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Answered by:  Dr B Shakuntala Baliga MD (AIIMS), FICOG    |  Professor and Senior Consultant Gynecologist & Colposcopist
Mazumdar-Shaw Center for Cancer Research & Narayana Hrudayalaya Multispecialty Hospital, Bangalore

Women of what age bracket are most vulnerable. In India,cancer cervix has peak age incidence in the 50s. However, aim of screening is to detect the prcancer stage- which occurs almost 15 years ahead. So if a country has limited resources, we advise screening every woman at least once in her lifetime around age 35-40 years. Data for precancer in adolescents is not avaialble for India as hardly any adolescent in India comes for health check, despite early age of marriage still being prevalent in India. 2 What conditions will make them susceptible to cervical cancer/HPV infection. Early age of marriage/ sexual activity (especially before age 16 years) Multiple partners Early age of first child birth (especially before age 17 years) Multiple pregnancies (>/= 5 childeren) Smoking Use of combined oral contraceptive pills (slight increase in precancer- probably related to life style) Diet deficient in nutrients and vitamins Poor genital hygiene Unsafe sex Occurrence of Sexually transmitted infections- especially HPV, herpes, chlamydia,gonorrhea 3 What are the measures of prevention. Primary prevention by 1. life style changes- refer to above conditions and 2. vaccination Secondary prevention by screening wih Pap smear and high-risk HPV DNA test (latter test is useful in women after age 35years) (to detect and treat precancer) 4 What is the status of the vaccines' availability in India. Both the vaccines- Gardasil (against HPV 16, 18, 6 and 11)and Cervarex (against 16 and 18) are available in India 5 Which of the two vaccines is suggested/or is better.