Community engagement and cancer vaccination in India

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Published: 29 Mar 2017
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Dr Jaydip Bhaumik - Tata Medical Centre, Kolkata, India

Dr Bhaumik speaks with ecancertv at EBMCI 2017 about the work of the National Cancer Grid in establishing cancer prevention policy.

He outlines how community-based screening and engagement, while researched, is under-utilised for widespread cancer prevention.

Comparing the success of vaccination to reduce the incidence of polio and tetanus, Dr Bhaumik has hopes for the wide adoption of a cervical cancer screening and vaccination programme.

The National Cancer Grid is set up define or design a strategy by which there’s uniform standard of care throughout the country. So, experts from all over the place, all different areas, are collected together, they meet and then we will define the policy and will submit it to government to tell that it is the way forward for the treatment of cancer in India.

How does screening for cervical cancer impact national policy?

As I speak to you, by this time two women have died of cervical cancer; one woman is dying every eight minutes in India from cervical cancer which is largely a preventable disease. So, as a clinician, as a doctor working in this field, I think it’s our responsibility to be very outspoken about what is exactly happening, what the wrong things are and what the right things should be to prevent this cancer and prevent so many young women dying and so many families getting destitute just because there are no mothers, no wives in those families. So, prevention is a very big aspect here. We do not have a screening programme; there have been many studies on screening but they are limited to the studies only, nothing has been done. We need a community based cancer screening project. We have funding for research, we’ll go there, we’ll go to a village, we’ll screen a few women and then we’ll say this research is done but nothing happens for the community. So, the incidence of cervical cancer, death from cervical cancer, is not decreasing. Incidence wise it is the commonest cancer in India but if you consider death it is the most common cancer in India.

How will a vaccination programme impact this?

In India, all the vaccination programmes have been marvellous: small pox has been eradicated many years ago and now we know that even polio and tetanus, the two most dreaded diseases are eliminated, not eradicated but eliminated. So, we have a very successful vaccine programme and if we can introduce a vaccine that will be a lot better than just trying to identify opportunistic screening or just doing Pap smears which have never worked in India. There are other methods, of course, by which we should screen. Screening should continue but for the future, for the better of this country, vaccination is the answer.

Is there anything that would prevent this from happening?

It’s prohibitively expensive. Initially when the vaccine was launched it was expensive; if it was cheap the government would have probably introduced it earlier. Also, when the vaccine was tried in India in a research project, mainly to trial between two doses and three doses of the vaccine, now we know that the WHO has recommended that the vaccine should be given in only two doses for young women between nine and thirteen years. That came out of an incomplete study in India; the study was stopped because somebody died during the study and that was nothing to do with this vaccine. But the press had the good news, the politicians had a good way to publicise themselves unfortunately, that was five years ago and in these five years we have lost 300,000 women. I don’t know who is going to pay the cost of those lives but we have lost those lives. If we had introduced the vaccine by now we could have saved so many more women.