BMJ 2013;347:f6959 doi: 10.1136/bmj.f6959 (Published 19 November 2013)
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NEWS India must use research evidence to tackle high burden of cervical cancer, experts say Sanjeet Bagcchi Kolkata
India needs immediately to translate its science research findings into effective policies to reduce the country’s huge burden of cervical cancer, researchers have urged.1
Cervical cancer is the most common cancer in women aged 15 or older in India. One in 53 Indian women in their lifetime develops cervical cancer, double the one in 100 in developed countries.2 India carries a quarter of the global burden of cervical cancer, and it is projected that at the current incidence India’s annual burden of new cases of cervical cancer would be 225 000 by 2025.
“We are recommending implementation of science research,” said Suneeta Krishnan, a social epidemiologist attached to RTI International, a non-profit research and development organisation based in North Carolina, and Bangalore’s St John’s Research Institute. “This is research that can facilitate the translation of existing knowledge about cervical cancer screening, early detection, and treatment into effective policies and programs,” added Krishnan, lead author of the research article published in the Oncologist.1 Krishnan and colleagues reviewed English language, peer reviewed publications and other literature, including unpublished programme reports, white papers, and conference presentations, on the prevention of cervical cancer in India. They also interviewed people involved in the design and implementation of government led efforts at cervical cancer prevention in Tamil Nadu. The researchers found that in India qualitative research could help identify factors that influence the feasibility and acceptability of human papillomavirus vaccination to prevent cervical cancer.
Cross sectional studies and randomised controlled trials could show the potential of screening methods based on visual approaches to achieve sensitivity and specificity similar to those in cytology based screening.3 Such screening approaches could
For personal use only: See rights and reprints http://www.bmj.com/permissions
be implemented by frontline health workers and could substantially reduce cervical cancer incidence and mortality, the researchers noted.
They also found that the government led efforts in Tamil Nadu demonstrated the feasibility of applying insights from research to public health policy and practice. The researchers said that research results needed to be implemented to ensure wide acceptance of cost effective ways to prevent cervical cancer.
“Given the high burden and the availability of tools to screen [for cervical cancer], treat pre-cancer, promote early detection of cancer, and offer treatment with the high possibility of good outcomes, prevention of cervical cancer should be a high priority in India,” Krishnan told the BMJ.
Partha Basu, head of the department of gynaecological oncology at the Chittaranjan National Cancer Institute in Kolkata, pointed out that most of the evidence on the effectiveness and feasibility of cervical cancer screening methods have come from Indian population based studies but that little had been done to translate that evidence into interventions. “There has to be strong advocacy to make health policy makers in India, both at the federal and the state level, understand that cervical cancer is a major public health problem,” Basu told the BMJ, adding, “Action needs to be taken to prevent untimely deaths of women of reproductive age.” 1 2 3
Krishnan S, Madsen E, Porterfield D, Varghese B. Advancing cervical cancer prevention in India: implementation science priorities. Oncologist 11 Nov 2013, doi:10.1634/ theoncologist.2013-0292. Bhaumik S. India has world’s highest number of cervical cancer deaths. BMJ 2013;346:f3108. Kay M. Screening with acetic acid could prevent 22 000 deaths from cervical cancer in India every year. BMJ 2013;346:f3935.
Cite this as: BMJ 2013;347:f6959 © BMJ Publishing Group Ltd 2013
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
News
NEWS India must use research evidence to tackle high burden of cervical cancer, experts say Sanjeet Bagcchi Kolkata
India needs immediately to translate its science research findings into effective policies to reduce the country’s huge burden of cervical cancer, researchers have urged.1
Cervical cancer is the most common cancer in women aged 15 or older in India. One in 53 Indian women in their lifetime develops cervical cancer, double the one in 100 in developed countries.2 India carries a quarter of the global burden of cervical cancer, and it is projected that at the current incidence India’s annual burden of new cases of cervical cancer would be 225 000 by 2025.
“We are recommending implementation of science research,” said Suneeta Krishnan, a social epidemiologist attached to RTI International, a non-profit research and development organisation based in North Carolina, and Bangalore’s St John’s Research Institute. “This is research that can facilitate the translation of existing knowledge about cervical cancer screening, early detection, and treatment into effective policies and programs,” added Krishnan, lead author of the research article published in the Oncologist.1 Krishnan and colleagues reviewed English language, peer reviewed publications and other literature, including unpublished programme reports, white papers, and conference presentations, on the prevention of cervical cancer in India. They also interviewed people involved in the design and implementation of government led efforts at cervical cancer prevention in Tamil Nadu. The researchers found that in India qualitative research could help identify factors that influence the feasibility and acceptability of human papillomavirus vaccination to prevent cervical cancer.
Cross sectional studies and randomised controlled trials could show the potential of screening methods based on visual approaches to achieve sensitivity and specificity similar to those in cytology based screening.3 Such screening approaches could
For personal use only: See rights and reprints http://www.bmj.com/permissions
be implemented by frontline health workers and could substantially reduce cervical cancer incidence and mortality, the researchers noted.
They also found that the government led efforts in Tamil Nadu demonstrated the feasibility of applying insights from research to public health policy and practice. The researchers said that research results needed to be implemented to ensure wide acceptance of cost effective ways to prevent cervical cancer.
“Given the high burden and the availability of tools to screen [for cervical cancer], treat pre-cancer, promote early detection of cancer, and offer treatment with the high possibility of good outcomes, prevention of cervical cancer should be a high priority in India,” Krishnan told the BMJ.
Partha Basu, head of the department of gynaecological oncology at the Chittaranjan National Cancer Institute in Kolkata, pointed out that most of the evidence on the effectiveness and feasibility of cervical cancer screening methods have come from Indian population based studies but that little had been done to translate that evidence into interventions. “There has to be strong advocacy to make health policy makers in India, both at the federal and the state level, understand that cervical cancer is a major public health problem,” Basu told the BMJ, adding, “Action needs to be taken to prevent untimely deaths of women of reproductive age.” 1 2 3
Krishnan S, Madsen E, Porterfield D, Varghese B. Advancing cervical cancer prevention in India: implementation science priorities. Oncologist 11 Nov 2013, doi:10.1634/ theoncologist.2013-0292. Bhaumik S. India has world’s highest number of cervical cancer deaths. BMJ 2013;346:f3108. Kay M. Screening with acetic acid could prevent 22 000 deaths from cervical cancer in India every year. BMJ 2013;346:f3935.
Cite this as: BMJ 2013;347:f6959 © BMJ Publishing Group Ltd 2013
Subscribe: http://www.bmj.com/subscribe
