Cervical cancer is the leading cause ofcancer mortality in India, accounting for 17 percent of allcancer deaths among women age 30 to 69 years. At currentincidence rates, the World Health Organization (WHO)estimates that the annual burden of new cases in India willincrease to nearly 225,000 by 2025. Despite the considerableburden of cervical cancer morbidity and mortality in India,there are few large-scale, organized cervical cancerprevention programs in the country. We reviewed the researchliterature and conducted interviews with individuals engagedin research and public health program implementation toidentify important elements of cervical cancer preventionefforts in India and implementation issues that meritfurther investigation. Although primary prevention throughHPV vaccination has been endorsed by WHO, under certainconditions, in low- and middle-income countries (LMICs), itscost, partial efficacy and safety have been intenselydebated in India. Further research and advocacy efforts areneeded to determine the optimal strategies for itsintroduction and sustained use in the country. However,there is considerable research and programmatic evidence insupport of secondary prevention of cervical cancer throughscreening and treatment. Regardless of screening approach,research and prevention programs have underscored theimportance of ensuring strong linkages between screening,diagnosis, and treatment services for program and costeffectiveness. Available evidence also emphasizes thatprograms that are 'women-centered,' or activelyrespond to women's concerns and constraints are likelyto be the most successful. In conclusion, research andprevention program experiences provide a strong rationalefor investments in cervical cancer prevention in India.
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