News

India has world’s highest number of cervical cancer deaths

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f3108 (Published 13 May 2013) Cite this as: BMJ 2013;346:f3108
  1. Soumyadeep Bhaumik
  1. 1Kolkata

More women die from cervical cancer in India than in any other country in the world, including China, shows an analysis of data from 50 countries.

The data appear on a crisis card developed by the US based research and advocacy group Cervical Cancer-Free Coalition, which shows that most deaths from cervical cancer occur in the two most populous nations in the world: India and China. Zambia has the highest proportion of deaths from cervical cancer.1

Currently India ranks highest in terms of the overall number of deaths from cervical cancer, with 72 825 deaths a year, more than twice China’s 33 914. Bangladesh, Indonesia, Pakistan, Russia, and Thailand also have high overall numbers.

But the coalition identifies Africa as “the most dangerous place to be a woman with cervical cancer.” Zambia has 38.6 deaths from cervical cancer per 100 000 deaths. India ranks 17th with 15.2 per 100 000.

The data on the card show that across the world a total of 275 000 women die from cervical cancer each year and that 500 000 new cases are detected. The coalition estimates that by 2030 the overall number of cervical cancer deaths will almost double. It predicts that by 2030 almost half a million women will die of cervical cancer a year and that over 98% of these deaths will be in low and middle income countries.

The coalition has called for the “aggressive rollout of HPV vaccines that prevent disease and for the scaling up of screening and treatment options,” because, it says, the evidence shows that the vaccine is effective in reducing death rates.

Australia, which has had a national human papillomavirus (HPV) vaccination programme to protect against cervical cancer since 2007, has the lowest rate of cervical cancer mortality (1.4 per 100 000 deaths) among the 50 countries and ranks 46th in terms of the overall number, with only 241 deaths a year.

However, with a three dose course of HPV vaccine retailing at around $390 (£250; €300),2 cost remains a major barrier to coverage in low and middle income countries. Zambia’s total expenditure on health per capita is $99,3 while in Malawi, which has the second highest rate of death from the disease, it is just $77.4

The global humanitarian organisation Médecins Sans Frontières has said that the cost remained “unjustifiably high” even after the application of the 96% discount offered to the Global Alliance for Vaccines and Immunisation (GAVI Alliance) last week for supply of the vaccine to poor nations.5

Notes

Cite this as: BMJ 2013;346:f3108

References