Cervical Cancer in SAARC Countries

Purvish M Parikh; Sujith Kumar Mullapally; Sachin Hingmire; A F M Kamal Uddin; M M Thinn; Arun Shahi; Ugyen Tshomo; Indu Mohan; Satinder Kaur; Nikhil Ghadyalpatil

doi:10.1055/s-0043-1764227

Cervical Cancer in SAARC Countries

South Asian J Cancer. 2023 Feb 25;12(1):1-8. doi: 10.1055/s-0043-1764227. eCollection 2023 Jan.

Authors

Affiliations

¹ Department of Clinical Hematology, Mahatma Gandhi University of Health Sciences and Technology, Jaipur, Rajasthan, India.
² Department of Medical Oncology, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India.
³ Department of Medical Oncology, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India.
⁴ Department of Radiation Oncology, National Institute of ENT, Dhaka, Bangladesh.
⁵ Department of Gynaecology, Yangon Central Women's Hospital, Yangon, Myanmar.
⁶ Department of Medical Oncology, Patan Academy of Health Sciences, Kathmandu, Nepal.
⁷ Department of Gynaecology, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
⁸ Department of Community Medicine, Mahatma Gandhi University of Health Sciences and Technology, Jaipur, Rajasthan, India.
⁹ Department of Gynaecological Oncology, Dharamshila Narayana Superspeciality Hospital, New Delhi, India.
¹⁰ Department of Medical Oncology, Yashoda Hospitals, Hyderabad, Telangana, India.

Abstract

Purvish M. ParikhIn the year 2020, a total of 342 000 women were estimated to die of cervical cancer, of which 90%) were expected amongst low- and middle-income countries (LMIC). Globally incidence of cervical cancer has reduced as a result of improved personal hygiene, better living conditions and higher application of opportunistic screening programs. Yet GLOBOCAN shows that absolute number of cases are still increasing. We therefore conducted a 21 question multiple choice questionnaire online survey in Jan 2023 amongst 9 SAARC countries. A total of 367 replies were received and the representative answers for each country are being reported in this manuscript. A good possibility of achieving World Health Assembly target (Nov 17, 2020) was felt only by Bhutan and Nepal. For screening, most countries (Bhutan, India, Myanmar, Nepal, Pakistan and Sri Lanka) recommend for all asymptomatic eligible patients. Public health experts have suggested VIA / VILI as the best solution for LMICs. However, a dual screening strategy (HPV DNA plus) cytology was preferred by doctors in Afghanistan, Bhutan, India, Myanmar, Pakistan and Sri Lanka. Screening, triage and then treatment was the preferred by Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, Sri Lanka. HPV vaccination was recommended in all girls between ages 10 to 26 years in Bangladesh, India, Myanmar, Nepal, Pakistan and Sri Lanka. All the 9 countries would use HPV vaccination to all eligible patients if the cost of the vaccine was reasonably low. Our survey clearly outlines challenges faced in tackling cervical cancer in SAARC countries. We also provide consensus regarding several potential solutions that can be used in both public and private cervical cancer control programs.

Keywords: HPV; LMIC; screening; vaccination.

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