Dear Editor, Cervical cancer, caused by human papillomavirus (HPV), is the fourth-most common cancer in women globally and the leading cause of cancer among women in India.1 In 2020, the World Health Organization approved a 90-7-90 strategy for the global elimination of cervical cancer, aiming for all countries to achieve and maintain an incidence rate of below 4 per 100,000 women. The plan includes achieving 90% coverage of HPV vaccination in girls under 15, providing two-lifetime cervical screens for women (at 35 and 45 years, with 70% coverage), and ensuring 90% treatment coverage for both preinvasive and invasive cancers. Each country is expected to meet these targets by 2030 to eliminate cervical cancer by 2120.2 People living with untreated HIV/AIDS are more susceptible to active HPV infections and have a greater risk of developing cervical, anal, vaginal, vulvar, and oropharyngeal cancers, as well as genital warts.3 Regular cervical screens every 3 years can significantly reduce cervical cancer in women with HIV, according to studies in South Africa.4,5 Cervical intraepithelial neoplasia (CIN) is typically identified through the Papanicolaou or “Pap” smear, which detects potentially precancerous changes.6 After the removal of CIN tissue through various methods, the risk of progression to cervical cancer is reduced. However, because infection does not provide lifelong immunity against reinfection, the lifetime recurrence rate of CIN is about 20% for certain categories of women.7 Vaccination could provide immunity against recurrence and contribute to herd immunity.6,8 Administering HPV vaccination to women who have undergone treatment for preinvasive or invasive cancers in high HIV areas can protect them from cervical cancer and genital warts. Therefore, Indian national health programs should prioritize providing HPV vaccination to women living with HIV/AIDS who have been treated for preinvasive or invasive cancers. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Gupta et al. (Wed,) studied this question.