Cervical cancer is the third most common cancer in women worldwide. The role of human papilloma virus (HPV) in the genesis of cervical carcinoma is well documented. The HPV 16 and 18 are found to be most commonly associated with invasive cervical carcinoma. The advent of cervical carcinoma vaccine has advanced the hopes that eradication of cervical carcinoma might be possible in future. The scenario of prevention of cervical carcinoma is completely different in developed and developing countries. The implementation of the vaccination as a routine in India is still controversial. Here we have tried to critically analyse these issues in Indian context. However it is clear that cervical cancer vaccine is not an immediate panacea and cannot replace the cervical cancer screening which is mandatory in Indian context. 1. Introduction Cervical Cancer is the third most common cancer in women worldwide with estimated 529000 new cases and 275000 deaths globally in 2008 [1]. More than 85% of the global burden of cervical cancer cases and 88% of cervical cancer deaths occur in developing countries. Indian contribution to cervical cancer cases is 25.4% and contribution to the mortality due to this disease is 26.5%. The age-standardized incidence and mortality rate of cervical cancer in India are 27.0 and 15.2, respectively [2]. The majority of the Indian women diagnosed with cervical cancer have never been screened for the disease and around 70% of these cases present in advance stages due to absence of any organized cervical cancer screening program. It has been estimated that there will be around 205496 new cases and 119097 deaths due to cervical carcinoma by 2020 in India [3]. The most important risk factor for development of cervical cancer is persistent infection by a high-risk subset of human papilloma virus (HPV) [4] which is the most common viral sexually transmitted infection. The lifetime risk of HPV infection for sexually active males and females is more than 50%. In sexually active women of less than 25 years of age prevalence of HPV is about 20% [5]. Most women’s immune systems eliminate HPV infection spontaneously; however, for a very small proportion of women, the infection will persist and can cause precancerous changes in cells. HPV also causes anal cancer, with about 85 percent of all cases caused by HPV-16. HPV types 16 and 18 have also been found to cause close to half of vaginal, vulvar, and penile cancers [6]. The advent of HPV vaccination has advanced hopes that the dream of eradication of cervical cancer might be possible in future.
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