A strategic assessment of cervical cancer prevention and treatment services in 3 districts of Uttar Pradesh, India

Abstract

Background: Despite being a preventable disease, cervical cancer claims the lives of almost half a million women worldwide each year. India bears one-fifth of the global burden of the disease, with approximately 130,000 new cases a year. In an effort to assess the need and potential for improving the quality of cervical cancer prevention and treatment services in Uttar Pradesh, a strategic assessment was conducted in three of the state's districts: Agra, Lucknow, and Saharanpur.

Situation Analysis of Existing Facilities for Screening, Treatment and Prevention of Cervical Cancer in Hospitals/Primary health Centers of Delhi-NCR Region, India

“…Similar to our findings, a study by Dabash et al, 2005 has reported that there was lack of routine screening offered to asymptomatic women in healthcare facilities, with the exception of a few private providers and military hospitals from three district of Uttar Pradesh: Lucknow, Agra and Saharanpur. In the Public sector, Pap test were mostly limited to the tertiary care level on an outpatient basis, and usually only offered to women with symptoms of reproductive tract infections or advanced cervical cancer.…”

“…On the other hand, a study by Dabash et al, 2005 has reported that most gynecologists in Public and Private Facilities felt competent in taking cervical samples for Pap test but said that they generally referred clients to pathology laboratories for the pathologists, residents or technicians to take the cervical sample. Some reported doing so for their own convenience while others believed that laboratory personnel were better suited to take smears.…”

Human Papillomavirus Screening in North Indian Women

“…Cervical tumors have been shown to harbor HPV sequences in as many as 99.7% of the cases analyzed, implying a need for the sustained presence of viral DNA during carcinogenesis (Dabash et al, 2005). This finding led to the assumption that HPV testing would be useful for the diagnosis and monitoring of cervical cancer.…”

“…The high-risk Human Papillomavirus (HPV) types 16 and 18 are the major etiological agents of cervical cancer (Bosch et al, 2002;Zur, 2002); despite being a preventable disease, cancer of the uterine cervix claims the lives of almost half a million women worldwide each year (Stamenkovic, 2000) and about a fifth of the global cervical cancer cases are still in India (Ferlay et al, 2004). There are approximately 130,000 new cases of cervical cancer in India per year and the age-standardized incidence rate is 30.7 per 100,000 (Dabash et al, 2005). The link between genital HPV infections and cervical cancer was first demonstrated in the early 1980s by Harold zur Hausen, a German virologist; although HPV is considered as a major causative agent of cervical cancer, yet the viral infection alone is not sufficient for cancer progression and/or malignancy (Ganguly and Parihar, 2009).…”

Illness Representations of Cancer among Healthy Residents of Kolkata, India

“…Factors that hinder screening efforts in India include absence of screening facilities and equipment, poor literacy, and socio-cultural barriers. Dabash et al (2005) found that lack of confidentiality and privacy during screening, cultural norms encouraging modesty, and insufficient importance given to women's health issues were significant barriers to cervical cancer screening. They also found that having a positive confirmatory diagnosis of cervical cancer was associated with stigma due to questions of high parity and sexual promiscuity, which prevented women from screening (Satija, 2012).…”