Cancer is the second leading cause of death globally after cardiovascular diseases. And breast and cervical cancer, among the largest growing cancers in women worldwide, are the second most common in Indian women. Unfortunately, what was once an old-age disease is now killing more of the young. And early diagnosis and treatment remain the only solution.

‘Prevention is better than cure’ was drilled in my mind as a young medical student. In medical colleges, we study normal anatomy, functioning of the body for the first 1.5 years before embarking on pathology and preventive medicine. Outlining the importance of preventive steps, Australia was the first country in the world to introduce mass cervical cancer vaccine or a Human Papilloma Virus (HPV) vaccination scheme for girls in 2007. Initially there was resistance from parents as it was mandatory, leading to mass protests. Parents knew that HPV virus is transmitted by sexual intercourse and they felt their children were angels and didn’t need the vaccine.

The programme was later extended to boys too.

The new modelling was published recently by the Cancer Council New South Wales (NSW), a charity, in The Lancet Public Health Journal . It is predicted to be classified as a ‘rare cancer’ in Australia by 2022, when it is expected to drop to less than six cases per 1,00,000 people , about half the global average. Scientists attribute the progress to national prevention programmes.

Clearly it is one of the best evidences of preventive medicine working well with Public Health in preventing cancer, with a clear policy in force for the benefit of the population.

Elimination efforts

Cervical cancer is caused by several types of HPV, a sexually transmitted infection. India has a population of approximately 365.71 million women above 15 years of age, who are at risk of developing cervical cancer and approximately 6.6 per cent of women in the general population are estimated to harbour cervical HPV infection. It is important for every woman who is sexually active to know that cervical cancer can be fully prevented and treated, if diagnosed on time.

It is important that all young females starting from 12 years of age are vaccinated against the HPVs and are screened for any kind of pre-cancerous lesions from 21 years of age onwards. Women who are sexually active should undergo Pap smear tests, at least once a year.

The HPV vaccine is one step to prevention and does not protect against all types of virus, yet it is important to take the dosage because it protects against the common types of viruses. It certainly helps in preventing infections if you have already been exposed to the virus. A vaccination can help protect from one type of HPV and also protect from new exposures.

According to recent reports, there are still taboos about screening, which need to be addressed in the larger interest of society. Most patients come to treatment facilities when they are in an advanced stage and, therefore, at a higher risk of dying due to the disease.

We need to step up our efforts to generate and collect representative and accurate data, introduce or scale up cost-effective and socially acceptable programmes of prevention and early detection and treatment.

Cancer should not be ignored, but diagnosed and treated immediately, or even better, prevented entirely in the first place.

The writer is Founder Chairman & Senior Neonatologist at Cloudnine Group of Hospitals. Views are personal

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