Prevention is better than cure

Health experts seek government subsidisation for vaccine as solution for preventing cervical cancer.

ISLAMABAD: Given the rising number of cervical cancer patients in the country, health experts have demanded that the government include a vaccine for the disease in the National Immunization Programme.

Organised by Health Awareness Society (HAS), a press conference titled ‘Cervical Cancer is Preventable’ was held here at a local hotel on Wednesday. Health experts from Pakistan Institute of Medical Sciences (Pims) spoke about the incidence of cervical cancer in Pakistan and government measures needed for its prevention.

Addressing the conference, Professor of Paediatrics at Pims Dr Tabish Hazir said, “Despite the eligibility for international funding under WHO - The Global Alliance for Vaccines and Immunization Program, the political will to provide cervical vaccination at the community level seems inadequate,” he said. He expressed concern over the lack of government spending on health care, particularly on immunization programmes.

Dr Hazir said that Pakistan has moved from a low-risk to a moderate-risk country for cervical cancer, with increasing incidences in younger women. He said as the vaccine for cervical cancer is costly, the government needs to subsidise it. Three doses of the vaccine cost Rs24,000 which, “People of the middle and lower-middle class are unable to afford,” he added.

Speaking on the occasion, Dr Ghazala Mehmood head of gynaecology department at Pims, said cervical cancer is the third leading cause of cancer deaths among women globally, after breast and lung cancer. In terms of prevalence, it is the second most common cancer in women.

Cervical cancer develops in the lining of the cervix - the lower part of the uterus - as a result of a persistent infection caused by the Human Papillomavirus (HPV). The virus is extremely common and is easily transmissible from sexual activity. She said there are at least 15 high risk types of HPV virus, of which, two types account for over 70 per cent of cervical cancer cases.

As the virus does not depict any symptoms, it may reside silently in a patient for 10 or even 15 years. “So clearly, prevention for the disease is of highest importance.” She stressed that “every girl should get vaccinated against cervical cancer before getting married”.

According to GLOBOCON 2008 statistics, an online resource for cancer researchers established by the International Agency for Research on Cancer (IARC), the number of cervical cancer patients in Pakistan increased from 9 per 100,000 in 2002 to 19.5 per 100,000 in 2008. Deaths by the disease in 2008 were 12.9 per 100,000 patients.

Dr Hazir, the paediatrician from Pims, said there is a need to create awareness, not only among the public, but amongst oncologist, gynaecologist and nutritionist about the importance of vaccination for cervical cancer, its proper treatment and preventive measures. Women living in underprivileged areas are more prone to the disease only because of lack of awareness. “We need to join hands to help the innocent people from becoming victims of today’s health policies,” he added.

Dr Mehmood said there is no system under which cancer patients can be registered. She said the government should establish a proper registration process for preventable disease, including cancer, and make policies for their prevention.

The global burden of cervical cancer is around 500,000 cases and over 270,000 women deaths annually. This amounts to 1 death worldwide, every 2 minutes. Estimates show that up to 80 per cent of women will acquire HPV infection in their lifetime and a staggering 80 per cent of deaths related to cervical cancer occur in developing countries like Pakistan, she added.

Published in The Express Tribune, October 22^nd, 2010.