In the ocassion of World Cancer Day, BW Businessworld had an interaction with Dr Nikhil Mathur, Group Chief of Medical Services, CARE Hospitals Group

Cervical cancer is one of the leading causes of cancer death in women worldwide and its behavior epidemiologically resembles that of a venereal disease of low transmissibility.

In India, cervical cancer is the 3rd most common cancer with an incidence rate of 18.3 per cent (123,907 cases) and the second leading cause of death with a mortality rate of 9.1 per cent according to GLOBOCAN 2020. Yet, there is low awareness about the disease among the people if India.

In the ocassion of World Cancer Day (February 4), BW Businessworld had an interaction with Dr Nikhil Mathur, Group Chief of Medical Services, CARE Hospitals Group regarding cervical cancer, its awareness, and the need in the healthcare system to deal with it. Excerpts;

In today's date, what are the main causes of increasing numbers of cervical cancer?

Cervical cancer is a major contributor to mortality of women in India and accounts for approximately 6–29 per cent of all cancers in women. It is well proven that screening, vaccination and early detection and treatment can substantially reduce the mortality. Despite alarmingly high figures, there is no nationwide PPP model to implement the screening and vaccination program, to every nook and corner of India. Aggressive IEC (Information, Education and Communication) activities to create awareness and increase demand is the need of the hour. There is no countrywide government-sponsored public health policy on prevention of cervical cancer by either screening or vaccination or both. Recently, the government of India has announced that it is likely to approve the cervical cancer vaccine in the national immunisation program for compulsory immunisation of girls in the age group of 9-12 years. 

Do you think the majority Indian populace would be aware about the disease?

There is absolutely no awareness in the community at large on the importance of vaccination, screening, early detection and treatment. A mass movement like we did in polio eradication program is the way forward. Similarly, the ongoing pandemic of covid-19, has immensely enriched our knowledge that India is capable of reaching every citizen. It has pointed out our strength and weaknesses in our public health infrastructure and we were able to maximise it during the pandemic. Ensuring outreach to the remotest areas, where not only lack of awareness but poor accessibility to health is the major drawback, should be the goal of our cervical cancer elimination strategy. . 

By what means can the awareness be spread among people about this?

The approach should be different for the urban and rural areas and for remote, difficult terrain areas. Today, access to radio and TV or social media is high and the easiest way of information dissemination. Mass campaigns during the month of February which is the cancer awareness month is an excellent way of getting attention and spreading information. Inclusion of awareness on cancer prevention in school health program and in all women health programs, is the immediate need. 

What is the importance of creating awareness of cervical cancer in Tier II cities?

CARE Hospitals focuses on offering health in Tier II cities. Access to health-related information, especially on preventive health is skewed in favour of urban areas. Only in recent times is the community in these cities getting access to the mushrooming health facilities. But these also focus on curative care rather than preventive and promotive aspects of care. Awareness and campaigns on public health issues is a mandate of the governments. Almost all Tier II cities in the country have good number of schools, which can be utilised for spreading awareness. Similarly, ASHA workers can be trained to spread awareness. Once knowledge increases there will be an automatic demand generation. Then both public and private players can step in to provide the support for screening and vaccination 

What major aspects do people need to get aware about cervical cancer?

Focus should be on what is cervical cancer, causes, high risk groups, linkage of human behaviours and the disease, preventive aspects including screening and vaccination.

How is CARE Hospitals working towards treatment of cancer?

Cancer screening and treatment is available in most of the CARE Hospitals. We conduct outreach programs in gated communities, corporates, and other focus groups. Our health packages include screening for various cancers. Our team of cancer specialists are well trained and highly experienced in the latest technologies available. Upgradation of the facilities to include innovations in early detection and treatment of cancer is the vision of the group. 

Care Hospitals have Medical and surgical oncologists, including those specialised in Hemato-oncology and stem cell therapy. Apart from this, we have surgeon trained in Robo assisted surgeries, which permit removal of masses completely. Other modalities of treatment include liver transplants for liver cancers, radiation therapy, chemotherapy, hormone therapy, targeted therapy and many more.

How do you see the future of cancer treatments with the growing healthcare technologies?

Cancer prevention, diagnosis and treatment is undergoing a tech revolution and what once seemed impossible in cancer research is now a reality thanks to a number of technological innovations that have led to breakthroughs in the ways we detect, understand, and treat cancer. Artificial intelligence, telehealth and robo assisted surgeries are already impacting cancer care. Advances in sensors, contrast agents, molecular methods and AI will in the future guide detection of cancer specific signals, real time 

What treatment modalities is healthcare system of India lacking for complete cure of any type of cancers?

Widespread availability of cryogenics, proton therapy and cost-effective treatment to reach the middle class and poor is a huge impediment to cancer cures. Even if detected early, cost of treatment is prohibitive. 

As per you, how can this disease be prevented?

The most important things you can do to help prevent cervical cancer are to get vaccinated against HPV (Human Papillomavirus), and having regular screening tests

Vaccination is recommended for preteens aged 11-12 years but can be given starting at age 9. This vaccination is also recommended for all from age 26 years if not vaccinated earlier, as it prevents new onset infection with HPV. 

Screening is done by PAP smear test, to look for precancerous cell changes

Safe sex is advised. Use of condoms and avoiding multiple sex partners is also advised

Extensive, focussed media campaign through conventional media, digital media and mass campaign is needed

Lastly, what is your take on the allocation of Union Budget 2023-24 towards health sector?

The union budget 2023 was indeed a progressive budget. Covid-19 pandemic has taught us the importance of having skilled healthcare workers. Adding 157 new nursing colleges is a welcome move and will surely help in adding skilled workforce in the healthcare ecosystem. Mass screening for sickle cell anaemia eradication by 2047 is a step-in right direction in ensuring the population around the rural parts of the country are also leading a healthy life.

Doctor: Dr Nikhil Mathur, Group Chief of Medical Services, CARE Hospitals

Reference Link: http://bwwellbeingworld.businessworld.in/article/Need-To-Create-Awareness-About-Cervical-Cancer-In-Tier-II-Cities/04-02-2023-464324/