LUCKNOW, Nov. 19 -- Doctors at the King George's Medical University (KGMU) are following the three-pronged strategy of WHO (World Health Organisation) - vaccination, screening and treatment - for eliminating cervical cancer by 2030. The initiative stems from a 2020 commitment by 194 countries to work towards ending the disease as a public health threat. Prof Nisha Singh, department of gynaecological oncology, KGMU, explained that HPV vaccination (Human Papillomavirus) for girls aged 9 to 14 years is a must. The price of the vaccine is significantly lower at government hospitals as compared to market price, and it is 70 to 80% effective. In India, HPV is administered mostly to women, but in other countries it is a gender neutral vaccine, she added. The HPV vaccine is administered twice after a gap of six months. It is available at government hospitals for Rs 500, and the same vaccine is available in the market for Rs 4,500 to 9,000. She explained that screening of eligible women - those between the age of 25 to 65 years - is imperative, and women of this age group must get screened at least twice in their life term: once at the age of 35 years and a second time, when they are 45 years old. "Ideally, a woman should get screened once every five years, after the age of 25," she said. By getting screened they can get to know if they are at a pre-cancer stage or if things have gone beyond that. If during the screening precancer is detected, there is no need to worry as one does not need hysterectomy, the surgical removal of the uterus. But it can be treated by simpler shorter ablative or excision (minor) procedures. The third step, treatment, includes those women in whom cervical cancer has been detected. In early stage cases, the best option of treatment is surgery with removal of the uterus, ovaries, fallopian tubes and lymph glands, she said. For younger women, fertility preservation surgeries are also available. For advanced stage cases, radiation and chemotherapy are required. "Thus, it is always better to prevent or get diagnosed at an early stage," prof Singh said. Prof Rajeev Gupta, HoD of radiation oncology, KGMU, said in the pre-cancer stage, only the cervix is removed using minimally invasive procedures. When cancer is detected and is in the early stages, the entire reproductive apparatus is surgically removed. In case the cancer has reached an advanced stage, then, both external radiation therapy, from outside the affected body part, and intracavitary radiation therapy (Brachytherapy), which is used to deliver radiation from inside the body cavity, is opted for. Radiation therapy by both methods is collectively applied on the affected part of the patient's body to get the best results, he added. Cervical cancer symptoms are mostly manifested in the mid-20s. Generally, these are women who got married at an early age and had multiple pregnancies in a short duration. Bad personal hygiene was another factor, he said....