The Indian Council of Medical Research  (ICMR) has issued a draft 'consensus document' for the management of cervical cancer, whose incidence is alarmingly high in some regions of the world including India.

Senior ICMR officials said that this consensus document represents the experts ‘current thinking on the topic based on available evidence. This has been developed by national experts in the field and does not in any way bind a clinician to follow this guideline verbatim. One can use an alternate mode of therapy based on discussions with the patient and institution, national or international guidelines. The mention of pharmaceutical drugs for therapy does not constitute endorsement or recommendation for use but is guidance for clinicians in complex decision making.

The need to develop consensus document for cervical cancer arose due to the fact that cervical cancer is most common cancer in Indian women though breast is the leading cancer site globally.  In India, cervical cancer had increased from 0.11 million in 2000 to 0.16 million in 2010. The proportion ranged from 15 per cent to 55 per cent of female cancers from different parts of the country.  Over 80 per cent of the cervical cancer present at a fairly advanced stage and annually around 80,000 deaths are reported in India.

Cervical cancer remains a significant cause of morbidity and mortality among women globally, even though it is the cancer with the greatest potential for secondary prevention.  This disease is highly preventable and curable. A number of guideline documents are available for the management of common cancers in the published literature. Large academic institutions typically produce their own local guidelines and use them on a daily basis. In this document, all the recommended interventions are based on scientific evidence with the level of evidence and/or grade of recommendation indicated, officials said.

India, the second most populous country in the world, accounts for 27 per cent of the total cervical cancer deaths. The disproportionately high burden of cervical cancer in developing countries and elsewhere in medically under served populations is largely due to a lack of screening that allows detection of precancerous and early stage cervical cancer. It is now well recognized that cervical carcinogenesis occur in a stepwise fashion. This transition of normal epithelium to pre-neoplastic lesions and invasive carcinoma occur sequentially and progress through well recognized stages and takes approximately 10–20 years to develop an overt malignancy.