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An official publication of the Middle-Eastern Association for Cancer Research
Clinical Cancer Investigation Journal
ISSN Print: 2278-1668, Online: 2278-0513
ARTICLE
Year: 2019   |   Volume: 8   |   Issue: 6   |   Page: 261-262     View issue
Strengthening measures to eliminate cervical cancer in the South East Asian Region
Saurabh Shrivastava, Prateek Shrivastava

Cervical cancer has been identified as one of the leading cancers in the South East Asian Region (SEAR). In the year 2018 in the SEAR alone in excess of 0.16 million new cases and 0.096 million deaths have been attributed to the disease. The target for the region is to eliminate cervical cancers by the year 2030 and for the accomplishment of the same, a lot needs to be done. Screening has been identified as one of the crucial strategies to prevent the cancer and there is a definite need to implement an organized screening program in the entire nation. It is vital to understand that mere capacity building won't affect the results, instead we surely require improvement in the quality of offered services. In conclusion, elimination of cervical cancer from the region will significantly improve the quality of life of women. However, to accomplish that the need of the hour is to strengthen the immunization, screening, treatment and rehabilitation services.

Cervical cancer, elimination, World Health Organization

Introduction

Cervical cancer has been identified as one of the leading cancers among women across different regions of the world.[1] Even in the South East Asian Region (SEAR), the condition has been ranked as the third-most predominant form of cancer.[2] In the year 2018 in the SEAR alone in excess of 0.16 million new cases, 0.096 million deaths have been attributed to the disease.[2] In addition, cancer accounts for an extensive burden on the health-care delivery system, out-of-pocket expenditure, sickness absenteeism, and impairment in the quality of life and also disturbance in the family life.[1],[2],[3]

Public Health Strategies

Acknowledging the magnitude of the cancers in the region, they have been considered as a public health priority, and steps have been taken to target predisposing factors to eventually reduce the prevalence of the condition.[2],[3],[4] In fact, the target for the region is to eliminate cervical cancers by the year 2030 and for the accomplishment of the same, a lot needs to be done.[3] Screening has been identified as one of the crucial strategies to prevent cancer and there is a definite need to implement an organized screening program in the entire nation, as encouraging results in terms of reduction in the incidence and mortality has been observed in the nations in the SEAR itself.[2],[3],[4] The live example is about REACH-Bhutan study, wherein international agencies supported the national government to assess the feasibility of screening test done on self-collected samples.[4]

Scope of Human Papillomavirus Vaccines

Human papillomavirus (HPV) vaccines have emerged as a safe and effective mode for the prevention of 70% of cervical cancers, and are the most effective if given before exposure to HPV. In fact, it has been advocated to vaccinate all girls between 9 and 14 years (prior to the initiation of sexual activity in majority of them).[1],[2] In continuation, 4 nations (namely, Thailand, Maldives, Bhutan, and Sri Lanka) in the region have incorporated the HPV vaccine in their national immunization schedule, and this is a strong move.[2] The target for the region is to vaccinate 9 out of 10 girls by the time they attain 15 years of age, and it will essentially require support from different stakeholders.[2] Further, we have to expand the screening, diagnostic, and therapeutic options for early invasive cancers for everyone and across all the geographical settings to halt the rising magnitude of the disease.[2],[3]

Other Initiatives

It is vital to understand that mere capacity building would not affect the results; instead, we surely require improvement in the quality of offered services.[1],[3] Moreover, behavioral surveys have also been conducted to understand the distribution of various risk factors and the extent to which they determine the prevalence of the disease.[5] One of the essential components for the success of any of these initiatives is the extent of awareness about the disease and the prevention strategies in the general population.[1],[5] Thus, the success will be determined by the opinion and acceptability of the approaches by the local population and hence, we have to be prepared to tailor-made the approaches depending on the various sociodemographic factors.[2],[5]

Conclusion

In conclusion, elimination of cervical cancer from the region will significantly improve the quality of life of women. However, to accomplish that the need of the hour is to strengthen the immunization, screening, treatment, and rehabilitation services.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

Shrivastava SR, Shrivastava PS. Exploring the role of health sector in the prevention and control of cervical cancer. Biol Med (Aligarh) 2019;11:e130.

World Health Organization. Accelerate Efforts to Eliminate Cervical Cancer: World Health Organization; 2019. Available from: http://www.searo.who.int/mediacentre/releases/2019/1720/en/. [Last accessed on 2019 Sep 12].

Shrivastava SR, Shrivastava PS, Ramasamy J. Encouraging and expanding screening activities for cervical cancer in low-resource settings. Ann Trop Med Public Health 2017;10:1121-2.

Baussano I, Tshering S, Choden T, Lazzarato F, Tenet V, Plummer M, et al. Cervical cancer screening in rural Bhutan with the care HPV test on self-collected samples: An ongoing cross-sectional, population-based study (REACH-Bhutan). BMJ Open 2017;7:e016309.

Basu P, Hassan S, Fileeshia F, Mohamed S, Nahoodha A, Shiuna A, et al. Knowledge, attitude and practices of women in Maldives related to the risk factors, prevention and early detection of cervical cancer. Asian Pac J Cancer Prev 2014;15:6691-5.

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ISSN Print: 2278-1668, Online: 2278-0513