This document outlines a plan to eliminate cervical cancer as a public health problem in the state of Mizoram, India by 2040. It discusses conducting HPV vaccination drives for girls, integrating screening and treatment into primary healthcare, promoting health education, and strengthening collaboration between health services. The objectives are to prevent cervical cancer through vaccination and screening, promote healthy behaviors, and enhance health services. Expected outcomes include high vaccination and screening rates, increased diagnostic capabilities, and improved access to treatment. Required resources include health educators, community workers, and expanded medical infrastructure.

1. RAJAGIRI COLLEGE OF SOCIAL SCIENCES (AUTONOMOUS)
Demystifying
Cervical Cancer
TOGETHER WE CAN MAKE HISTORY, IT'S WITHIN OUR REACH
Date: FEBRUARY 28, 2022

2. WE THE TEAM
ALEENA SEBASTIAN
ANILA K S
JAISON KURIAKOSE
LIJA MARY MATHEW
NESTY PAUL
SONIYA GEORGE
TAIBAH HAIDARY

3. Learning
Agenda
What we'll discuss
this morning
What is cervical cancer
Planning Community based
interventions
Why treating it is important
Strategies to eliminate cervical
cancer
Scaling Up

4. Director- General, World Health Organisation
Dr Tedros Adhanom Ghebreyesus
“One woman dies of
cervical cancer every
two minutes…Each
one is a tragedy, and we
can prevent it.”

5. What is
Cervical Cancer?
Is it just a lesion inside the cervix??

6. Cervical cancer is a type of cancer that
develops in a woman's cervix (the
entrance to the uterus from the vagina).
The infection with high-risk human
papillomaviruses (HPV), an exceedingly
prevalent virus spread through sexual
contact, is connected to almost all
cervical cancer cases (99 percent).
Although most HPV infections go away
on their own with no symptoms, a
persistent infection can lead to cervical
cancer in women.

7. The fourth most frequent cancer in women
is cervical cancer.
Cervical cancer was diagnosed in around
570 000 women worldwide in 2018, with
approximately 311 000 women dying from
the disease. (WHO,2019)

8. Nearly half of high-grade cervical pre-cancers are
caused by two human papillomavirus (HPV) strains (16
and 18).
HPV is mostly transmitted through sexual contact,
and the majority of persons become infected with HPV
shortly after sexual activity begins. More than 90% of
them finally recover from the virus.
Cervical cancer is six times more likely in HIV-positive
women than in HIV-negative women.
Cervical cancer can be prevented at a low cost by
vaccinating against HPV and screening and treating
pre-cancer lesions.
Cervical cancer can be cured if caught early and treated
effectively.
Primary prevention (HPV vaccine), secondary
prevention (screening and treatment of pre-cancerous
lesions), and tertiary prevention (detection and
treatment of invasive cervical cancer) and palliative
care are all part of a comprehensive cervical cancer
control strategy.

9. It takes 15 to 20 years for cervical cancer to develop in women with
normal immune systems.
It can take only 5 to 10 years in women with weakened immune
systems, such as those with untreated HIV infection

11. Cervical cancer is typically not detected
until it has progressed and symptoms
appear in low- and middle-income
countries, where access to these
preventive methods is limited.
Furthermore, access to cancerous lesion
treatment (for example, cancer surgery,
radiation, and chemotherapy) may be
limited in these nations, resulting in a
greater rate of cervical cancer death.
In high-income nations, there are
programmes in place that allow
girls to be vaccinated against HPV
and women to be checked and
treated appropriately on a regular
basis. Screening identifies pre-
cancerous lesions at an early
stage, when they can be easily
treated.

12. HPV Vaccination is not included in National
Vaccination schedule.
Fewer than 1 in 10 women have been
screened for cervical cancer in the last 5
years
Crude cervical cancer incidence per 100
000 women (2020): 18.7
Mizoram is the "Cancer Capital" of the
country and it tops in the list of Cervical
Cancer Incidence.
In India,

13. Goal of the
project
“To eliminate Cervical Cancer
as a public health problem
through Prevention,
Protection and Promotion in
the state of Mizoram by
2040”.

14. Objectives
To prevent and
protect women
from the
incidence of
cervical cancer
through
vaccination,
screening and
treatment
To promote
cancer free
healthy
behaviour
through
health
education
programmes
To enhance the
provision of
formal and
informal health
services to
women in order
to reduce
cervical cancer
risks and
prevalence
To strengthen the
health services by
enhancing
coordinated
collaboration of
multisectoral
governmental
and non-
governmental
partners

15. Platforms
of Care
1.The self-care interventions are
• Following healthy behaviours which protect the
individual from cervical cancer. (Safe sexual
practices, hygienic surroundings)
• Self-motivation of the individuals to take
vaccinations and screening tests.
• HPV self-sampling kits can be used to screen.
2.Primary Health Care:
Vaccinations, Primary and early screening and referrals
can be provided through primary health care services.
This level of care platform can be utilised for awareness
generation, early prevention and protection against the
disease.
3. Specialist Health Care:
Affordable and accessible treatments like surgery,
radiotherapy, chemotherapy etc. can be done through
specialist care services

16. Conduct a massive HPV vaccination drive for girls below the age of 15
in 8 districts of Mizoram.
School-based immunization programs
Community-based outreach programs for girls who are out of
school.
Integrating screening and treatment services to primary care systems
like sexual and reproductive health services, HIV care and treatment
clinics, antenatal care, well women clinics and school-based health
outreach.
Distribution of self-screening kits among women
Increasing laboratories with high quality pathology services.
Making affordable telepathology services in integration with medical
colleges in Mizoram.
Improving surgical and radiation capacity of hospitals in Mizoram.
1.
2.
Objective 1: To prevent and protect women from the
incidence of cervical cancer through vaccination,
screening and treatment

17. Objective 2: To promote cancer free
healthy behaviour through health
education programmes
Awareness programmes in collaboration with various governmental, non-
governmental organisation in providing health literacy and other educational
initiatives, age-appropriate information on sexual and reproductive health, safer
sexual practices such as delaying sexual debut, decreasing the number of sexual
partners, condom use, and male circumcision in educational institutions and
communities.
Distribution of dissemination materials through IEC, media etc

18. Objective 3: To strengthen the health services by enhancing
coordinated collaboration of multisectoral governmental and
non-governmental partners.
Collaborate with health service delivery systems like hospitals,
labs, medical institutions to provide affordable and accessible
primary, secondary and tertiary services to people
Objective 4: To enhance the provision of formal and informal
health services to women in order to reduce cervical cancer
risks and prevalence
Connecting community health workers with individuals so that
proper health services are provided.
Conducting regular inspections and house visits by health workers
to ensure that vaccinations and screenings are done properly

19. Expecting
Outcomes
90% of girls under the age of 15 are HPV
vaccinated in Mizoram state by 2025.
80% of women are screened for high
performance VIA test for detecting cervical
cancer.
50 laboratories with sophisticated diagnosing
machines are introduced with VIA screening by
2030.
25 % Increase in number of oncology centres in
the state by 2030.
90% of women diagnosed with cervical cancer
receives treatment from affordable and
accessible health services by 2030.

20. All schools in state of Mizoram receive awareness programs on
cervical cancer.
Massive distribution of IEC materials in 8 districts of
Mizoram.
Increased number of MOUs with various health delivery
organisations.
90% of women are registered on a common database for
regular screening and diagnosis.
90% of households in Mizoram are visited by community
health workers by 2030 to promote healthy behaviours and
monitor the progress in preventing cervical cancer.

21. Manpower requirements
Teachers
for health
education
programs
in schools.
ICDS and
ASHA
workers for
health
education,
vaccination
and
screening
Community
Health
Workers &
Social
Workers
Medical
Professionals
and Lab
workers
Government
officials

22. SCALING UP
USER ORGANISATION
ENVIRONMENT
THE INNOVATION
RESOURCE TEAM
DISSEMINATION &
ADVOCACY
COSTS/ RESOURCE MOBILISED
ORGANSATIONAL
PROCESS
MONITORING & EVALUATION
TYPES OF SCALING UP

23. Thank you!
"Through cost-effective, evidence-
based interventions, including human
papillomavirus vaccination of girls,
screening and treatment of
precancerous lesions, and improving
access to diagnosis and treatment of
invasive cancers, we can eliminate
cervical cancer as a public health
problem and make it a disease of the
past."
Dr Tedros Adhanom Ghebreyesus,
Director-General, World Health
Organization