Cervical Cancer: Leading Cause of Death in Women, 1,493 Die Yearly in Nepal.

Cervical cancer, the fourth most common cancer in women globally, poses a significant health challenge in Nepal. According to the World Health Organization (WHO), the disease results from abnormal cell growth in the cervix—the entrance to the uterus—and, while treatable if detected early, continues to claim the lives of thousands each year. 

Dr. Rajendra Baral, a renowned oncologist, emphasizes the importance of early detection in reducing mortality rates. "Cervical cancer is highly preventable with timely screenings and vaccination. Unfortunately, many cases are diagnosed too late, which diminishes the chances of successful treatment," Dr. Baral explains. 

Global and National Statistics

Worldwide, an estimated 604,000 women were diagnosed with cervical cancer in 2020, with 342,000 succumbing to the disease. In Nepal, the situation is alarming. Around 1,493 women die from cervical cancer annually, with the country reporting a cervical cancer incidence of 16.4 per 100,000 women. Among cervical cancer patients, 80.9% are diagnosed at a late stage, highlighting the pressing need for better awareness and early detection.

Causes and Risk Factors

Human papillomavirus (HPV), a sexually transmitted infection, is responsible for 99% of cervical cancer cases. While most HPV infections resolve naturally without symptoms, persistent infections can lead to the development of abnormal cells that may progress to cancer within 15-20 years—or even sooner, within 5-10 years, in women with weak immune systems.

High-risk groups include young mothers, hormonal contraceptive users, smokers, and individuals with other sexually transmitted infections.

Symptoms and Treatment

WHO identifies several warning signs of cervical cancer, including:

• Unusual bleeding (e.g., between periods, after menopause, or post-intercourse)
• Persistent pain in the back, legs, or pelvis
• Foul-smelling or excessive vaginal discharge
• Weight loss, fatigue, and loss of appetite
• Swelling in the legs

Treatment options range from surgery and radiotherapy to chemotherapy and pain management. Early diagnosis through professional medical evaluation is crucial to improving outcomes.

Preventive Measures and Vaccination Efforts

HPV vaccines are vital in the fight against cervical cancer. Despite their effectiveness, access remains limited in many low-income countries, including Nepal.

In 2016, Nepal piloted HPV vaccination programs in Chitwan and Kaski districts, targeting girls aged 11-13. In 2022, the country purchased 20,000 vaccine doses, reaching 9,000 girls aged 14-15. Building on these efforts, health authorities have now embarked on a nationwide campaign to vaccinate over 1.68 million girls aged 10-14.

Vaccination campaigns often face challenges, from logistical hurdles to vaccine hesitancy. In Nepal, schools have played a pivotal role in administering vaccines after other outreach efforts saw limited success.

With cervical cancer claiming a woman’s life every two minutes globally, the stakes are high. Advocacy for HPV vaccination, early screening, and treatment access is critical to reducing the burden of this preventable disease.

Nepal’s intensified focus on nationwide HPV vaccination campaigns marks a promising step, yet sustained efforts are needed to ensure that every girl and woman in the country is protected from cervical cancer.