โฆ๐ฉ๐๐๐๐๐๐ 2014 ๐๐๐ 2018, ๐๐๐ ๐๐๐๐๐๐๐ ๐๐๐๐๐๐๐๐๐ ๐๐๐๐ 300 ๐๐๐๐๐ ๐๐ ๐๐๐๐๐๐๐๐ ๐๐๐๐๐๐, ๐๐๐ ๐๐๐ ๐๐๐๐๐ ๐๐๐๐๐๐ ๐๐ ๐๐๐๐๐ ๐๐๐๐ ๐๐๐๐๐๐๐ 18,313 ๐๐๐๐๐ 2022
Phurpa Wangmo
Cervical Cancer has become the most common cancer in women and ranks among the leading causes of death for Bhutanese women. Between 2014 and 2018, the country reported over 300 cases of cervical cancer, with the total recorded cases reaching 18,313 by 2022.
Meera Chhetri, a Senior Health Assistant at Gyaltsuen Jetsun Pema Wangchuck Mother and Child Hospital, highlighted the prevalence of cervical cancer, revealing that it leads to 70 to 80 new diagnoses annually and claims the lives of 20 to 25 women each year. The primary cause of cervical cancer is persistent HPV infection, which is transmitted through sexual contact.
According to Mera, HPV infections usually clear up within 1 to 2 years, but if left untreated, they increase the risk of developing cervical cancer. Several risk factors make some individuals more susceptible to the disease, such as early age at sexual debut, early age at first childbirth, multiple sexual partners, smoking, immuno-suppression, and prolonged use of oral contraceptive pills.
Laigden Dzed, Chief Program Officer of the Non-Communicable Diseases Division under the Department of Public Health, MoH, emphasized that cervical cancer is a significant public health concern in Bhutan. It has now become the leading type of cancer in the country, imposing a considerable burden on the healthcare system. The Ministry of Health (MoH) has initiated various measures to combat the disease, including providing HPV vaccination to students at the age of 6 and administering vaccines to both girls and boys, aiming to reduce the burden of cervical cancer.
Recent developments include the introduction of HPV DNA screening for women above 30 years, improving detection efficiency. The MoH offers treatment protocols for those detected positive during HPV testing, while those tested negative are required to return for screening after five years.
While cervical cancer is treatable when detected early, about 30% of cases are diagnosed at advanced stages, significantly reducing treatment success. Proper awareness and advocacy programs are essential to educate the public about the dangers, symptoms, and available services related to cervical cancer.
Every year since 2022, the Bhutan Youth Development Fund, in partnership with the Ministry of Health and World Health Organization, organise “Walk the Talk” events. These events highlight critical public health topics in the country, and this year’s focus was on cervical cancer prevention and awareness. This year it addressed the critical concern of cervical cancer. On 5 August 2023, young volunteers in all 20 dzongkhags engaged their friends, families, and communities, about the dangers of cervical cancer, urging all Bhutanese to get screened, get vaccinated, and stay educated.
The estimated age incidence of cervical cancer in Bhutan is 20.5 per 100,000, indicating that approximately 20.5 women in a specific age group are expected to contract cervical cancer in any given year. The estimated mortality rate is 4.7 per 100,000, suggesting that an estimated 4.7 of every 100,000 Bhutanese women die of cervical cancer annually.
Bhutan took significant steps to combat cervical cancer, including the introduction of the Cervical Cancer Screening Program in 2006 and vaccinating young girls with the HPV vaccine since 2010. By 2017, around 97% of all adolescent girls had been vaccinated against HPV. In 2020, Bhutan became the first country in the South-East Asia Region to vaccinate young boys against HPV.
In January 2019, Bhutan committed to “Eliminate Cervical Cancer by 2030” at the 144th session of the World Health Organization’s Executive Board meeting in Geneva, Switzerland. Consequently, Bhutan became the first country in the region to launch a comprehensive national strategic plan to achieve this goal.
Rinzin Jamtsho, Member of Parliament, National Assembly of Bhutan, stressed that cervical cancer is highly preventable, and it is everyone’s responsibility to raise awareness, get educated, screened, and vaccinated on time for prevention.
Chungdruk Rabsel Wangchuck, the youth representative for Young Volunteers-in-Action (Y-VIA) ‘Walk the Talk’ event, highlighted that cervical cancer is not gender-biased, and prevention is the responsibility of both genders.
Singye Dem, a 93-year-old, shared her experience of giving birth to 15 children during a time when cervical cancer was not well understood, and she did not suffer from any cervix-related diseases.
The Gynecologist from JDWNRH revealed that every week, 2 to 4 patients are referred to Kolkata for treatment, which lasts about 8 weeks. From 2014 to 2022, a total of 18,313 cases of cervical cancer were reported. Currently, 7 to 8 women receive chemotherapy on an OPD basis, and 20 are undergoing radiation treatment in Kolkata.
Cervical cancer is a pressing concern in Bhutan, demanding immediate action through prevention, awareness, and comprehensive health initiatives. The commitment of the authorities and collaborative efforts from all sectors of society are crucial in the fight against cervical cancer.