Cervical cancer in Bihar: an exploration of opportunities and challenges

Cervical cancer has a major impact on the lives of Indian women with an estimated 132,000 new cases and 67,000 deaths reported worldwide in 2012. Locally advanced cervical cancer is commonly seen in Bihar because of the high prevalence of associated risk factors like low socioeconomic status, poor access to health care, high parity, early age of marriage and first pregnancy, smoking, persistence of genital infection specially HPV, low immune status, poor genital hygiene and nutritional status. Besides, there is lack of organized screening programme and treatment facilities for these patients in Bihar. With this background, this review was done to evaluate data from National census and Health survey in context to the above known risk factors for cervical cancer and methods for improving prevention and treatment of cervical cancer in the state of Bihar. Data from National census of India, 2011 and health survey 2011-12 was evaluated for the prevalence of risk factors in the state of Bihar. Further availability of cancer treatment facilities in the state was also evaluated in terms of requirement as per given standard recommendations. Conclusion: Increasing awareness about early signs and symptoms especially among the rural population, widespread use of HPV vaccination and simple screening techniques like visual inspection with use of acetic acid is urgently required to control the rising number of cervical cancer cases in the state of Bihar. A tremendous boost is also required in the availability of radiotherapy units, other infrastructure and trained personnel in the field of oncology.