Cervical cancer is the second common cancer worldwide. About half a million cervical cancer cases are diagnosed each year, with 80% of them occurring in developing countries. It is estimated that around 274,000 women die globally every year in
these countries due to cervical cancer. There are about 500,000 new cases of cervical cancer. National Cancer Registry Program (NCRP) comprising of data collected from 7 major hospitals of Nepal shows that cervical cancer is among the top ten cancers,
and is the number one cancer among women. Nepal has a population of 10.16 million women ages 15 years and older who are at risk of developing cervical cancer. Current estimates indicate that every year 2332 women are diagnosed with cervical cancer
and 1367 die from the disease. Cervical cancer ranks as the 1st most frequent cancer among women in Nepal and the 1st most frequent cancer among women between 15 and 44 years of age. About 2.0% of women in the general population are estimated to
harbor cervical HPV-16/18 infection at a given time, and 80.3% of invasive cervical cancers are attributed to HPVs 16 or 18. Cervical cancer generally affects women with multiple school age children and their deaths have a major negative impact on the social fabric of their communities.

There is a sufficient scientific evidence to conclude that screening for cervical cancer can result in significant reduction in mortality. Evidence from Nordic countries as well as UK and other developed countries where screening is implemented as a
nationwide population based public health program shows 40-50% reduction in mortality in cervical cancer.

Cervical cancer screening is a process using Visual Inspection with Acetic Acid (VIA) and Pap Smear to identify precancerous and potentially precancerous changes in cervical cells and tissue. Cervical cancer acts as the biggest killer and most preventable cancer in Nepalese women.Human papilloma virus (HPV) infection is chiefly the reason for cervical cancer. In majority cases, early exposure to sexual intercourse, multiple sex partners and addiction are considered as risk factor. In Developing country like Nepal, screening for cervical cancer is not easily available to people at risk. A vaccine is available which reduces the risk of HPV. The vaccine will be effective if received before the onset of sexual activities 9-13 years. Cervical cancer screening program has many difficulties in terms of limited medical services, difficult geographical terrain creating difficulties in delivering health services. A special program needs to be designed and delivered to population focusing on reducing burden of cervical cancer.

Taking up screening all the sexually active women in Nepal is a big challenge and it is another matter to have the school children vaccinated with HPV vaccination before they become sexually active is another demand . A method to prevent this form
of cancer in women is providing vaccination against Genital Human Papilloma Virus (HPV) infection to them before they become sexually active.HPV vaccine has been found to be safe with high acceptability in Nepalese school girls. It will really be a feat
when all Nepalese school going girls will be vaccinated with HPV vaccination which could eventually lead to very few cervical cancer cases in the country. The prevention strategy through the vaccination program backed up by proper screening on a regular
basis would do much to fight the cancer that takes a heavy toll of women lives globally.

There are also plans to making this vaccination a part of the National Immunization Programs (NIP). High cost and lack of awareness are the main reasons for difficulties in the implementation of the HPV vaccination program in a low resource country like Nepal.

Merck & Co. a USA based pharmaceutical research giant has introduced first time in Nepal a quadrivalent Human Papilloma Virus vaccine that covers HPV 6,11,16 & 18 types. It is indicated in females aged 9 through 45 years for prevention of cervical, vulvar, vaginal cancer, precancerous lesions and genital warts. Girls aged 9-14 years are recommended 2 dose schedule while 15 years and older are recommended 3 dose schedule.

Let us live healthy, live long.