Good news is that Cervical Cancer incidence and mortality is decreasing steadily.
However most of the reduction happened in the developed countries as this graph shows.(GLOBOCAN)
All this happened even before HPV vaccine was introduced . Even pap smear screening was not total in some countries.
How did this happen?
Its clear that improved personal hygiene due to access to toilets with privacy was an important factor . Personal genital hygiene in both men and women can reduce cervical cancer.
Just compare with the countries with least number of toilets per capita ( WHO/UNICEF)
All in the areas with high cervical cancer.
Of course there are other factors like unprotected sexual activity and HPV does spread due to poor habits. There was a nice study way back in 1999 from Kerala, in a survey based in Trivandrum centre, that highlighted the correlation of cervical dysplasia to lack of access to hygiene with toilets, sanitary napkins etc .
Expensive vaccines and even more expensive population screening are not suitable for large rural populations like India and Africa.
The fact however is that the rural and urban poor ARE AWARE of the ill effects of poor hygiene but just don’t have the access.
That’s a preventable tragedy!
Its time for action !!
Conflict of interest:
I know Akshay Kumar but was neither influenced or approached to write. The thought developed for sometime in discussion with Dr Anita Borges.