## NPCDCS Cervical Cancer Screening Guidelines **Key Point:** The NPCDCS recommends opportunistic screening for cervical cancer targeting women aged 30–65 years using Visual Inspection with Acetic acid (VIA) or HPV testing, with a screening interval of 5 years or once in a lifetime for HPV-based screening. ### Rationale for Target Age Group - **30–65 years**: Peak incidence of cervical cancer in India; balances sensitivity and specificity - **Before age 30**: Low prevalence of precancerous lesions; screening less cost-effective - **After age 65**: Declining incidence; screening benefit diminishes if previously screened ### Screening Modalities Under NPCDCS | Modality | Sensitivity | Specificity | Cost | Feasibility in India | |----------|-------------|-------------|------|----------------------| | VIA (Visual Inspection with Acetic acid) | 70–80% | 85–90% | Low | High (no lab needed) | | HPV testing | 90–95% | 95–98% | Moderate | Increasing | | Pap smear | 60–70% | 95%+ | Moderate | Limited infrastructure | | Colposcopy | High | High | High | Tertiary centres only | **High-Yield:** VIA is the preferred screening method in resource-limited settings like India because it is: - Non-invasive - Results available immediately - No laboratory infrastructure needed - Cost-effective - Can be performed by trained health workers ### NPCDCS Implementation Strategy - Screening offered at primary health centres (PHCs) and sub-centres - Positive cases referred to secondary/tertiary centres for confirmation and management - Integration with reproductive and child health (RCH) services [cite:Park 26e Ch 10]
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