Women's Health: Know Cancer - No Cancer

I often wondered if someone with my background could discover a pathway to effect substantial transformation and change in the larger community. I stepped out of my comfort zone after 2 decades of transformation experience? to join an entrepreneurial journey - with Karkinos Healthcare . The journey of creating value as a platform company for society at large has been fascinating. Over the last 3 years, I have been part of several key building blocks at Karkinos Healthcare and one such being Cervical Cancer Elimination under mentorship of our CEO Venkataramanan R and our Director of Prevention Dr. R Sankarnarayanan.

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Few highlights from our work which I would like to share:

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Cervical cancer is conducive to prevention and early detection. Yet, In India, Cervical cancer is the 2nd most common cancer among women. Every year 123,907 women are diagnosed with cervical cancer and 77,348 die from the disease. Moreover, these figures are significantly underreported. These are disturbing statistics.

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The World Health Organization (WHO) has set ambitious goals for cervical cancer elimination by 2030 which rests on a 3 pillar strategy. HPV vaccine was introduced in India in 2008. Yet, the uptake has been very low. The current interim budget encouraging the integration of HPV vaccination is indeed a significant stride forward for women's health. However, we must confront the stark reality that the WHO endorsed HPV DNA testing remains conspicuously absent from our national screening guidelines. Shockingly, cervical cancer screening rates hover at a mere 2%, leaving a notable gap in our healthcare landscape.

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There are multifaceted barriers to change:

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a)?Lack of awareness: As almost all cervical cancer cases (99%) are linked to human papillomaviruses infection (HPV). Yet in my years of work, I noticed several women did not know of HPV. Nearly 9 of 10 women are not aware that PAP tests are NOT the most accurate in detecting cervical cancer. For those who know of HPV, are not aware of the importance of taking a clinically validated test. Unfortunately, there are over 600 HPV tests in the market which are not clinically validated.

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b)?Perception of Price: A clinically validated HPV DNA test has a very high negative predictive value. WHO has recommended HPV test (twice in lifespan only) as sufficient for cervical screening - which reduces the lifetime cost of testing. Why test with a low performance test every year which could miss the HPV infection? Additionally, for the policy makers, sharing a recent article* so well written by my colleague Kausar Kidwai which highlights how health systems expenditures can come down if India were to adopt HPV testing as part of Universal screening program.

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c)?Stigma and embarrassment towards cervical screening: Did you know there exists a method for self-sample collection at home?

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d)?And there is such much more that I can go on with respect to challenges towards equitable access, lack of technology innovation, overlapping forms of discrimination and societal apathy leading to adverse health outcomes and inefficient interventions towards prevention of cervical cancer.

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Over the last 2 years, more than 10 lakh women benefited from Karkinos’ early detection services either in the form of health risk assessment or HPV DNA testing or HPV vaccination, with over 80% patient retention through continuous engagement and guidance to women through our Command Center service. Awareness through industry leaders, gynecologists, advocates and change ambassadors has moved the needle to improve screening adoption among women.

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At Karkinos, we have made notable strides transforming cancer care for women using latest technology and behavioral science methods. As the only organization in India completing 45,000 clinically validated HPV DNA tests in the last year and half, detecting over 4000 HPV infections early, I appreciate efforts of all our SHEroes, Change ambassadors & Field champions, who have worked tirelessly with public-private partners, community groups and corporations to not only detect cervical cancer in women, but also deliver treatment through pragmatic ‘screen and treat’ approaches using connected platform approach, that guides women at every step of the care journey.

In addition to urban women, Karkinos has also supported women living with HIV and women prisoners & making in-roads to support women across all walks of life as strong advocates for WHO’s cervical cancer elimination mission.

I am glad to be a part of this journey in creating a new women wellness category. I am committed to serve many more women and I understand we have only scratched the surface !

Kudos to our entire team on this effort:

Dr Sravanthi Nuthalapati Dr. Ashwathy Rohith Chandrasekhar Kausar Kidwai Milan Toraskar Dr Malini Chandrasekharan Easwar S S Dr. Jagadish Kudkuli Dr. Ajit Nambiar Anurag Pandharpurkar Mayank Chhabra Lakkshmi Nairr Dr Devu Prakash

*https://www.news18.com/opinion/opinion-unveiling-solutions-pmjays-wellness-power-in-cervical-cancer-awareness-8751469.html