## NPCDCS Cervical Cancer Screening Guidelines **Key Point:** The NPCDCS recommends opportunistic screening for cervical cancer in women aged **30–65 years** using either **HPV testing** or **Visual Inspection with Acetic acid (VIA)** at **5-yearly intervals** as the most cost-effective and feasible approach for India's resource-constrained settings. ### Rationale for Age Group and Interval - **Age 30–65 years:** Peak incidence of cervical cancer occurs in this age group; screening before age 30 is less cost-effective because HPV infection is common but usually self-clears. - **5-yearly interval:** Cervical cancer has a long natural history (10–15 years from dysplasia to invasive disease); 5-yearly screening is sufficient to detect precancerous lesions. ### Screening Methods Under NPCDCS | Method | Sensitivity | Specificity | Cost | Feasibility in India | | --- | --- | --- | --- | --- | | **VIA (Visual Inspection with Acetic acid)** | 70–80% | 85–90% | Low | High (can be done at primary health centers) | | **HPV Testing** | >95% | 90–95% | Moderate | Increasing (molecular labs in district hospitals) | | **Pap Smear** | 60–70% | 95%+ | Moderate | Limited (requires trained cytopathologists) | | **Colposcopy** | N/A (diagnostic, not screening) | N/A | High | Limited (tertiary centers only) | **High-Yield:** NPCDCS prioritizes **VIA and HPV testing** over Pap smear because they are more feasible, require less infrastructure, and can be performed by trained paramedical workers at the primary level. **Clinical Pearl:** In India, **opportunistic screening** (when women attend health facilities for other reasons) is the current strategy; organized population-based screening is not yet universally implemented due to resource constraints. **Mnemonic:** **VIAH** — VIA, HPV, Age 30–65, 5-yearly interval = NPCDCS cervical cancer screening.
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