| dc.description.abstract | The World Health Organization has called for elimination of cervical cancer as a public
health problem and has adopted strategies in this regard. However, the estimates for
achieving the goals depend on the ability to provide timely treatment in a certain pro-
portion of cases. The coronavirus disease 2019 pandemic has had a serious impact on
healthcare delivery in many low and middle income countries (LMICs) with the highest
burden of cervical cancer; funds and infrastructure are being reallocated to deal with
the emergency, and cancer care has been seriously affected. In the absence of clear and
reliable estimates, the exact extent of disruption remains unclear. It is, therefore, essen-
tial that pragmatic approaches are adopted to save lives. There has been considerable
debate regarding the use of the 9 Gy × 2 fractions high dose rate brachytherapy sched-
ule for the treatment of locally advanced cervical carcinoma. However, in LMICs with
the highest global burden of locally advanced cervical cancer cases, radiation facilities
have been using this fractionation schedule in many cases to deal with the overwhelming
number of patients, who would have otherwise been denied timely treatment. In view of
the current pandemic, and the difficulties in accessing and delivering timely healthcare,
mortality owing to delayed treatment cannot be denied in LMICs, which already have
underequipped healthcare facilities. Use of the shortest available fractionation schedule
to provide timely treatment would serve to save more lives in regions with high incidence
and mortality from the disease. | spa |
