New Delhi, May 11 : With nearly 73,000 women dying every year, India now tops the world in cervical cancer deaths according to a report released today by a US-based research and advocacy group.
India represents 26.4 per cent of all women dying of cervical cancer globally, with China, Bangladesh, Pakistan, Indonesia and Thailand also showing high death incidence, says the "Cervical Cancer Global Crisis Card" released by the Cervical Cancer-Free Coalition.
According to the report card, cervical cancer kills an estimated 275,000 women every year and 500,000 new cases reported worldwide. This entirely preventable disease is the second largest cancer killer of women in low and middle-income countries, with most women dying in the prime of life, it said.
Using data from the WHO, United Nations, the World Bank and IARC Globocan, the Crisis Card has ranked 50 countries in the descending order of cancer mortality rates.
India, China, Brazil, Bangladesh and Nigeria represent more than half of the "global burden of cervical cancer deaths," says the US based body basing its study on global rankings.
According to the Crisis Card, Australia has the lowest cervical cancer mortality rate, which is due to the successful rollout of a comprehensive package of HPV vaccines, treatment and prevention.
The Crisis Card report also highlighted the startling disparities between women in the developed and developing world personified by cervical cancer.
"A woman in Zambia is 25 times more likely to die from cervical cancer than a woman in Australia and India has 750 times more deaths than Norway. This level of inequity is also reflected across gender indicators with girls less likely to attend school but more likely to be malnourished and married as a child," said the report.
Recent data released by India's Health Ministry based on the National Cancer Registry Programme (NCRP) report in 2009 the number of cervical cancer cases were 101938 which has increased to 107690 in 2012.
In Uttar Pradesh a total of 17367 cases were reported in 2009 and it increased to 18692 in 2012. After Uttar Pradesh the number of cases of cervical cancer in 2012 which has shown an increasing trend are Maharashtra (9892), Bihar (9824), West Bengal (8396), Andhra Pradesh (7907), Tamil Nadu (7077) and others.
"Cervical cancer can happen to anyone. Certain women are at greater risk. These include women who started sexual activity at an early age, had multiple pregnancies, had multiple partners themselves, or their partners have multiple partners," said Dr Neerja Bhatla, Professor, Department of Obstetrics and Gynaecology at All India Institute of Medical Sciences (AIIMS).
Dr Bhatla said, "Also, women with STIs like chlamydia, gonorrhoea, herpes simplex, women with immune suppression, for example, HIV or transplant recipients, smokers and prolonged use of oral contraceptives have a higher risk. There is thought to be a small element of genetic predisposition as well."
It is being estimated that the number of cervical cancer cases and deaths are estimated to increase by 2025 to 203,757 and 115,171, respectively.
Cervical cancer is caused by the human papillomavirus (HPV), a fairly ubiquitous virus that will be acquired by about 80 per cent of women some time during their lives. Most women clear this virus by their immune system, but in about 8-10 percent of cases the infection remains persistent.
These women are at risk of the disease and in the presence of certain co-factors, risk factors; they can go on to develop precancerous lesions called CIN (cervical intraepithelial neoplasia). Again, if left untreated, some of these women will develop cervical cancer. The main spread of HPV is by sexual contact, but spread by fomites and mother to child transmission are reported.
"If you have found out you have cervical cancer, it does not mean that it is the end. Cervical cancer is a treatable cancer if found early enough. Just go through the treatments, they are hard and the side effects are awful, but life will continue as normal after everything is done," said Genevieve Sambhi, former Miss Universe Runner Up and a cervical cancer survivor.
Genevieve who was diagnosed with cervical cancer at the age of 35 said initially she had no symptoms, a little abnormal bleeding but nothing that made her think she had cancer.
She then went for a Pap smear and that's when she found out she had cancer.
"Cervical cancer, like all cancers, may be asymptomatic in its precancerous phase and while it is an early cancer. Symptoms that point to the cancer include inter menstrual and post coital bleeding, postmenopausal bleeding and persistent vaginal discharge," said Dr Bhatla.
Recently, Ghulam Nabi Azad, Minister of Health and Family Welfare had responded to a starred question in Lok Sabha.
"Data of the Indian Council of Medical Research (ICMR) of the number of breast and cervical cancer cases among women has increased in the country. At present the Government of India is looking for alternative techniques and afford ability to implement test to be used for detection of cervical cancer."
The minister further added that while health is a state subject, the Centre has launched the national programme for prevention and control of cancer, diabetes, cardiovascular disease and stroke (NPCDCS) in 2010 in 100 districts across 21 states.
Strengthening of government medical college and erstwhile regional Cancer Centres (RCC) across the country as Tertiary Cancer Centre (TCC) for providing comprehensive Cancer care was also undertaken as well as campaigns are carried out through print and electronic media, he said.
