Cervical cancer is caused due to genital infection by the Human Papilloma Virus (HPV) and transmitted through sexual contact, and its incidence can be greatly reduced through routine cervical smear tests.
The study, published in the International Journal of Gynecology and Obstetrics in July, shows that only five per cent of Nepali women aged 21—65 years have ever had a cervical test.
“We used rigorous sampling techniques to obtain a nationally representative sample,” lead author Anju Ranjit of the Harvard Medical School tells SciDev.Net.
“Conducting cervical screening in Nepal is difficult due to cultural barriers,” explains Surendra B. Bade Shrestha, president, Nepal Network for Cancer Treatment and Research (NNCTR), a pioneering organisation in cervical cancer screening and HPV vaccines which are useful in resource-poor settings.
A 2012 study by NNCTR identified a range of socio-cultural factors that act as barriers to dealing with the disease. These included ignorance, shyness to consult with a health provider, husband’s apathy, poverty and reliance on traditional healers. “Pilot programmes for preventive HPV vaccinations are now being implemented in Nepal, but it is yet to be included in the national immunisation programme,” says Ranjit.
In 2010, a national guideline for cervical cancer screening and prevention set a target of covering 50 per cent of women in the 30—60 age group by 2015. “The only thing they (the government) managed to do was collaborate with some hospitals in 2015 to operate training programmes,” Shrestha said.
Since 2015, GAVI – an international organisation for promoting new and underused vaccines -– has been administering vaccines in the Kaski and Chitwan districts to girls between ages 9—13 years and providing screenings for older women.
"Laboratory services and pathologists trained to evaluate cervical smears are practically non-existent in rural parts of Nepal…in urban settings, where laboratory facilities and trained pathologists are available, increased case burden and the associated costs limit cervical smear screening of eligible women," the new study notes.
This piece was produced by SciDev.Net’s South Asia desk.