A weapon against cervical cancer
A study of rural women says analysing the blood on used menstrual pads could act as an effective screening tool for cervical cancer.
The study was carried out by the Tata Memorial Hospital and the National Institute for Research in Reproductive Health in Mumbai. It took place over the course of three years between 2013 and 2016. It involved health workers collecting used menstrual pads from 529 rural women in the Ahmednagar and Pune districts of Maharashtra.
The blood on the pads underwent molecular tests, or Pap smears. This was to detect if human papillomavirus (HPV) – which causes the majority of cervical cancer cases – was present. If a woman tested HPV-positive, she would be referred for a colposcopy. Six women in the study were diagnosed as being precancerous and placed on treatment.
67,477 deaths a year
There is a pressing need for effective screening tools for cervical cancer in India. It is is the second most frequent type of cancer among women in the countryI and contributes to as many as 29 percent of cases. Each year, 122,844 new cases of cervical cancer are diagnosed. There are 67,477 deaths, accounting for 17 percent of cancer deaths in women in India.
Despite more than 453 million Indian women being at risk of developing cervical cancer, women in India have little to no access to cervical screening, especially in rural areas. BBC News notes “a lack of adequate infrastructure and facilities in rural areas as well as burdening costs, coupled with unease at undergoing the invasive examination.” Sociocultural taboos also play a significant role.
In fact, such taboos presented an issue for health workers in collecting the used pads, with many women reluctant to give them to the health workers. Some were reportedly fearful that the pads would be used for ‘black magic’, reports Deutsche Welle.
A fatal lack of public health policy
Compounding the issue is the absence of a “countrywide government-sponsored public health policy on prevention of cervical cancer by either screening or vaccination or both.” This means that immunization against the HPV vaccine is available only in the private sector and through a pilot programme in Punjab. Immunisation would reduce the risk of contracting cervical cancer by about 80 percent. There is also limited public awareness among the demographics vulnerable to the disease.
A major issue uncovered by is poor genital hygiene – a risk factor for cervical cancer. This is made worse by the absence of proper toilet facilities and poor standards of sanitation in rural communities.
The use of household cloths, rather than proper sanitary products, as makeshift menstrual pads is another problem contributing to the lack of genital hygiene. This is practised out of necessity, by more than 90 percent of rural Indian women. Sanitary pads in India are taxed under the Goods and Services Tax (GST) which contributes to rendering them unaffordable for most.
The collection of used menstrual pads, the study’s authors accept, is not a feasible method of implementing a nationwide screening programme for cervical cancer. Logistical issues, such as where to store the menstrual pads so that reliable testing can be performed, come into play. However, as diagnostic innovations proceed, some form of local testing may become possible.
The need for greater screening facilities and improved access for Indian women reinforces the fact that the accessibility of healthcare in rural India is often abysmal at best, nonexistent at worst. Made worse by social taboos, this fosters a situation where thousands of women needlessly die every year, from a disease where precautionary measures could – and should – have been taken.
The study can be accessed here.