From evidence to implementation: a policy and health systems roadmap for cervical cancer elimination in India

Abstract

Background Cervical cancer is the first cancer that can be eliminated, yet it remains a leading cause of cancer-related mortality among women in low- and middle-income countries. India accounts for a substantial share of the global burden, making its trajectory central to global elimination efforts. Although effective tools—including HPV vaccination, HPV-based screening, and treatment of precancerous lesions—are well established, progress has been uneven. The central challenge is no longer scientific discovery but large-scale implementation, building on India's demonstrated capacity for nationwide public health delivery through polio eradication, HIV/AIDS control, and COVID-19 vaccination. Methods We conducted a conference-informed policy and implementation synthesis drawing on expert presentations from the International Papillomavirus Society (IPVS) 2025 “The World Could End Cervical Cancer If it Tried: spotlight on India” session, complemented by peer-reviewed literature and policy documents. A rapid thematic synthesis approach was used to identify and organize implementation priorities across the prevention and care continuum. Findings Five interrelated priorities emerged. First, demand generation must move beyond awareness to trust-driven uptake through credible messengers and clear service pathways. Second, strengthening provider capacity is essential to improve vaccine confidence and recommendation practices across the clinical workforce. Third, screening programmes must be redesigned around completion of the care cascade rather than participation alone, with integrated pathways for triage and treatment. Fourth, community engagement should be embedded within service delivery and navigation systems to translate trust into sustained participation and follow-through. Fifth, governance, financing, and digital infrastructure—including national registries and interoperable data systems—are critical to enable coordinated, accountable scale-up. Across all domains, trust functions as a central cross-cutting mechanism linking awareness to uptake and continuity of care. Interpretation Cervical cancer elimination in India is achievable but requires a shift from fragmented initiatives to coordinated national implementation. Bridging the gap between evidence and delivery will depend on aligning communication, workforce capacity, service integration, community engagement, and system-level governance with urgency and accountability. India's success will not only determine national outcomes but will be pivotal to achieving global cervical cancer elimination within this generation.