Cervical cancer: the Indian perspective. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer.
Cancer of the uterine cervix is the commonest gynaecologic cancer in India, with most women presenting with disease extending beyond the cervix. The majority of women belong to the lower socioeconomic status, are rural, aged between 35 and 64 years and highly noncompliant for complete treatment and follow-up. Opportunistic screening with cytology, colposcopy and test for Human Papilloma Virus and appropriate treatment are available on payment at urban private medical centres but are not available at urban and rural government health centres that are accessed by women of the lower socioeconomic status. The Government's investment in health is 0.9% of the GDP. Thus cytology screening as a government health measure is not feasible. The 'social vaccine' of health empowerment along with visual inspection and appropriate referral by the rural and urban health personnel (Department of Health and Family Welfare); with an additional input of health awareness and motivation by Anganwadi Workers (Department of Women and Child Development), elected women representatives in the Panchayats (Department of Rural Development and Panchayati Raj) and non-governmental development agencies could be a collaborative effort towards "downstaging" cervical cancer. This could lay the foundation for the introduction of cytology screening when resources are available.
Vallikad
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Division of Gynaecologic Oncology, St. John's Medical College, Bangalore, Karnataka, India. elizabethvallikad@gmail.com
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006291:Health Policy; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000517:prevention & control; D011203:Poverty; D011322:Primary Prevention / Q000458:organization & administration*; D012923:Social Class; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D016387:Women's Health; D014932:Women's Health Services / Q000458:organization & administration