Cervical cancer and HPV vaccine - adolescent girls

Cervical cancer is a leading cause of cancer-related fatalities among women in India, primarily resulting from ongoing infections with high-risk types of human papillomavirus (HPV). The persistent nature of these infections underscores the need for a proactive approach to prevention. Vaccination against HPV, particularly in adolescent girls, has demonstrated its effectiveness as a primary prevention method. By preventing the initial infection, the vaccine significantly reduces the risk of cervical cancer, thereby saving countless lives. The vaccine's effectiveness and cost-efficiency make it an ideal solution for preventing cervical cancer. Recent advancements, such as the introduction of locally produced and single-dose vaccines, are expected to enhance accessibility and coverage, ultimately leading to improved health outcomes. However, several challenges persist, including vaccine hesitancy, logistical issues, and a lack of awareness, which must be addressed to ensure the successful implementation of HPV vaccination programs. The Indian government has initiated national initiatives to incorporate HPV vaccination into the Universal Immunisation Programme, with the ultimate goal of achieving widespread protection and making significant progress towards the elimination of cervical cancer.

1. ~ 71 ~
International Journal of Obstetrics and Gynaecological Nursing 2025; 7(2): 71-74


E-ISSN: 2664-2301
P-ISSN: 2664-2298
www.gynaecologicalnursing.com
IJOGN 2025; 7(2): 71-74
Received: 05-06-2025
Accepted: 07-07-2025

Geethanjali N
Ph.D. Scholar, Department of
Community Health Nursing,
Index College of Nursing,
Malwanchal University,
Indore, Madhya Pradesh,
India

Dr. Smriti G Solomon
Principal, Index College of
Nursing, Malwanchal
University, Indore, Madhya
Pradesh, India





































Corresponding Author:
Geethanjali N
Ph.D. Scholar, Department of
Community Health Nursing,
Index College of Nursing,
Malwanchal University,
Indore, Madhya Pradesh,
India

An insight into cervical cancer prevention through the
human papillomavirus (HPV) vaccine for the budding
generation in India

Geethanjali N and Smriti G Solomon

DOI: https://www.doi.org/10.33545/26642298.2025.v7.i2b.216

Abstract
Cervical cancer is a leading cause of cancer-related fatalities among women in India, primarily
resulting from ongoing infections with high-risk types of human papillomavirus (HPV). The persistent
nature of these infections underscores the need for a proactive approach to prevention. Vaccination
against HPV, particularly in adolescent girls, has demonstrated its effectiveness as a primary
prevention method. By preventing the initial infection, the vaccine significantly reduces the risk of
cervical cancer, thereby saving countless lives. The vaccine's effectiveness and cost-efficiency make it
an ideal solution for preventing cervical cancer. Recent advancements, such as the introduction of
locally produced and single-dose vaccines, are expected to enhance accessibility and coverage,
ultimately leading to improved health outcomes. However, several challenges persist, including
vaccine hesitancy, logistical issues, and a lack of awareness, which must be addressed to ensure the
successful implementation of HPV vaccination programs. The Indian government has initiated national
initiatives to incorporate HPV vaccination into the Universal Immunisation Programme, with the
ultimate goal of achieving widespread protection and making significant progress towards the
elimination of cervical cancer.

Keywords: Cervical cancer, HPV vaccine, human papillomavirus, prevention, adolescent girls

Introduction
Cervical Cancer: Disease Overview: Cervical cancer is characterized by the malignant
transformation of cervical tissue, primarily resulting from infection with the human
papillomavirus (HPV). Notably, types 16 and 18 of HPV are particularly prevalent among
women in India and are major contributors to the incidence of this disease. This highlights
the critical need for increased awareness and preventive strategies to combat the impact of
HPV on women's health in the region
[1-2]
. The disease is the second leading cause of cancer
deaths among women in India, with a significant proportion of the female population at risk

[3-4]
. Women in low- and middle-income countries, including India, face a higher burden due
to limited access to screening and vaccination. Both married and unmarried women are
susceptible, and the disease often remains undetected until advanced stages, contributing to
high mortality rates
[4]
.

Burden of Cervical Cancer in India
Cervical cancer remains a significant public health issue in India, accounting for 20-23% of
the global burden and being the second most common cancer among Indian women
[5-7]
.
Over the last three decades, there has been a significant decline in both the incidence and
mortality rates of the disease, with particularly notable reductions observed in states such as
Jharkhand and Himachal Pradesh. Nevertheless, the disease remains a substantial contributor
to mortality, with a rate of 11.2 per 100, 000 women, which is markedly higher than the
global average
[8]
. The highest occurrence of cases is observed among women in the age
group of 55 to 59 years. Unfortunately, a significant number of these cases are diagnosed at
later stages, primarily due to inadequate screening measures and a lack of awareness about
the condition
[9]
. Several key risk factors contribute to this issue, including early marriages
that may limit individual autonomy, having multiple sexual partners which increases
exposure to sexually transmitted infections, and experiencing multiple pregnancies that can

2. International Journal of Obstetrics and Gynaecological Nursing https://www.gynaecologicalnursing.com
~ 72 ~
strain a woman's health. Additionally, factors such as poor
genital hygiene, which can lead to infections, malnutrition
that compromises overall health, and a general lack of
awareness about reproductive health all play crucial roles in
increasing susceptibility to the disease. Efforts to improve
education and access to screening are vital in addressing
these risk factors and promoting early detection
[10]
.

Early Prevention Strategies
Screening
India currently faces a significant public health challenge in
the form of cervical cancer, largely due to the absence of a
comprehensive and coordinated national screening program.
Without such a program in place, many women are not
receiving timely screenings, resulting in diagnoses that
occur at advanced stages of the disease. This delay often
leads to increased mortality rates, as late-stage cervical
cancer is much more difficult to treat effectively. The lack
of organized efforts in cancer prevention and early detection
contributes to a growing health crisis that disproportionately
affects women across various demographics in the country

[11-13]
. Screening methodologies such as visual inspection
with acetic acid (VIA), visual inspection with Lugol's iodine
(VILI), cytology (Pap smear), and HPV DNA testing have
demonstrated their effectiveness. Notably, VIA and VILI
are particularly advantageous in resource-limited settings
due to their simplicity and cost-effectiveness
[2, 6-7]
. In India,
groundbreaking randomized controlled trials have revealed
that even a single instance of screening-no matter how brief
or limited-can lead to a remarkable reduction in mortality
rates. This invaluable insight underscores the profound
impact that proactive health measures can have on saving
lives
[2]
.

HPV Vaccination
Human papillomavirus (HPV) infection, particularly with
types 16 and 18, plays a crucial role in the high incidence of
cervical cancer in India, which underscores the importance
of targeted health initiatives. By focusing on these specific
strains, we can enhance awareness and encourage the
implementation of effective vaccination programs.
Additionally, promoting regular screening and education
around cervical health can empower individuals and
communities to take proactive steps in preventing this
disease. Ultimately, a comprehensive approach that includes
prevention, early detection, and treatment can significantly
reduce the burden of cervical cancer in India
[3, 12]
. India now
offers four different HPV vaccines, one of which is an
indigenous vaccine that received approval in 2022. This
local development is significant as it has the potential to
enhance access and increase the uptake of vaccination
among the population. Research suggests that extensive
HPV vaccination campaigns, especially those utilizing a
single-dose schedule, could lead to a remarkable reduction
in HPV infection rates by as much as 97%. Moreover,
achieving high coverage among girls aged 10 years could
significantly diminish the lifetime risk of developing
cervical cancer, potentially lowering it by 71% to 78%. This
underscores the importance of implementing effective
vaccination strategies to protect future generations from this
serious health threat
[9]
. National advisory groups are
advocating for a significant increase in the administration of
the human papillomavirus (HPV) vaccine, emphasising its
crucial role as a primary preventive strategy against HPV-
related diseases. These recommendations highlight the
importance of expanding vaccination efforts to protect
individuals, particularly adolescents, from various cancers
linked to HPV, including cervical cancer and others. By
enhancing access to and awareness of the HPV vaccine,
these organizations aim to improve public health outcomes
and reduce the overall incidence of HPV infections
[14]
.

Health System and Policy Initiatives
National initiatives like the National Programme for
Prevention and Control of Cancer, Diabetes, Cardiovascular
Diseases, and Stroke (NPCDCS) and Ayushman Bharat are
making significant strides in embedding cervical cancer
screening and prevention within the primary healthcare
framework. These programs emphasize the Visual
Inspection with Acetic Acid (VIA) screening method for
women aged between 30 and 65, aiming to ensure early
detection and timely intervention. Additionally, they
advocate for universal health coverage to make these
essential services accessible to all
[4]
.
Despite these efforts, several challenges remain. The
healthcare infrastructure in many regions is still
underdeveloped, leading to inadequate access to screening
facilities. Furthermore, there is a notable lack of awareness
among the general population regarding the importance of
cervical cancer screening. Compounding these issues is the
shortage of trained healthcare personnel who are skilled in
administering screening procedures and educating women
about their health options. Addressing these barriers is
crucial for the success of the programs and ultimately
improving women’s health outcomes
[4, 8]
.

Recommendations for Early Life Prevention
• Promote HPV vaccination for adolescent girls before
sexual debut to maximize preventive impact
[15]
.
Implement school- and community-based awareness
programs targeting girls, boys, parents, and
communities to increase knowledge about cervical
cancer and its prevention
[3, 5]
.
• Integrate simple, cost-effective screening methods like
VIA/VILI into primary healthcare, especially in high-
prevalence areas
[2, 4, 6 &16]
.
• Strengthen health infrastructure and training to ensure
effective delivery of vaccination and screening services

[4, 8]
.

Vaccination
1. HPV vaccination is the most effective primary
prevention method, capable of preventing over 90% of
HPV-attributable cancers
[1, 3]
.
2. Vaccines available in India include bivalent,
quadrivalent, nonavalent, and the indigenous
CERVAVAC
[2, 5]
.
3. Vaccination is recommended for girls aged 9-14 years,
with recent evidence supporting the effectiveness of a
single-dose schedule
[1-2, 6]
.

Screening
Screening methods such as visual inspection with acetic
acid (VIA), Pap smear, and HPV DNA testing are also
effective, especially when combined with vaccination
[3-4, 7]
.

Vaccination Schedule
The recommended vaccination schedule calls for a single

3. International Journal of Obstetrics and Gynaecological Nursing https://www.gynaecologicalnursing.com
~ 73 ~
dose administered to girls between the ages of 9 and 19
years. This guideline is in accordance with the most recent
directives issued by health authorities and is supported by
extensive research demonstrating strong immunogenicity-
the ability to provoke a favorable immune response-as well
as significant protection against potential health risks. The
data collected emphasizes not only the vaccine's safety but
also its critical role in safeguarding young women during
this pivotal stage of development
[1-2, 6]
.


Implementing catch-up vaccination programs specifically
aimed at girls and women up to the age of 20 can
significantly amplify the overall effectiveness of public
health initiatives. By addressing gaps in vaccination
coverage, these programs not only provide essential
immunizations but also help protect this demographic from
preventable diseases. Engaging communities to promote the
importance of these vaccinations can lead to better health
outcomes and contribute to societal well-being as a whole

[10]
.

Cost Effectiveness
In India, both the HPV vaccination and the associated
screening protocols are considered to be highly cost-
effective strategies for combating cervical cancer. The
implementation of the HPV vaccine, whether administered
as a standalone intervention or in conjunction with regular
screening programs, has been shown to significantly lower
the incidence and mortality rates associated with cervical
cancer. This reduction is achieved while maintaining
acceptable incremental cost-effectiveness ratios, making
these interventions viable from both a health and economic
perspective.
Moreover, the introduction of single-dose vaccination
presents an even more efficient approach, particularly in
resource-limited settings where healthcare resources are
scarce. This single-dose option maximizes the effectiveness
of each vaccination administered, offering a practical
solution to those in underserved communities
[11]
.

By
focusing on these strategies, India can make substantial
strides in reducing the burden of HPV-related diseases,
ultimately improving public health outcomes
[8]
.

Clinical Trials and Evidence
Indian trials have demonstrated that a single dose of
quadrivalent HPV vaccine provides robust and lasting
protection against HPV 16 and 18, with similar infection
rates to two- and three-dose schedules over seven years
[6, 16]
.
Modelling studies project a 71-78% reduction in lifetime
cervical cancer risk with high-coverage vaccination
[8]
.

Challenges and Barriers
Barriers include lack of awareness, vaccine hesitancy,
cultural attitudes, logistical issues, and concerns about
vaccine duration and safety Limited epidemiological data
and prioritization challenges also hinder widespread
implementation
[2, 4-5]
.

Government of India Programme
The government has placed a strong emphasis on the
ambitious goal of eradicating cervical cancer, setting in
motion a comprehensive strategy that includes extensive
prevention, screening, and management initiatives. These
programs, designed to reach every corner of the community,
are implemented under the banner of the National Health
Mission, reflecting a commitment to safeguarding women's
health and promoting early detection for a brighter, cancer-
free future
[2-4]
.


In 2024, the HPV vaccine became a key component of the
Universal Immunization Programme, specifically targeting
girls between the ages of 9 and 14. This initiative introduced
CERVAVAC, an affordable and locally developed vaccine,
aimed at enhancing access to critical preventive healthcare.
By integrating this innovative vaccine into the national
immunization strategy, the program seeks to protect young
girls from human papillomavirus, which is known to cause
cervical cancer and other related diseases
[2, 5]
.



Conclusion
Cervical cancer continues to cast a daunting shadow over
the lives of countless women across India, but the promise
of early prevention through the power of HPV vaccination,
comprehensive screening, and heightened public awareness
offers a beacon of hope that can dramatically lower both the
incidence of the disease and the toll it takes on lives.
Amplifying the reach of HPV vaccinations-especially by
utilizing cost-effective single-dose regimens and
homegrown vaccines-while simultaneously establishing
robust screening programs, is not just important but
essential for realizing the ambitious goal of cervical cancer
elimination in India. To confront these challenges head-on,
it is imperative to foster public awareness, empower
healthcare providers through education, and deploy
culturally sensitive campaigns that resonate deeply with
diverse communities. Sustained commitment from the
government, along with collaborative efforts across multiple
sectors, is critical to achieve the WHO’s transformative
2030 elimination targets and paving the way for a future
free from cancer for the generations yet to come.

Declarations
Funding: None.

Conflict of interest: Not declared.

Ethical approval: Not required.

References
1. Halemani K, J S. Advancements in HPV vaccination
for cervical cancer prevention: A comprehensive
review. Saudi J Nurs Health Care. 2024;7(5). DOI:
10.36348/sjnhc.2024.v07i05.002
2. Sharma M, Kaur I, Sandhu R, Kaur S. Human
papillomavirus vaccine for cervical cancer prevention
in India: new improvement and way forward. Int J
Community Med Public Health. 2024;11(5). DOI:
10.18203/2394-6040.ijcmph20243322
3. Ramesh S, R S, S S. Human papillomavirus (HPV)
vaccination of the girl child: an intervention for primary
prevention of cervical cancer in India. Int J Life Sci
Pharm Res. 2022;12(6):L165-72.
DOI: 10.22376/ijpbs/lpr.2022.12.6.l165-172
4. Deshmukh V, Patil S, Hinge D. The burden and
prevention of human papillomavirus (HPV) infections
and cervical cancer in India: a literature review. Cureus.
2024;16:e72435. DOI: 10.7759/cureus.72435
5. Dwivedi P, Lahariya A, Pandey S, Sreedevi A, Lohiya
A, Lahariya C. Cervical cancer and human papilloma
virus (HPV) vaccines: a primer for general physicians.

4. International Journal of Obstetrics and Gynaecological Nursing https://www.gynaecologicalnursing.com
~ 74 ~
Prev Med Res Rev. 2024;5(1).
DOI: 10.4103/pmrr.pmrr_16_23
6. Mishra G, Pimple S, Shastri S. Prevention of cervix
cancer in India. Oncology. 2016;91(1):1-7. DOI:
10.1159/000447575
7. Singh M, Jha R, Shri N, Bhattacharyya K, Patel P,
Dhamnetiya D. Secular trends in incidence and
mortality of cervical cancer in India and its states,
1990-2019: data from the Global Burden of Disease
2019 Study. BMC Cancer. 2021;22:732. DOI:
10.1186/s12885-022-09232-w
8. Gupta K, Mandal R, Chatterjee P. Navigating the
landscape of cervical cancer in India: epidemiology,
prevention, current status, and emerging solutions. J
Obstet Gynaecol Res. 2024;50(Suppl 1):S10-S21. DOI:
10.1111/jog.16030
9. Sreedevi A, Javed R, Dinesh A. Epidemiology of
cervical cancer with special focus on India. Int J
Womens Health. 2015;7:405-14.
DOI: 10.2147/IJWH.S50001
10. Bobdey S, Sathwara J, Jain A, Balasubramaniam G.
Burden of cervical cancer and role of screening in
India. Indian J Med Paediatr Oncol. 2016;37(4):278-85.
DOI: 10.4103/0971-5851.195751
11. Sankaranarayanan R, Bhatla N, Gravitt P, Basu P,
Esmy P, Ashrafunnessa K, et al. Human papillomavirus
infection and cervical cancer prevention in India,
Bangladesh, Sri Lanka and Nepal. Vaccine.
2008;26(Suppl 12):M43-52.
DOI: 10.1016/j.vaccine.2008.05.005
12. Krishnan S, Madsen E, Porterfield D, Varghese B.
Advancing cervical cancer prevention in India:
implementation science priorities. Oncologist.
2013;18(Suppl 2):13-25.
DOI: 10.1634/theoncologist.18-S2-13
13. Man I, Georges D, De Carvalho T, Saraswati L,
Bhandari P, Kataria I, et al. Evidence-based impact
projections of single-dose human papillomavirus
vaccination in India: a modelling study. Lancet Oncol.
2022;23(11):1422-31.
DOI: 10.1016/S1470-2045(22)00543-5
14. Sankaranarayanan R, Joshi S, Muwonge R, Esmy P,
Basu P, Prabhu P, et al. Can a single dose of human
papillomavirus (HPV) vaccine prevent cervical cancer?
Early findings from an Indian study. Vaccine.
2018;36(32 Pt A):4783-91.
DOI: 10.1016/j.vaccine.2018.02.087
15. Chauhan A, Prinja S, Srinivasan R, Rai B, Malliga J,
Jyani G, et al. Cost effectiveness of strategies for
cervical cancer prevention in India. PLoS One.
2020;15(9):e0238291.
DOI: 10.1371/journal.pone.0238291
16. Arora S, Tuffaha H. Cost‐effectiveness analysis of
human papillomavirus vaccines for the prevention of
cervical cancer in India. Asia Pac J Clin Oncol.
2023;20(1):44-53. DOI: 10.1111/ajco.13962

How to Cite This Article
Geethanjali N, Solomon SG. An insight into cervical cancer
prevention through the human papillomavirus (HPV) vaccine for the
budding generation in India. International Journal of Obstetrics and
Gynaecological Nursing. 2025; 7(2): 71-74.





Creative Commons (CC) License
This is an open access journal, and articles are distributed under the
terms of the Creative Commons Attribution-NonCommercial-
ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, which
allows others to remix, tweak, and build upon the work non-
commercially, as long as appropriate credit is given and the new
creations are licensed under the identical terms.