Cervical cancer in India, rising incidence, screening challenges, and need for human papillomavirus vaccine in the national immunization policy

Abstract Cervical cancer, primarily caused by persistent infections with high-risk human papillomavirus (HPV) types (HPV-16 and HPV-18), is one of the leading causes of cancer-related deaths among women globally. In India, the incidence of cervical cancer is rising, with an estimated 96,922 new cases and 60,078 deaths in 2018. By 2025, the country’s cervical cancer burden is expected to reach 1.5 million disability-adjusted life years. Despite the availability of effective preventive measures such as HPV vaccination and regular screening, the uptake remains low due to insufficient awareness, cultural stigma and limited healthcare infrastructure, particularly in rural areas. The World Health Organization’s 2020 Global Strategy for cervical cancer elimination emphasizes vaccination and screening as key interventions. In India, vaccines such as Cervarix, Gardasil, and Gardasil 9 are available and have shown significant efficacy in preventing cervical cancer. However, challenges persist in expanding vaccination coverage, with <1% of girls vaccinated and only 2% of women screened for the disease. This article advocates for the inclusion of HPV vaccines in India’s National Immunization Policy and proposes a comprehensive approach that combines vaccination, awareness campaigns, and improved screening services to reduce cervical cancer incidence. Addressing the gaps in vaccination access, infrastructure, and awareness is crucial to eliminating cervical cancer as a public health problem in India by the year 2030.