Vaccine for cervical cancer must for all?

As the Indian government toys with the idea of offering the cervical cancer vaccine to all girl children as part of its national immunisation plan, the issue divided a gathering of national and international oncologists at the Tata NCPA in Mumbai on Saturday .

The gathering–a threeday conference to observe the platinum jubilee of the country’s premier cancer care hub Tata Memorial Hospital in Parel-saw several international oncologists endorse the use of cervical cancer vaccine. Tata Memorial Hospital director Dr Rajendra Badwe, though, stood up to say that there wasn’t enough evidence to start vaccinating India’s girls. Cervical cancer kills roughly 70,000 Indian women annually and is the second most common cancer (after breast cancer) in India. But, as Dr Freddie Bray from World Health Organisation’s section of cancer surveillance, said, “India accounts for one-fourth of all cervical cancer deaths in the world. India has to do something to reduce this figure.“cervical

Dr Bray, along with professor Julian Peto from the London School of Hygiene & Tropical Medicine, held that the vaccine was doing significantly well in countries where it was being offered. An expert from the US who was seated in the audience said that 69 cancer centres across the US had last week decided to vaccinate all children under 11 years of age. Dr Daniel Hayes, elected president of the American Society of Clinical Oncology , said, “It is astounding and shaming that cervical cancer is the number one killer in India because it’s a preventable cancer.“ However, he said while the US had the resources to vaccinate all its children, India had to devise ways to check cervical cancer.

Oncologists Are Divided On The Issue

Explaining his reservations, Dr Badwe told TOI that cervical cancer rates across India were falling across most metro cities without any medical intervention. “The cervical cancer incidence rates in our metro cities, be it Mumbai, Delhi or Kolkata, are almost similar to the rates in the US,“ he said, adding that the incidence in Mumbai stood at 8 per 1,00,000 population.

Cervical cancer incidence rates in India’s rural areas have been steady at 30 per 1,00,000 population. “Howe ver, we found out that the rate at a moderately urbanised town barely 50km from one of our rural cancer registry site is barely 17 per 1,00,000 population,“ he said. The difference, he said, was due to education, availability of running water and bathrooms. Moreover, he said the cervical cancer vaccine was too expensive to be offered across India. “It’s best to allow a cafeteria approach of permitting several screening measures for people to choose (visual inspection using acetic acid, for instance) instead of only offering vaccination,“ he said.