Understanding Cervical Cancer
Screening & HPV Vaccination in India

Cervical cancer develops slowly, typically over 10 to 15 years, and almost always from a persistent infection with certain strains of the Human Papillomavirus (HPV). This slow progression is precisely what makes it preventable: if detected early through screening, pre-cancerous changes can be treated before they become cancer.

Despite this, India accounts for roughly one-fifth of the global cervical cancer burden. Lack of awareness, limited screening infrastructure, and cultural barriers all contribute. As a gynaecological oncologist, I see the consequences of late diagnosis every day. This article is an effort to put the facts directly into the hands of patients and families.

Who Should Be Screened, and How Often?

Current Indian guidelines recommend that all women who have been sexually active should begin cervical cancer screening from age 30.^[1] This is a practical threshold — most pre-cancerous HPV infections in younger women resolve spontaneously without intervention.

• Ages 30–65: HPV DNA testing every 5 years is the preferred approach, or a Pap smear (cytology) every 3 years if HPV testing is not available.
• Co-testing (HPV + Pap together): Every 5 years. This offers the highest level of reassurance when both tests are negative.
• Women over 65: Screening can stop if you have had three consecutive normal Pap smears, or two normal co-tests, in the last ten years.
• Women who have had a hysterectomy: If the cervix has been removed and there is no history of high-grade pre-cancer, screening is not required.

Women who are immunocompromised — including those living with HIV — require more frequent screening and should discuss an individualised schedule with their doctor.

What Happens During a Colposcopy?

If a Pap smear or HPV test returns an abnormal result, the next step is usually a colposcopy. Many patients find the word alarming, but the procedure itself is straightforward.

A colposcope is simply a magnifying instrument placed outside the body. It allows the gynaecologist to examine the cervix in detail under bright light. A mild vinegar solution is applied to the cervix, which makes any abnormal areas temporarily turn white — this is called aceto-white change — allowing them to be identified precisely.

What to Expect

• The procedure is performed in an outpatient clinic. No general anaesthesia is required.
• It takes approximately 15–20 minutes from start to finish.
• A small biopsy (tissue sample) may be taken from any suspicious areas. This causes brief, mild discomfort — similar to a sharp pinch.
• Mild spotting or cramping for 1–2 days after is normal.
• Biopsy results are typically available within 10–14 days.

Importantly, an abnormal screening result does not mean you have cancer. The vast majority of abnormal results indicate low-grade changes that either resolve on their own or require only minor treatment.

HPV Vaccination — Who Needs It and When?

HPV vaccines are among the most effective tools we have in cancer prevention. They protect against the HPV strains responsible for approximately 70–90% of cervical cancers, as well as several other cancers and genital warts.^[2]

Approved Vaccines Available in India

• Cervavac (Make in India initiative) — protects against HPV 6, 11, 16 and 18.
• Gardasil 4 — protects against HPV 6, 11, 16, and 18.
• Gardasil 9 — protects against nine HPV strains; the most comprehensive option currently available.

Recommended Age Groups

• Ideal age: 9–14 years, before sexual debut. At this age, only two doses are needed (given 6–12 months apart) and the immune response is strongest.
• 15–26 years: Three doses are recommended. Vaccination is still highly beneficial in this group.
• 26–45 years: Vaccination can be considered after discussion with a gynaecologist. It is most useful in women who have not previously been exposed to the relevant HPV strains.

The National Immunisation Programme in India introduced HPV vaccination for girls aged 14 years in 2026.^[3] This is a landmark step by the Government of India — but it will take a generation to see its full impact. For women currently of screening age, regular testing remains the single most important preventive measure.

A Final Word

Cervical cancer does not have to reach an advanced stage to be discovered. The tools to prevent it — screening tests and vaccines — are available and effective. The barrier is almost always knowledge and access, not medicine.

If you or someone in your family is overdue for a screening test, or if you have questions about HPV vaccination, please do not wait. An appointment with a gynaecologist takes an hour. The peace of mind, and the protection it provides, lasts years.

Dr. Dipanwita Banerjee

MCh (Gynaecological Oncology) · AIIMS New Delhi · IFCPC IARC Certified Colposcopist

Senior Consultant Gynaecological Oncologist at Chittaranjan National Cancer Institute, Kolkata. Site Principal Investigator for the Serum Institute HPV vaccine trial. Specialising in complex cancer surgeries, colposcopy, and cervical cancer prevention.