Date : 30/09/2023

Relevance – GS Paper 1 - Social Issues

Keywords – HPV Vaccination, Lancet report, Women in Leadership Roles, Societal Stigma

Context

Recently, Lancet, a renowned medical journal, released a report titled 'Women, Power, and Cancer,' spotlighting the disparity in cancer care concerning gender. The report underscores societal neglect of women's health, lack of awareness, knowledge gaps, and the absence of quality healthcare professionals at the grassroots level, all contributing to delayed access to cancer prevention, detection, and treatment.

Noteworthy findings from the Lancet Report:

Elevated Cancer Incidence and Mortality Among Women:

The report accentuates that despite men being at a higher risk of cancers affecting both genders, women continue to face alarmingly high rates of cancer incidence and mortality. Globally, 48% of new cancer cases and 44% of cancer-related deaths involve women. This trend persists despite certain women-specific cancers, such as breast and cervical cancers, being highly preventable and treatable.

Preventable Loss of Women's Lives:

The report reveals a stark reality - around 6.9 million cancer-related deaths among women in India could have been prevented, and 4.03 million were treatable. Timely intervention, risk reduction, and proper diagnosis could have averted 63% of premature deaths due to cancers in Indian women. Additionally, 37% of these deaths could have been avoided with prompt and optimal treatment.

Factors Contributing to Women's Diminished Outcomes:

Limited Awareness and Financial Constraints:

A significant hurdle women face is the lack of timely and appropriate care due to limited knowledge, decision-making power, financial resources, and the unavailability of services at the local level. Irrespective of geography or societal standing, women often lack the authority and information to make well-informed healthcare decisions. Furthermore, they are disproportionately affected by financial burdens caused by cancer.

Underrepresentation of Women in Leadership Roles:

In the realm of cancer care, the report highlights the underrepresentation of women in leadership positions, often subject to gender-based discrimination and harassment. Astonishingly, the unpaid cancer caregiving efforts by women account for approximately 3.66% of India's national health expenditure.

Low Health-Seeking Behavior:

Healthcare-seeking behavior among women, particularly in economically disadvantaged sectors, remains notably low. Despite similar risks for certain cancers, such as those associated with tobacco use, women's treatment often lacks priority, leading to disproportionate impact.

Societal Stigma:

Breast and cervical cancers are prevalent among women; however, societal stigma inhibits them from seeking help. Many women hesitate to approach male doctors with these concerns or allow female doctors to conduct necessary examinations, leading to delayed diagnoses and treatments.

Limited Access to Healthcare Facilities:

The need to travel to distant hospitals for screenings, diagnostic tests, and treatment compounds the problem, causing delays in care and subsequently poorer outcomes.

The Significance of Screening:

Concerning the most prevalent cancers in women – breast and cervical cancers – early detection is pivotal as they are highly preventable and treatable. Medical experts emphasize the importance of regular screenings. Women are advised to conduct self-examinations of their breasts monthly and have a clinical examination by a doctor annually. Additionally, women over 40 years old should undergo a mammogram annually to check for breast cancer. Immediate consultation with a doctor is necessary if any lumps are detected during self-examination. For cervical cancer, women aged 25 to 65 should have a pap smear test to detect pre-cancerous growth on their cervix. An HPV test, which detects the human papillomavirus responsible for most cervical cancers, can be done every five or ten years.

Government's Role in Cancer Prevention:

Conducting Extensive Awareness Campaigns:

A crucial step is raising awareness, particularly among women, encouraging them to undergo screenings and seek medical care. Similar to the successful Covid-19 vaccine awareness campaigns, such initiatives are vital for cancer prevention.

Implementing HPV Vaccination Programmes:

The government is in the process of launching an HPV vaccination programme, aiming to reduce cervical cancer cases. The vaccine, effective in preventing the virus's entry into the body, is to be administered to women under 25 years before sexual activity begins. Including it in the universal immunization programme is a priority.

What is the HPV Vaccination Programme?

The HPV vaccine provides protection against genital warts and the majority of cervical cancers. It guards against cancers of the vagina, vulva, penis, or anus triggered by HPV. Additionally, the vaccine offers protection against mouth, throat, head, and neck cancers resulting from HPV infections. By introducing the body to specific HPV strains, the vaccine enables the immune system to recognize and combat these strains more effectively if the person is exposed to them in the future.

India's Status in the HPV Vaccination Initiative:

Availability since 2011, But Limited Implementation:

• The HPV vaccine has been accessible in India since 2011, yet it hasn't been integrated into the government's immunization program. Despite its availability for over a decade, marketing data indicates that the vaccination rate among girls has remained shockingly low, at less than 1% in the past 11 years.

Alarming Uptake Statistics in India:

• The uptake of HPV vaccination in India has been dismal. A study conducted in December 2020 highlighted that a staggering 52% of women surveyed were unaware of the existence of HPV vaccination. This lack of awareness contributes significantly to the low vaccination rates in the country.

Accessible Screening at Primary Health Centers (PHCs):

Government-run screening programmes at PHCs and sub-centres can facilitate early diagnosis. Challenges arise in patient follow-up when referrals are required for biopsy and further treatment. Thus, enhancing PHCs' capabilities is crucial.

Training Nursing Staff for Simple Procedures:

In cervical cancer cases, trained nursing staff at PHCs can offer treatments, a practice successful in countries like Bangladesh. Procedures involving acetic acid highlight cancerous regions, which can then be treated by trained nurses using freezing or burning methods.

Recommendations from the Lancet Report:

Regular Data Collection and Monitoring:

The report underscores the necessity of systematically collecting gender and social demographic data for cancer health statistics. This data aids in developing targeted interventions.

Policy Interventions to Reduce Exposures:

• Developing and enforcing policies to minimize known cancer risks are vital. Strengthening laws in this regard is necessary for public health.

Promoting Women's Participation in Cancer Research:

• Equal participation of women in cancer research is crucial. The report advocates for equitable access to research resources, leadership roles, and funding opportunities for women, ensuring diverse perspectives in cancer-related studies.

Conclusion:

Many women delay seeking treatment due to various reasons, often not taking their health seriously. Raising awareness, especially among economically disadvantaged women, is crucial. Timely screenings, coupled with accessible healthcare and informed policies, can significantly reduce the incidence and mortality rates among women.

Source – Indian Express