Gynaecological cancers are a group of cancers that affect the female reproductive organs. The main types of gynaecological cancers include:

• Cervical Cancer: Starts in the cervix, the lower, narrow end of the uterus.

• Ovarian Cancer: Originates in the ovaries, which produce eggs and hormones.

• Uterine Cancer (Endometrial Cancer): Begins in the lining of the uterus.

• Vaginal and Vulvar Cancers: Affect the vagina and the outer female genital organs, respectively.

While each type of cancer has unique characteristics, they all pose significant health risks to women, especially in developing countries.

The risk factors for gynaecological cancers are varied and are influenced by a combination of genetics, lifestyle, and environmental factors.

• Human Papillomavirus (HPV) Infection: This is the most significant risk factor for cervical cancer. The HPV virus is a common sexually transmitted infection.

• Age: The risk of most gynaecological cancers increases with age. For instance, ovarian and uterine cancers are more common in women after menopause. In India, a considerable number of cervical cancer cases are diagnosed in younger women, often due to risk factors like early marriage and childbirth.

• Reproductive History: Early age at first childbirth, having multiple pregnancies, and using certain hormonal contraceptives can influence risk.

• Lifestyle: Obesity and a sedentary lifestyle are known to increase the risk of uterine and ovarian cancers.

• Genetics: A family history of breast or ovarian cancer, particularly inherited mutations in genes like BRCA1 and BRCA2, increases the risk of ovarian cancer. Similarly, genetic syndromes like Lynch syndrome can increase the risk of uterine and ovarian cancers.

• Socioeconomic Factors: In India, poor hygiene, lack of awareness, and limited access to healthcare, particularly in rural areas, are major contributors to the high incidence of certain gynaecological cancers, especially cervical cancer.

Gynaecological cancers represent a major public health challenge in India, with an epidemiological profile that differs from that of Western countries.

• Cervical Cancer: Historically, cervical cancer was the leading cause of cancer-related death in Indian women. While it has now been surpassed by breast cancer in urban areas, it remains a significant burden, especially in rural India. The high mortality is often due to late-stage diagnosis.

• Ovarian Cancer: The incidence of ovarian cancer is rising in India, particularly in urban populations, often attributed to lifestyle changes. Despite being less common than cervical and breast cancer, it has a high mortality rate due to its late-stage diagnosis.

• Late-Stage Diagnosis: A major issue across all gynaecological cancers in India is that a majority of cases are diagnosed at a locally advanced stage. This is a result of low public awareness, a lack of organised national screening programs, and socioeconomic barriers to healthcare.