Cervical cancer kills around 75,000 women in India every year. Second only to breast cancer in incidence. And almost uniquely among cancers, we have the tools to prevent most of those deaths before they happen.
The HPV vaccine works. Cervical screening works. The problem isn’t medical. It’s the gap between what exists and what actually reaches women.
The typical cervical cancer patient in India presents late. Not because the disease was impossible to catch, but because the window to catch it early was either never offered or not followed up on. A single abnormal smear that nobody acted on. A vaccination program that didn’t reach a specific community. A woman who was once told to come back for a screening, but never did.
A Gynecologist is the frontline of this prevention story. Routine pelvic exams, cervical screening, and HPV vaccination counselling belong in every gynecological consultation for women in the relevant age groups. Not as optional extras. As baseline care that should happen every single time.
What a Multispeciality Hospital with a dedicated cancer centre provides is the other end of that line: the point where, if prevention didn’t happen and early detection didn’t happen, treatment does. Advanced radiation, surgical oncology, chemotherapy, and the infrastructure to manage what preventive care was supposed to make unnecessary.
The goal is for the cancer centre to become redundant for this particular disease. The reality, for now, is that it isn’t.
What HPV Actually Is and Why the Vaccine Matters
Human papillomavirus causes virtually all cervical cancers. Not all of them. Almost all.
There are over 100 strains of HPV, and while most clear on their own without causing any symptoms, a handful of high-risk strains, particularly 16 and 18, cause persistent infections that can progress to precancerous changes and then to cancer over a period of years. The progression is slow. That’s actually the good news, because slow progression means a long window to intervene.
The HPV vaccine targets these high-risk strains and is most effective when given before first sexual exposure. In girls aged 9 to 14, a two-dose schedule provides robust, long-lasting protection. Countries that have run national vaccination programs are now projecting the near-elimination of cervical cancer within a generation in vaccinated cohorts. Some are already seeing it in the data.
India has approved HPV vaccines and included them in the national immunization schedule. Coverage remains far below what’s needed for population-level impact. That gap is not a medical problem. It’s a public health infrastructure problem, and it’s being felt as individual tragedies across the country every day.
The Pap Smear Problem
Cervical screening through a Pap smear or liquid-based cytology identifies abnormal cells before they become cancer. This window of opportunity exists because cervical cancer doesn’t appear overnight. Precancerous changes, called CIN lesions, can be present for years before crossing into invasive disease.
Caught in that window, treatment is minor. Cryotherapy. A LEEP procedure. A cone biopsy in some cases. No chemotherapy. No radiation. No prolonged recovery. The outcomes are close to uniform.
The problem in India is that screening rates are low, and follow-up rates are lower still. Women who receive an abnormal result don’t always return for the colposcopy that should follow. The system depends on patients coming back, and the system frequently doesn’t make that easy.
Gynecologists who screen and then actively track results, who follow up when patients don’t return, are the ones who bridge this gap in practice. It requires more than performing the test. It requires owning the result until it’s resolved.
When Prevention Fails
Even with good systems, cases will progress. A woman with no symptoms turns out to have stage 2 disease on investigation. Another had symptoms for months she attributed to something else.
At this point, the treatment becomes complex. Early-stage cervical cancer may be managed with surgery alone. More advanced disease typically requires external beam radiation combined with brachytherapy, often alongside chemotherapy. The treatment is demanding. Recovery runs into months. Long-term effects on bladder and bowel function are common and real.
This is the daily reality of a cancer centre. It’s also the reality that vaccination and screening are designed to make rare. The fact that the cancer wards stay busy is a measure of how far short prevention efforts have fallen.
Two Things Worth Saying Directly
If you are a woman between 25 and 65, you should have had a cervical screening in the last three to five years. If you haven’t, that’s worth fixing at your next gynecology appointment. It takes a few minutes. What it can catch, if caught in time, is entirely treatable.
If you have a daughter between 9 and 14, the HPV vaccine is among the most effective cancer prevention tools that exist for this age group, and the window for maximum protection is now. Not later. Now.
These are not complicated asks. They require a conversation with a doctor and some follow-through. The alternative, for too many women, has been a diagnosis that didn’t need to happen, at a stage where the only option left is treatment.
Prevention is always the better story. In this case, it’s also the available one.