Advancing Cervical Cancer Prevention in India : Insights from Research and Programs

Cervical cancer is the leading cause of cancer mortality in India, accounting for 17 percent of all cancer deaths among women age 30 to 69 years. At current incidence rates, the World Health Organization (WHO) estimates that the annual burden of new cases in India will increase to nearly 225,000 by 2025. Despite the considerable burden of cervical cancer morbidity and mortality in India, there are few large-scale, organized cervical cancer prevention programs in the country. We reviewed the research literature and conducted interviews with individuals engaged in research and public health program implementation to identify important elements of cervical cancer prevention efforts in India and implementation issues that merit further investigation. Although primary prevention through HPV vaccination has been endorsed by WHO, under certain conditions, in low- and middle-income countries (LMICs), its cost, partial efficacy and safety have been intensely debated in India. Further research and advocacy efforts are needed to determine the optimal strategies for its introduction and sustained use in the country. However, there is considerable research and programmatic evidence in support of secondary prevention of cervical cancer through screening and treatment. Regardless of screening approach, research and prevention programs have underscored the importance of ensuring strong linkages between screening, diagnosis, and treatment services for program and cost effectiveness. Available evidence also emphasizes that programs that are 'women-centered,' or actively respond to women's concerns and constraints are likely to be the most successful. In conclusion, research and prevention program experiences provide a strong rationale for investments in cervical cancer prevention in India.

Bibliographic Details

Main Authors:	Krishnan, Suneeta, Madson, Emily, Porterfield, Deborah, Varghese, Beena
Language:	English en_US
Published:	World Bank, Washington, DC 2013-10
Subjects:	ABILITY TO PAY, ABNORMALITIES, ACCESS TO CARE, ACCESS TO HEALTH SERVICES, ACCESS TO TREATMENT, ADOLESCENCE, ADOLESCENT GIRLS, ADOLESCENT HEALTH, ADULTHOOD, ADVOCACY EFFORTS, AIDS RESEARCH, ALLERGIC REACTIONS, BIOPSY, BLIND, CANCER PREVENTION AND CONTROL, CARDIOVASCULAR DISEASE, CAREGIVERS, CERVICAL CANCER, CERVICAL CANCER SCREENING, CERVICAL CANCERS, CHRONIC CONDITIONS, CHRONIC DISEASES, CLINICAL OUTCOMES, CLINICS, COMMUNICABLE DISEASE, COMMUNITY EDUCATION, COMMUNITY HEALTH, CONTRACEPTION, COST EFFECTIVENESS, COUNSELING, COUNSELORS, CRYOTHERAPY, CYTOLOGY, DEOXYRIBONUCLEIC ACID, DEVELOPING COUNTRIES, DIABETES, DIAGNOSIS, DISABILITY, DISEASE PREVALENCE, DISEASE PREVENTION, DNA, DOCTORS, DRUGS, DYING, EARLY DETECTION, EARLY MARRIAGE, EDUCATIONAL ACTIVITIES, EPIDEMIOLOGY, EQUITABLE ACCESS, EXPENDITURES, FAMILIES, FAMILY MEMBERS, FAMILY SUPPORT, FEMALE, FEMALES, FERTILITY, GENITAL WARTS, GLOBAL HEALTH, GOVERNMENT DEPARTMENTS, GOVERNMENT HEALTH WORKERS, GOVERNMENT PROGRAMS, GROSS NATIONAL INCOME, HEALTH ACTIVISTS, HEALTH CARE, HEALTH CARE ACCESS, HEALTH CARE INFRASTRUCTURE, HEALTH CARE PROVIDER, HEALTH CARE PROVIDERS, HEALTH CARE SERVICES, HEALTH CARE SYSTEM, HEALTH CARE WORKERS, HEALTH CENTERS, HEALTH EXPENDITURE, HEALTH FACILITIES, HEALTH INFORMATION, HEALTH INFORMATION SYSTEM, HEALTH INFORMATION SYSTEMS, HEALTH POLICY, HEALTH PROMOTION, HEALTH RESEARCH, HEALTH SERVICES, HEALTH SPECIALIST, HEALTH SYSTEM, HEALTH SYSTEMS, HIGH FERTILITY, HIV, HOSPITAL, HOUSEHOLD RESPONSIBILITIES, HUMAN DEVELOPMENT, HUMAN RESOURCES, HUSBANDS, HYPERTENSION, ILLNESS, ILLNESSES, IMMUNE SYSTEM, IMMUNIZATION, INCLUSION OF WOMEN, INFECTION, INFLAMMATION, INFORMATION SYSTEM, INFORMATION SYSTEMS, INFORMED CONSENT, INFORMED DECISIONS, INJURY, INPATIENT CARE, INSURANCE, INSURANCE SCHEMES, INTERPERSONAL COMMUNICATION, INTERVENTION, LACK OF AWARENESS, LIFETIME RISK, MEDICAL CARE, MEDICAL ETHICS, MEDICAL EXPENSES, MEDICAL OFFICERS, MEDICAL RESEARCH, MEDICINE, MEDICINES, MIDWIFE, MIDWIVES, MIGRATION, MINISTRY OF HEALTH, MINORITY, MORBIDITY, MORBIDITY AND MORTALITY, MORTALITY, MORTALITY RATE, NATIONAL AIDS, NATIONAL GOVERNMENT, NCD, NONCOMMUNICABLE DISEASES, NUMBER OF DEATHS, NUMBER OF WOMEN, NURSE, NURSES, NUTRITION, OLDER WOMEN, PAP SMEAR, PATHOLOGY, PATIENT, PATIENTS, PHYSICIANS, PILOT PROJECTS, POLITICAL SUPPORT, POPULATION DISCUSSION, PREMATURE DEATH, PREVALENCE, PREVENTION EFFORTS, PREVENTION STRATEGIES, PRIMARY CARE, PRIMARY HEALTH CARE, PRODUCTIVE YEARS, PROGNOSIS, PROGRESS, PUBERTY, PUBLIC HEALTH, PUBLIC HEALTH OFFICIALS, PUBLIC HEALTH SERVICES, QUALITY ASSURANCE, QUALITY IMPROVEMENT, QUALITY OF CARE, RANDOMIZED CONTROLLED TRIALS, REAGENTS, REPRODUCTIVE AGE, REPRODUCTIVE HEALTH, REPRODUCTIVE TRACT, REPRODUCTIVE TRACT INFECTIONS, RESEARCH EFFORTS, RESOURCE ALLOCATION, RESOURCE CONSTRAINTS, RURAL AREAS, SANITATION, SCREENING, SERVICE DELIVERY, SERVICE PROVISION, SEXUAL ACTIVITY, SEXUAL HEALTH, SEXUALLY ACTIVE, SEXUALLY TRANSMITTED DISEASES, SOCIAL NORMS, SPECIALIST, STATE GOVERNMENTS, SURGERY, SURVIVAL RATE, SYMPTOMS, SYRINGES, TERTIARY LEVELS, TRANSPORTATION, TREATMENT, TREATMENT SERVICES, VACCINATION, VACCINATION PROGRAM, VACCINATION PROGRAMS, VACCINE, VACCINE DELIVERY, VACCINE SAFETY, VACCINES, VIRUS, WOMAN, WOMEN'S HEALTH, WORKERS, WORLD HEALTH ORGANIZATION, YOUNG AGE, YOUNG MEN, YOUNG WOMEN,
Online Access:	http://documents.worldbank.org/curated/en/2013/10/19226581/advancing-cervical-cancer-prevention-india-insights-research-programs https://hdl.handle.net/10986/17850
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