Comparison of iBreastExam with clinical breast examination for early detection of breast cancer in community outreach clinics in Pune, India.

Clinical breast examination (CBE) is the only feasible option for the low- and middle-income countries that have the rising burden of breast cancers but lack adequate infrastructure and human resources for organised mammography screening programmes. However, CBE is a subjective test and this warrants evaluation of alternatives to CBE. We conducted a cross-sectional study to evaluate the agreement between iBreastExam (iBE) and CBE for early detection of breast cancers.

Cancer of the cervix uteri: 2025 update.

Since the publication of the 2021 FIGO Cancer Report, there has been further progress in the global effort to attain the WHO goal of cervical cancer elimination using a three-pillar approach of vaccination, screening, and treatment. The HPV vaccination is now included in the national program of over 140 countries. Two-dose schedules are being implemented in 80 countries and one-dose schedules in 60 countries.

World health Organization's guidance for tracking non-communicable diseases towards sustainable development goals 3.4: an initiative for facility-based monitoring.

Background: Non-communicable diseases (NCDs) account for over 60% of annual global deaths, disproportionately affecting low- and middle-income countries. This trend undermines progress toward Sustainable Development Goal (SDG) 3.4, which seeks to reduce premature mortality from NCDs by one-third by 2030.

Co-designing and evaluation of a context-appropriate strategy to improve access to early detection and care of oral, breast and cervical cancers in rural India: a formative phase implementation research protocol.

Background: In India, cancers of oral cavity, breast and cervix account for more than one-third of all cancers among the Indian population and cause nearly 0.25 million deaths every year in the country. Cancer has a catastrophic impact on the rural men and women of India, the majority of whom are socioeconomically disadvantaged with one-fifth living below the national poverty line.

Designing and Implementing a Cancer Screening Program for Underserved Tribal Women in Jharkhand.

Background: The status of cancer screening in India is concerning, especially in tribal states like Jharkhand, where the percentage of women who have ever undergone screening for cervical, breast, and oral cancer is 0.5, 0.1, and 0.

A randomised controlled non-inferiority trial to compare the efficacy of 'HPV screen, triage and treat' with 'HPV screen and treat' approach for cervical cancer prevention among women living with HIV.

We report results of a randomized controlled trial to compare 'HPV screen and treat' (Arm 1) and 'HPV screen, triage and treat' (Arm 2) in women living with HIV (WLHIV), using visual inspection with acetic acid (VIA) as the triaging test. Treatment was offered to all HPV-positive women in Arm 1 and to VIA-positive women in Arm 2 with either thermal ablation or large loop excision. All women underwent a repeat HPV test one year after randomization.

Analysis of time trends of prevalence of high-risk HPV infections, high grade cervical precancer and cervical cancer disease in women from Eastern India over 20 years - Pooled analysis from three studies.

Background: Cervical cancer remains a leading cause of cancer related morbidity and mortality among women worldwide, particularly in low-and middle- income countries (LMICs). The incidence of cervical cancer has declined in India over the last two decades despite the lack of any organised population-based screening programme or HPV vaccination. This study analyses the trends in high-risk human papilloma virus (hrHPV) prevalence and CIN 2 + detection and examines the influence of sociodemographic factors in West Bengal, India from over a span of two decades.

A prospective cohort study comparing efficacy of 1 dose of quadrivalent human papillomavirus vaccine to 2 and 3 doses at an average follow up of 12 years postvaccination.

Background: While recommending a human papillomavirus (HPV) single-dose vaccination schedule in 2022, the World Health Organization highlighted the need for long-term follow-up studies to monitor waning of protection. We report on vaccine efficacy against HPV infections in 1-, 2-, and 3-dose schedules and protection against cervical precancers at a median follow-up of 12 years postvaccination.

Methods: This randomized multicenter study in India was originally designed to vaccinate unmarried girls aged 10-18 years with either 2 or 3 doses of quadrivalent HPV vaccine.

Improving access to cancer care among rural populations in India: Development of a validated tool for health system capacity assessment.

Background: Cancer burden in India is rapidly growing, with oral, breast, and uterine cervix being the three most commonly affected sites. It has a catastrophic epidemiological and financial impact on rural communities, the vast majority of whom are socio-economically disadvantaged. Strengthening the health system is necessary to address challenges in the access and provision of cancer services, thus improving outcomes among vulnerable populations.

A portable thermal ablation device for cervical cancer prevention in a screen-and-treat setting: a randomized, noninferiority trial.

Implementing standard-of-care cryotherapy or electrosurgical excision to treat cervical precancers is challenging in resource-limited settings. An affordable technological alternative that is as effective as standard-of-care techniques would greatly improve access to treatment. This randomized controlled trial aims to demonstrate the noninferiority efficacy of a portable, battery-driven thermal ablation (TA) device compared to cryotherapy and electrosurgical excision (large loop excision of transformation zone (LLETZ)) to treat cervical precancer in a screen-and-treat program in Zambia.

Impact of age at vaccination and cervical HPV infection status on binding and neutralizing antibody titers at 10 years after receiving single or higher doses of quadrivalent HPV vaccine.

Long-term follow-up of a cohort of unmarried girls who received one, two, or three doses of quadrivalent HPV vaccine, between 10 and 18 years of age, in an Indian multi-centric study allowed us to compare antibody responses between the younger and older age cohorts at 10-years post-vaccination, and study the impact of initiation of sexual activity and cervical HPV infections on antibody levels. Among the younger (10-14 years) recipients of a single dose, 97.7% and 98.

Health and economic effects of introducing single-dose or two-dose human papillomavirus vaccination in India.

Background: Cervical cancer is a major public health problem in India, where access to prevention programmes is low. The WHO-Strategic Advisory Group of Experts recently updated their recommendation for human papillomavirus (HPV) vaccination to include a single-dose option in addition to the two-dose option, which could make HPV vaccination programmes easier to implement and more affordable.

Methods: We combined projections from a type-specific HPV transmission model and a cancer progression model to assess the health and economic effects of HPV vaccination at national and state level in India.

Building resilient cervical cancer prevention through gender-neutral HPV vaccination.

The COVID-19 pandemic has disrupted HPV vaccination programmes worldwide. Using an agent-based model, EpiMetHeos, recently calibrated to Indian data, we illustrate how shifting from a girls-only (GO) to a gender-neutral (GN) vaccination strategy could improve the resilience of cervical cancer prevention against disruption of HPV vaccination. In the base case of 5-year disruption with no coverage, shifting from GO to GN strategy under 60% coverage (before disruption) would increase the resilience, in terms of cervical cancer cases still prevented in the disrupted birth cohorts per 100,000 girls born, by 2.

Cancer survival in Africa, central and south America, and Asia (SURVCAN-3): a population-based benchmarking study in 32 countries.

Background: Population-based cancer survival is a key measurement of cancer control performance linked to diagnosis and treatment, but benchmarking studies that include lower-income settings and that link results to health systems and human development are scarce. SURVCAN-3 is an international collaboration of population-based cancer registries that aims to benchmark timely and comparable cancer survival estimates in Africa, central and south America, and Asia.

Methods: In SURVCAN-3, population-based cancer registries from Africa, central and south America, and Asia were invited to contribute data.

Perspective on oral cancer screening: Time for implementation research and beyond.

Screening aims to detect cancer in asymptomatic populations. In oral cancer, clinical oral examination is the current standard method for screening. Oral cancer screening may be performed by a physician or a healthcare workers and is an affordable and feasible method.

Evaluation of immune response to single dose of quadrivalent HPV vaccine at 10-year post-vaccination.

Background: The recent World Health Organization recommendation supporting single-dose of HPV vaccine will significantly reduce programmatic cost, mitigate the supply shortage, and simplify logistics, thus allowing more low- and middle-income countries to introduce the vaccine. From a programmatic perspective the durability of protection offered by a single-dose will be a key consideration. The primary objectives of the present study were to determine whether recipients of a single-dose of quadrivalent HPV vaccine had sustained immune response against targeted HPV types (HPV 6,11,16,18) at 10 years post-vaccination and whether this response was superior to the natural antibody titres observed in unvaccinated women.

Impact of HPV vaccination on HPV-related oral infections.

Background: Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. Although the efficacy of the HPV vaccine in preventing the development of cervical pre-malignant lesions has been well demonstrated, the efficacy of the HPV vaccine in preventing HPV infection in the upper respiratory tract has been poorly studied.

Methods: In the context of the IARC cohort study of two versus three doses of HPV vaccine in India, we compared the HPV type prevalence in the oral cavity of women vaccinated with three doses, two doses, or a single dose of quadrivalent HPV vaccine with that of unvaccinated women.

Effectiveness of triennial screening with clinical breast examination: 14-years follow-up outcomes of randomized clinical trial in Trivandrum, India.

Background: This study presents the preliminary results of a randomized controlled trial (RCT) initiated in January 2006 in India to evaluate the effectiveness of clinical breast examination (CBE) in reducing breast cancer mortality as compared to a no-screening control group reported significant downstaging in the intervention group. The present manuscript reports long-term follow-up outcomes.

Methods: Women 30-69 years old from 133 intervention clusters and 141 control clusters were invited to participate.

Awareness, perceptions, and choices of physicians pertaining to human papillomavirus (HPV) vaccination in India: A formative research study.

Introduction: India accounts for one-fifth of the global burden of cervical cancer cases and mortality. A safe and effective vaccine to prevent human papillomavirus (HPV) infections, the primary cause of cervical malignancies, is available in India but multiple barriers lead to its low uptake in the country. Physicians are a key stakeholder and communicator in the Indian health system and have the potential to increase HPV vaccine uptake.

Evidence-based impact projections of single-dose human papillomavirus vaccination in India: a modelling study.

Background: Despite the high burden of cervical cancer, access to preventive measures remains low in India. A single-dose immunisation schedule could facilitate the scale-up of human papillomavirus (HPV) vaccination, contributing to global elimination of cervical cancer. We projected the effect of single-dose quadrivalent HPV vaccination in India in comparison with no vaccination or to a two-dose schedule.

A Distributed Cancer Care Model with a Technology-Driven Hub-and-Spoke and further Spoke Hierarchy: Findings from a Pilot Implementation Programme in Kerala, India.

Background: The technology enabled distributed model in Kerala is based on an innovative partnership model between Karkinos Healthcare and private health centers. The model is designed to address the barriers to cancer screening by generating demand and by bringing together the private health centers and service providers at various levels to create a network for continued care. This paper describes the implementation process and presents some preliminary findings.

Accuracy of high-risk HPV DNA PCR, p16 immunohistochemistry or the combination of both to diagnose HPV-driven oropharyngeal cancer.

Background: The incidence of high-risk human papillomavirus (hrHPV)-driven head and neck squamous cell carcinoma, in particular oropharyngeal cancers (OPC), is increasing in high-resource countries. Patients with HPV-induced cancer respond better to treatment and consequently have lower case-fatality rates than patients with HPV-unrelated OPC. These considerations highlight the importance of reliable and accurate markers to diagnose truly HPV-induced OPC.

Implementation of visual inspection with acetic acid and Lugol's iodine for cervical cancer screening in rural China.

Objective: To address the value of visual inspection where HPV-based screening is not yet available, we evaluated the real-world effectiveness of visual inspection with acetic acid (VIA) and with Lugol's iodine (VILI) as a primary screening method for cervical cancer in rural China.

Methods: A total of 206 133 women aged 30-59 years received two rounds of VIA/VILI screening for cervical cancer in 2006-2010. Women with positive screening results underwent colposcopy and direct biopsy, and were treated if cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was diagnosed.