Cervical Cancer Elimination by 2030: The “SMASH” Strategy of Raj © A Global Public Health Treatise

Abstract

Cervical cancer is a leading cancer among women, being the second most gynecological cancers in the developing countries, accounting for about 6 million new cases every year and 3.5 million deaths. The Cervical cancer is easily detectable by simple screening tests, like visual inspection methods, pap smear examination, and the recent HPV DNA test methods. If the precancer conditions are diagnosed, treatment can be done by ablation or excisional methods. The women can be followed by periodic cervical biopsy examinations, ideally once in 6 months for 3 years. If, at the end of 3 years, there is no evidence of cervical precancer, then the women will not develop invasive cancer stages. The HPV vaccination of adult and adolescent girls, offer more than 90% protection against Cervical Cancer. Thus, Cervical cancers are early detectable, effectively treatable and successfully preventable. The author, having been the Principal Investigator for one of the largest Cervical Cancer Screening programs in India, atAmbillikai, Tamil Nadu, India, during 2000–2007, which was in collaboration with the International Agency for Research on Cancer – IARC / WHO. The program was successful in reducing the Incidence Rate of Cervical Cancer by 25% and Mortality Rate due to Cervical Cancer, by 35% in a span of 5 years. From the experiences of this “Proof of Concept” project, the author has advocated, “SMASH” strategy of Raj©, for Cervical Cancer Elimination by 2030, which is deliberated in detail, i n this chapter. Hope that, this will serve as a Global Public Health Treatise, for the health care planners and providers in particular and the community at large, worldwide.