPV) — a vaccine for cervical cancer — in the national immunisation programme remains unfulfilled.

In the state, a total of 73,554 women above the age of 30 years were examined, of which 925 were detected with undiagnosed cervical cancer.

Cervical cancer is a common sexually transmitted infection. Long-lasting infection with certain types of HPV is the main cause of cervical cancer. Even after getting infected, the virus can sometimes take years before it causes any symptoms.

According to a study — ‘HPV Vaccination of Girl Child in India’ published in Asian Pacific Journal of Cancer Prevention — stated that globally 27 per cent of total cervical cancer cases are from India, which is home to 16-17 per cent of the world’s women population.

“The incidence of cervical cancer is already high in India. The existing vaccines have proven helpful in preventing cervical cancer globally. So, of course, if it is included in the national immunisation programme in which it would be given free of cost to girls, it would help reduce the burden,” said Dr Nikhil Datar, senior gynaecologist and Medical Director, Cloudnine Group of Hospitals.

It can be prevented to a large extent with the administration of HPV immunisation among girl children before they turn 14 years. Although HPV vaccination was introduced in 2008, it has yet to be included in the national immunisation programme.

“Cervical cancer is considered as the most common type of cancer witnessed among women which also has a high mortality rate due to late detection. HPV is the need of the hour,” said Dr Bakul Parekh, former president of the Indian Academy of Paediatrics (IAP).

Currently, two vaccines licensed globally are available in India — a quadrivalent vaccine (Gardasil, from Merck) and a bivalent vaccine (Cervarix, from GlaxoSmithKline). Each dose costs Rs 2,800 (Gardasil) or Rs 3,299 (Cervarix). Due to the high cost, women often shy away from taking the jab in private centres.

“These vaccines are expensive because of less demand. But once it is included in the immunisation programme and with mass awareness programmes, its demand will increase which might help bring down its price,” said Dr Parekh.

The Indian Academy of Paediatrics Committee on Immunisation (IAPCOI) recommends that HPV vaccines be given as a two-dose regimen, six months apart for girls below the age of 14 years. For those who are 15 and older, the vaccine is given in a three-dose regimen.

“The government is contemplating about the vax considering the risk and benefit equation and cost efficiency. It is upto the national immunisation committee to take a final call. But if it can save so many lives then why not,” he added.

In July, the Serum Institute of India (SII)’s vaccine Cervavac — India’s first quadrivalent human papillomavirus vaccine (qHPV) against cervical cancer — received the Drugs Controller General of India’s (DGCI) approval for market authorisation.

With this, WHO chief scientist Dr Soumya Swaminathan told The Indian Express then, “It will be great to see this vaccine being rolled out in the national HPV vaccination strategies in India and globally. We have a real opportunity to eliminate cervical cancer which causes a lot of death and suffering worldwide among women.”

As The Indian Express reported in August, the National Technical Advisory Group on Immunisation had said in a June 28 meeting (the minutes were released on July 17): “The indigenously developed qHPV vaccine may be considered for introduction in the UIP as a two-dose regime… once the HPV WG satisfactorily reviews the requested data.” But so far, the state hasn’t received any updates on it.





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