The Cervical Cancer Crisis: A Vaccine Exists - So Why Are Pakistani Women Dying?

Cervical cancer — a disease that’s almost entirely preventable — continues to claim the lives of more than 7,000 women in Pakistan every year. That’s over 19 women each day. Globally, it’s the fourth most common gynaecological cancer, and in Pakistan, it ranks third in frequency — a grim reality made worse by silence, stigma, and systemic gaps.

The culprit? A common but dangerously underestimated virus: Human Papillomavirus (HPV).

HPV is the leading cause of cervical cancer worldwide, and the science is clear — with vaccination, screening, and awareness, we can stop this cancer before it even begins.

Cervical cancer doesn’t need to be a death sentence. In fact, it doesn’t need to exist at all — at least not at the scale we’re seeing.

Cervical cancer originates in the cervix, which is the lower portion of the uterus. Cervical carcinoma occurs when cells in this area begin to grow abnormally and uncontrollably due to mutations. Nearly all cases of cervical cancer globally are linked to a long-lasting infection with the Human Papillomavirus (HPV), a widespread virus transmitted through sexual contact.

While there are over 100 strains of HPV, types 16 and 18 account for more than 70% of cervical cancer cases. In most instances, the body clears HPV infections on its own. However, when the infection lingers — particularly in the cervical region — it can gradually alter cellular structures, eventually forming pre-cancerous changes and progressing to cancer.

The tragedy lies in the fact that most HPV infections clear up on their own. But in some cases, the virus lingers silently, giving rise to cellular changes that may not show any symptoms until it’s too late. This is why routine screening and early detection are critical. Sadly, these life-saving tools are out of reach for many women in Pakistan — not just due to affordability or accessibility, but also because talking about sexual and reproductive health is still largely taboo.

The signs of cervical cancer often go unnoticed. They include unusual vaginal bleeding — during intercourse, between periods, or after menopause — pain during intercourse, abnormal vaginal discharge, and, in later stages, unexplained weight loss and fatigue. These symptoms are often dismissed, normalized, or misunderstood. By the time women present at gynecology clinics, the disease has frequently progressed, leaving fewer treatment options and significantly lowering the chances of survival.

Several risk factors contribute to the development of cervical cancer: early age at marriage, having multiple children, smoking, poor hygiene, low socioeconomic conditions, and prolonged use of oral contraceptives.

But across the world, the one consistent, confirmed cause in nearly all cases remains HPV infection — especially high-risk subtypes like 16 & 18.

Pakistan’s reality is stark. A study from rural Punjab revealed that 70% of women had never even heard of cervical cancer. Despite the global medical community’s endorsement of the HPV vaccine and routine screening via Pap smears and HPV DNA testing, uptake in Pakistan remains shockingly low. Although these tests are available in private healthcare settings and cost around 3000 PKR, they are inaccessible to the vast majority — especially women in remote or underprivileged communities.

Compounding the problem is the complete absence of a nationwide screening program, and no public HPV vaccination strategy. Without these public health pillars in place, countless women are left vulnerable, uninformed, and unprotected.

But even in a future where Pakistan establishes a robust, nationwide cervical cancer screening program, barriers to access and uptake will still remain — particularly for women in rural and underserved communities.

It’s not just about making Pap tests and HPV DNA testing available, it’s also about tackling the deep-rooted societal and structural challenges that prevent women from using them.

A national cervical cancer screening program in Pakistan is essential—but it won’t be enough. Distance, stigma, and ignorance still stand in the way.

Many women live hours from the nearest clinic, with no transport or family support to get there. Others face resistance at home—husbands or elders who control their healthcare choices. And even if they make it, do they understand why screening matters?

For women who’ve never heard of HPV or their own cervix, a Pap test seems unnecessary—or worse, shameful. Some fear judgment from doctors; others believe screenings cause cancer. Misinformation spreads faster than prevention.

The matter of fact is, tests alone won’t save lives if women can’t—or won’t—use them!

In a country where women bear the weight of countless unspoken burdens, cervical cancer has become yet another silent killer lurking in the shadows. What makes this especially heartbreaking? It's one of the few cancers we can actually prevent—yet in Pakistan, it continues to steal lives unnecessarily. Protecting yourself against cervical cancer begins with awareness and proactive healthcare choices.

The most effective way to prevent this disease is through HPV vaccination, which offers strong protection against the human papillomavirus — the primary cause of cervical cancer. Although not yet included in Pakistan’s national immunization programme, two globally licensed vaccines are available: Gardasil, which protects against HPV types 6, 11, 16, and 18 (including genital warts), and Cervarix, which targets types 16 and 18. Sadly, awareness remains low, with one study revealing that only 20% of women of reproductive age knew about the vaccine — and fewer than 10% had received it.

Add to that the stigma around reproductive health, and it’s no wonder so many cases are caught at advanced stages. Other protective steps include quitting smoking, which significantly reduces cancer risk, practicing safe sex by using condoms to lower HPV transmission, and adopting a healthy lifestyle. A balanced diet rich in fruits and vegetables, regular physical activity, and good hygiene can strengthen the immune system and offer further protection.

Together, these simple yet powerful measures can help safeguard women from a preventable, life-threatening disease.

The battle against cervical cancer in Pakistan can be won, but only through immediate, coordinated action. We must start by making HPV vaccines freely available through our national immunization program, prioritizing young girls who stand to benefit most from early protection. But vaccines and tests alone aren't enough. A nationwide education campaign is crucial to dismantle the stigma and misinformation surrounding women's health. We must empower communities with knowledge while training healthcare workers in affordable, effective detection methods.

The answers are within reach — what’s missing is the shared determination to act on them. If we make cervical cancer prevention a part of both our healthcare services and cultural conversations, we can turn a preventable illness into a major public health achievement.

The world already has what it takes to eliminate cervical cancer. Will Pakistan step up to protect its women, or will we let the opportunity pass us by?

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WHO Guidelines for Vaccination:

The World Health Organization (WHO) advises HPV vaccination as follows:

• Girls aged 9-14: 1 or 2 doses

• Individuals aged 15 to 20: same dosage as above

• Women aged 21 and above: 2 doses spaced 6 months apart are advised.

In addition to vaccination, regular cervical screening is essential for early detection.

Tests like Pap smears and HPV DNA screenings help identify abnormal cellular changes before they become cancerous.

WHO recommends:

• Screening every 5 to 10 years starting at age 30.

• For women with HIV, screenings should begin at age 25 and be repeated every 3 years.

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For further reading and references, see the list below:

• Chughtai, N., Perveen, K., Gillani, S. R., Abbas, A., Chunara, R., Manji, A. A., Karani, S., Noorali, A. A., Zakaria, M., Shamsi, U., Chishti, U., Khan, A. A., Soofi, S., Pervez, S., & Samad, Z. (2023). National cervical cancer burden estimation through systematic review and analysis of publicly available data in Pakistan. BMC Public Health, 23(1), Article 834. https://doi.org/10.1186/s12889-023-15531-zThe Ag

• Hirani, S., Khan, S., Akram, S., Virji, S. N., Shaikh, P. A., Naeem, E., Chaudhry, R. A., Khalid, A. B., Khan, J. U. D., Qasim, M. S., & Jehan, I. (2021). Knowledge, awareness, and practices of cervical cancer, its risk factors, screening, and prevention among women in Karachi, Pakistan. European Journal of Cancer Prevention, 30(1), 97–102. https://doi.org/10.1097/CEJ.0000000000000590

• Mukhtar, R., Mehmood, R., Parveen, S., Hussain, M., & Arif, M. Prevalence of Cervical Cancer in Developing Country: Pakistan.

• Qamar, J., Maheen, M., & Mohammad, J. G. (2025). Insufficient resources for cervical cancer in Pakistan: a significant burden on public health. Annals of Medicine and Surgery, 87(3), 1114–1116. https://doi.org/10.1097/MS9.0000000000003013PubMed+2

• Raza SA et al. Human papillomavirus infection in women with and without cervical cancer in Karachi, Pakistan. British Journal of Cancer, 2010. Available at: https://www.nature.com/articles/sj.bjc.6605664

• Riaz, L., Manazir, S., Jawed, F., Ali, S. A., & Riaz, R. (2020). Knowledge, Perception, and Prevention Practices Related to Human Papillomavirus-based Cervical Cancer and Its Socioeconomic Correlates Among Women in Karachi, Pakistan. Cureus, 12(3), e7183. https://doi.org/10.7759/cureus.7183

• WHO guidelines: https://www.who.int/news/item/20-12-2022-WHO-updates-recommendations-on-HPV-vaccination-schedule

• Image by Rawpixel.