In this article, Dr Puneet Rana Arora, Director – Gynaecologist & IVF Expert at CIFAR, Gurgaon, shares her outlook on cervical cancer, outlining what women need to know about symptoms, screening and vaccination. And how advances in treatment and technology are reshaping care in India across different age groups.
What is cervical cancer?
Cervical cancer begins in the cervix, the lower part of the uterus that opens into the vagina. It is one of the most common cancers in women and is strongly linked to persistent infection with high-risk human papillomavirus (HPV) types, particularly HPV 16 and 18.
In its early stages, cervical cancer often causes no symptoms, which is why regular Pap smear and HPV DNA testing are so important. When symptoms do appear, they may include abnormal vaginal bleeding (such as bleeding after intercourse or between periods) and pain during sex.
Because cervical cancer usually develops slowly from precancerous lesions to invasive disease, there is a long opportunity window for detection and cure. Preventive HPV vaccination, combined with regular screening, can dramatically reduce the risk of this cancer.
Evolving treatment options
For many years, cervical cancer treatment relied mainly on surgery, radiotherapy and chemotherapy, depending on the stage of disease. Today, these remain the backbone of care, but there is growing use of targeted therapies and immunotherapy, especially in advanced or recurrent cases.
Tisotumab vedotin (Tivdak), an antibody–drug conjugate that targets a protein called tissue factor on tumour cells, delivers chemotherapy directly to cancer cells while sparing more healthy tissue. Pembrolizumab, an immune checkpoint inhibitor, works by “releasing the brakes” on the immune system so that it can better recognise and destroy cancer cells. It is already approved in India for certain cervical cancer indications.
Clinical trials are evaluating combinations of immunotherapy, targeted agents and standard chemoradiation to improve survival and quality of life in advanced disease. As access to these newer therapies expands, more women with late-stage cervical cancer may benefit from personalised treatment.
Role of artificial intelligence
Artificial intelligence (AI) is reshaping how cervical cancer is screened and detected, particularly in low-resource settings. AI-powered algorithms can analyse Pap smears and cervical images with high sensitivity and specificity, reducing false negatives and helping cytopathologists manage increasing workloads.
Solutions such as AIndra’s CervAstra use AI-enabled microscopy to offer point-of-care cervical screening with rapid, affordable results, making it easier to reach women in rural and underserved areas. Other research groups, including collaborations supported by IARC, are developing deep learning models that can automate visual inspection and identify precancerous lesions with greater consistency than human readers alone.
These tools are still being scaled up, but they hold promise for expanding coverage, standardising quality and accelerating early diagnosis where specialist manpower is limited.
India’s cervical cancer burden and response
India carries one of the heaviest cervical cancer burdens globally, contributing an estimated 127,526 new cases and nearly 79,906 deaths in 2022 alone. Cervical cancer remains the second most common cancer among Indian women, with many cases still detected at advanced stages.
At the same time, the country has made significant strides in prevention and control. Under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), millions of women have undergone screening, and there is a renewed push to shift from visual inspection with acetic acid (VIA) to more accurate HPV DNA testing.
India has also introduced Cervavac, the first indigenously developed quadrivalent HPV vaccine that protects against HPV types 6, 11, 16 and 18, improving affordability and access. Recent national deliberations have emphasised rapidly expanding HPV vaccination for girls aged 9–14 years and scaling up DNA-based screening, with self-sampling pilots to improve uptake, as part of India’s roadmap to eliminate cervical cancer as a public health problem.
Why early detection and prevention matter
Preventive screening and HPV vaccination are the cornerstones of cervical cancer control. Screening can identify precancerous lesions long before they turn into invasive cancer, allowing timely treatment and very high cure rates.
Global and national targets aim to vaccinate girls between 9 and 14 years against high-risk HPV strains and to ensure that at least 70% of women are screened with a high-performance test by age 35 and again by 45. For India, improving awareness, tackling myths, and integrating HPV vaccination into routine immunisation will be critical to reach these goals.
With wider vaccine coverage, stronger screening programmes – including AI-enabled solutions – and better access to treatment, India has a real opportunity to sharply reduce cervical cancer incidence and mortality in the coming years.
