Health Talk | Why vaccinating girls between 9 to 14 years against cervical cancer is vital

The recent budget announcement by the Union finance minister to encourage an anti-HPV jab is a step in the right direction

Union finance minister Nirmala Sitharaman announced during her Budget speech on Thursday that the Centre planned to encourage cervical cancer vaccination for girls in the age group of 9 to 14 years. The government has been thinking about introducing vaccination against cervical cancer as a preventive measure against the disease through the Universal Immunisation Programme for a few years. Certain states, such as Punjab and Sikkim introduced the vaccination in the state immunisation programmes in 2016.

India accounts for about a fifth of the global burden for cervical cancer. The country witnesses about 1.23 lakh cases and around 67,000 deaths every year. (Representative Image/Shutterstock)

Why it is crucial to vaccinate

Cervical cancer is the second most common cancer in India in women accounting for nearly 23% of all cancer cases in women.

Experts said that vaccinating young girls is key to eliminating cervical cancer — one of the leading cancers in Indian women, and vaccine-preventable.

Human papillomavirus (HPV) infection is now a well-established cause of cervical cancer, and HPV types 16 and 18 are responsible for about 70% of all cervical cancer cases worldwide. It has been established that the vaccines have the potential to reduce the incidence of cervical and other anogenital cancers.

“Modelling studies have shown that early HPV vaccination in populations before social transitions in sexual behaviour can substantially mitigate the increased risk of HPV infection attributable to transition. Even if rates continue to decline, the number of annual cases of cervical cancer in India is likely to increase as the population ages. Therefore, the public health impact of introducing timely HPV vaccination in India might be substantial given the window of opportunity,” said a review paper published in The Lancet.

“The results of the effectiveness of a single dose to prevent targeted HPV infections in observational studies done in Costa Rica and India are particularly consistent in showing a high level of prevention of vaccine-targeted HPV infection.”

First screen

A paper titled 'Current status of human papillomavirus vaccination in India's cervical cancer prevention efforts’ published in 2019 in The Lancet advocated scaling up HPV vaccination for adolescent girls in India — it called for a judicious combination of vaccination and screening as key to eliminating cervical cancer in India.

"I often say ‘Every small step is a giant leap in the fight against cancer’ so, it’s a step in the right direction to reduce the disease burden and loss of life. India detects approximately 180,000 new cases of cervical cancer every year and 50% of these patients succumb to the disease in the same year. Most advanced nations have either eliminated or are on the verge of eliminating cervical cancer through effective vaccination against HPV, a major cause of cervical cancer. For all women aged between 9 to 14 years, if vaccinated effectively, the disease can be eliminated within one generation,” said Harish Trivedi, CEO, Cancer Treatment Services International (CTSI) – South Asia, in a statement.

Serum Institute of India, last year, marketed an India-made HPV vaccine priced at ₹2,200, which is nearly half of what imported vaccines cost.

“What our paper recommended was screening for the mother and vaccination for the daughter as a tool for cervical cancer elimination. By elimination we mean more than 80% reduction in cases,” said Dr Ravi Mehrotra, one of the authors of The Lancet study, during the paper launch.

Rhythma Kaul, national deputy editor, health, analyses the impact of the most significant piece of news in the health sector this week in this column