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Even though Poonam Pandey may not have lost her life due to cervical cancer, every year more than 70,000 Indian women become victims of cervical cancer.
Pandey’s strategy of drawing attention to this condition is disgusting and insulting to say the least, but the reality is that cervical cancer is the second leading cause of cancer among women aged 15-44 in India. It is not only highly preventable but also highly treatable if detected in time. Yet, cervical cancer, like other women’s health issues, remains low on the priority list for technological disruption and funding. (Also read: Poonam Pandey’s death stunt on cervical cancer came into limelight)
There are more than 200 types of human papillomavirus (HPV) and most infections caused by HPV are actually harmless and resolve on their own. However, about 12 strains result in the majority of cancer cases of the vulva, vagina, cervix, penis, anus, mouth, and throat. The sad reality is that HPV is actually the most prevalent sexually transmitted disease and almost everyone will be exposed to and infected with some form of HPV at some point in their lives.
Although the statistics seem scary, the good news is that there is hope. Because cervical cancer is caused by viruses, it is also easy to prevent and vaccinate against HPV, unlike other cancers caused by internal cell replication problems. Merck’s Gardasil vaccine was, until recently, the only widely available vaccination on the market. However, its cost was prohibitive.
Now, the good news is that India’s own Serum Institute of India has developed a vaccine for HPV called CervaVac which is now being made available at 1/10th of the price. In fact, in the proposed Union Budget, there is talk of making it a part of the government vaccination program also. This is an incredibly welcome step. In many countries, HPV is a part of national vaccination programs, including Bhutan (in 2010), Thailand (2017), Sri Lanka (2017), and Maldives (2019).
Another great news is that if cervical cancer is detected early, the treatment and recovery outcome is excellent. However, that’s where the good news ends. Although we have made great strides in efforts to prevent cervical cancer, the technology to predict risk, identify and treat HPV still lags behind.
First, the current process for identifying cervical cancer, the Pap smear, is not designed to be scalable. In taking a Pap smear, a gynecologist removes some cells from a woman’s cervix and sends them for analysis. This method is intrusive and although most women do not experience pain, many women avoid it due to discomfort or embarrassment.
Secondly, there are only 70,000 gynecologists for approximately 360 million women of reproductive age in India. A Pap smear is usually done in a gynecologist’s clinic or hospital, so it is not accessible to most people.
Third, Pap smears rely on visual examination and are therefore prone to human error and prevent detection at very early stages.
Many young and unmarried women hesitate to ask their gynecologists about a Pap smear because of the social stigma and taboos associated with this test. The World Health Organization has recognized these issues and recommends a recent technology, DNA testing for HPV. However, in India, the cost of this test is prohibitive.
AI/ML based predictive models have great potential to break the barriers of invasiveness, dependence on human input and cost. There are many factors that can predict HPV, including behavioral, socioeconomic, and demographic in addition to reported symptoms and medical history. Some of these include having multiple sexual partners, being sexually active at a young age, belonging to a low socio-economic class, smoking, having a history of herpes, HIV or chlamydia, etc.
Even symptomatically, irregular bleeding like brown discharge, spotting, bloody discharge with unusual odor etc. are factors that can enable prompt testing and detection. This is just a small sample set from a very extensive list. We have created a predictive model that not only diagnoses current conditions but predicts issues like HPV and cervical cancer risk based on some of these variables.
By using AI/ML based technology, symptoms and medical history can be diagnosed instantly and can play a big role in not only detecting their current problem but also predicting future problems like cervical cancer. Such models using AI to observe cervical cancer cells can greatly help in early detection of cervical cancer and prevent unnecessary deaths.
Poonam Pandey’s methods of drawing attention to cervical cancer cannot be supported. However, now that we are talking about cervical cancer, let’s not focus on its dramatics, but rather on the availability of vaccines and improvements in technologies for early detection, where AI/ML holds a lot of promise. Is.
(Divya Kamerkar is a biologist and Global Health Fellow at Yale University and CEO of Pinky Promise, an AI/ML-based women’s health platform; Dr. Reema Shah is an obstetrician and gynecologist and medical director of Pinky Promise; Akanksha Vyas is an engineer and mathematician (with 15+ years of AI/ML work and CTO of Pinky Promise)
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