Community mobilisation needed to tackle rising cancer deaths

On World Cancer Day, here are some India-specific statistics that need immediate attention.
The incidence of cancer is 70-90 per 100,000 population, with prevalence stated to be about 2.5 million cases. Over 800,000 new cases and 550,000 deaths occur each year, with over 70% of the cases being diagnosed at an advanced stage. That means when a person comes for treatment, their chances of survival are very poor.

ICMR data on site specific cancer burden reveals that in males the most common cancers are those of the mouth, stomach and lung/bronchi. In females, it is that of the cervix, breast, mouth and oesophagus. After breast cancer, cervical cancer is the second most common cancer among women in India.

More women in India die from cervical cancer than in any other country, according to a 2014 report by the Cervical Cancer Free Coalition. Cervical cancer kills around 72,000 women in India every year, more than 26% of the 275,000 deaths worldwide.

The report also says that the causes are closely linked to attitudes towards women and unless that changes the deaths will rise. Because it is linked to sexual contact, “cervical cancer is a taboo issue in many places”, said the U.S-based group in a statement. “Unless women’s groups and civil society come together to lead movements that break through stigma, patriarchy and other societal barriers, we will continue to see large numbers of deaths and high mortality rates,”.

Cervical cancer, which mostly affects women between 18-45 years, is linked to human papillomavirus, a sexually transmitted virus.. The virus is believed to be responsible for most cervical cancer cases — more than 80%, according to some estimates. A pap smear can spot the virus at an early stage and HPV vaccines have been developed. In December 2014, the Indian health ministry announced that it wanted to introduce the vaccine in the universal immunisation programme at the earliest.

What is missing however is a countrywide cancer screening program to catch the disease early. Cervical cancer is a preventable disease but it can also be successfully treated if detected early.

The UNAIDS statement calling for a greater integration of health services to tackle cervical cancer is a welcome one. It says “the relationship between HPV and HIV offers significant opportunities to reduce the impact of both viruses, since existing HIV programmes could play an important role in expanding cervical cancer prevention and treatment services.” It goes on to recommend that every woman who tests HIV positive should be offered screening for cervical cancer and follow-up treatment if needed. And that HIV testing should also be offered during cervical cancer screening.

An effective intervention also calls for delivering age-appropriate programmes for adolescent girls, that includes HPV vaccines and regular screening. Steps India has to accord high priority to to rein in the galloping figures.

Also read: State of India’s Children | SNEHA