Page 34 - Essentia Vol 5 Issue 1

VOL V | ISSUE I | 5 AUGUST 2026 VOL V | ISSUE I | 5 AUGUST 2026
A BIANNUAL NEWSLETTER OF ASSAM CANCER CARE FOUNDATION A BIANNUAL NEWSLETTER OF ASSAM CANCER CARE FOUNDATION

districts with the highest documented burden see-and-treat protocols wherever feasible to
(Papumpare-pattern districts of Arunachal reduce loss to follow-up between screening
Pradesh, Mizoram, Nagaland, and high-burden and diagnosis
districts of Assam) for early rollout • Integrate HPV vaccination of adolescent girls
• Use self-collected HPV sampling to extend as the upstream complement to screening, in
coverage into tribal, hill, and border populations line with WHO’s 90-70-90 elimination targets,
where facility-based pelvic examination is a recognising that screening alone cannot close
major barrier to participation the gap in a region with this incidence profile
• Retain Pap cytology as the principal triage
test for HPV-positive women where cytology Conclusion
infrastructure already exists, while building Northeast India carries one of the highest cervical
capacity for partial genotyping or alternative cancer burdens in the country and, by some
triage strategies over time indicators, among the highest in Asia. Yet screening
• Make colposcopy referral, not screening and diagnostic capacity have not kept pace with
alone, the key performance indicator of the this risk. Evidence clearly favours HPV DNA testing
programme, track and report the proportion over VIA and Pap cytology as a primary screening
of screen-positive women who actually tool, supported by self-sampling for hard-to-
complete colposcopic evaluation, not merely reach hill, rural and tribal populations.
the proportion screened However, screening alone is not enough.
• Decentralise colposcopy capacity through A positive result must lead to colposcopy,
structured training of gynaecologists and histological confirmation and timely treatment.
surgical oncology trainees at district-level For the Northeast, meaningful progress will
facilities, supported by tele-colposcopy and require deliberate investment in colposcopy
image-sharing with tertiary centres for quality training, equipment and decentralised access
assurance across district and community-level facilities. The
• Adopt standardised colposcopic scoring screening pathway will only save lives when its
(e.g., Swede score) and same-visit biopsy/ weakest link, colposcopy, is strengthened.

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