Editorial: Waging war on cervical cancer in India

India’s proposed nationwide free HPV vaccination drive for girls aged 9 to 15 is significant, as its success could dramatically accelerate cervical cancer elimination targets globally

Despite being a largely preventable disease, cervical cancer is the second most common cause of cancer deaths in India, after breast cancer, among women of reproductive age. The country accounts for over 23% of the global burden — with 1.23 lakh cases and around 77,000 deaths per year. India’s alarming cervical cancer mortality rate is attributable to poor screening, lack of early detection, resistance to vaccination and poor hygiene. There is a greater impact of cervical cancer on those of lower socioeconomic status and a cultural stigma surrounding sexually transmitted infections. Against this grim backdrop, the central government’s plan to roll out a nationwide free vaccination drive, covering girls in the age group of 9 to 15 years, is a welcome development. Such an initiative could be a game changer in the battle against cancer. Cervical cancer, caused by the Human Papillomavirus (HPV), is largely preventable through a combination of early screening and vaccination. A mass inoculation drive is necessary in view of the general lack of public awareness about the disease in the country. It would be an effective strategy to target adolescents for vaccination before their exposure to the virus. A time-bound, mission-mode approach can help overcome the inertia that often slows the inclusion of new vaccines in routine immunisation. If implemented effectively, it could shield millions of girls from high-risk HPV strains responsible for the majority of cervical cancer cases. The vaccine, indigenously developed by Pune-based Serum Institute of India (SII), is 97% effective.

Universal immunisation of girls reduces the transmission of the infection to boys and protects them from other cancers. Cervical cancer kills one woman every eight minutes in the country. The vaccination campaign must prioritise rural districts and underserved communities where screening rates are low and cancer detection often comes too late. The HPV vaccine has long been available in the private market and a few States have piloted limited public programmes over the past decade. However, cost concerns, logistical hurdles and policy hesitations have delayed a universal rollout, leaving coverage fragmented and inequitable. The World Health Organization endorses HPV vaccination to eliminate cervical cancer. More than 160 countries have already incorporated it into their national programmes. India’s proposed nationwide rollout is especially significant, as success here would dramatically accelerate global elimination targets. Vaccine hesitancy, misinformation surrounding adolescent immunisation and sociocultural taboos related to HPV could impact outcomes. The involvement of private healthcare facilities and NGOs is also necessary for the success of the vaccination drive. Last-mile delivery will determine outcomes as the vaccine must be ideally administered to girls before they turn 16. This drive could become a transformative public health intervention. The HPV vaccine is given in two doses and data show that the antibodies can last up to six or seven years.

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