Cervical cancer: screening (VIA, Pap test) and HPV vaccination

Cervical cancer is one of the most common cancers in women in Bangladesh. The World Health Organization (WHO) says it can largely be prevented with HPV vaccination and regular screening. WHO also says it can be cured if it is found early and treated promptly. This article explains how the vaccine and screening work, which signs need a doctor, and which kind of doctor to see.

What is cervical cancer?

The cervix is the opening between the vagina and the womb (uterus). Cervical cancer is cancer that starts anywhere in the cervix.

WHO says almost all cervical cancers are caused by long-lasting (persistent) infection with high-risk types of human papillomavirus (HPV). HPV spreads through sexual contact. Most people get HPV at some point in their lives, often without any signs or symptoms, and the infection usually clears on its own. When it does not clear, it can cause changes in the cells of the cervix. These changes are called precancer. If they are not treated, they may become cancer.

According to WHO, this change usually takes 15 to 20 years. In women with a weakened immune system, such as women with untreated HIV, it can happen faster and take 5 to 10 years. This long gap is why screening is so useful.

How common is it in Bangladesh?

The International Agency for Research on Cancer (IARC) is WHO’s cancer agency. In its GLOBOCAN fact sheet for Bangladesh, IARC estimates that in 2024 there were about 11,100 new cases of cervical cancer and about 6,560 deaths from it. UNICEF Bangladesh also reports that more than five thousand women in the country die from cervical cancer every year.

HPV vaccination

WHO says that all licensed HPV vaccines protect against HPV types 16 and 18, which cause around 76% of cervical cancers. WHO recommends giving HPV vaccines to girls aged 9 to 14 years, before they become sexually active.

The vaccine in Bangladesh

On 2 October 2023 the government launched a free HPV vaccination campaign, with support from Gavi, UNICEF and WHO. The campaign was for girls in classes five to nine and for girls aged 10 to 14 who were not in school. The first phase took place in Dhaka division.
The final phase covered the other seven divisions: Barisal, Chattogram, Khulna, Mymensingh, Rajshahi, Rangpur and Sylhet. In December 2024, UNICEF reported that this phase had vaccinated 5.6 million girls, which is 93% of girls aged 10 to 14.
UNICEF reports that the vaccine became part of the routine immunisation programme (EPI) in 2025. UNICEF said that routine immunisation would cover girls in class five and 10-year-old girls who are not in school.
During the campaign, girls were registered on the government VaxEPI app or website. They were vaccinated at their school or at a vaccination centre.

If your daughter missed the vaccine, ask at her school, your local EPI centre or the upazila health complex what you should do next.

Common questions about the vaccine

Is it safe? UNICEF and WHO in Bangladesh describe the HPV vaccine as safe and highly effective. If you are worried about a reaction after any vaccine, speak to a health worker.
What about older girls and adult women? WHO recommends vaccinating girls aged 9 to 14 first. If you are older, ask a doctor whether the vaccine is right for you.
Does a vaccinated girl still need screening later? The vaccines protect against the HPV types that cause most cervical cancers, but not all of them. WHO describes vaccination and regular screening together as the way to prevent cervical cancer. A vaccinated woman should still ask about screening when she reaches screening age.

Screening: finding changes before cancer

Screening means testing women who have no symptoms. WHO says screening from age 30 can find precancer. For women living with HIV, it says screening should start at age 25. When precancer is treated in time, this can stop it from turning into cancer.

VIA (visual inspection with acetic acid)

VIA is the main screening test in Bangladesh’s national programme. The programme started in 2005 for women aged 30 to 60 years. Published reports on the programme say that women in this age group are offered VIA every 5 years and that trained nurses do the test. VIA is available at upazila health complexes and at higher-level government hospitals.

A trained health worker puts a weak acetic acid solution, similar to vinegar, on the cervix and looks for changes. A positive result does not mean you have cancer. It means you need a closer check.

Pap test

The Pap test is also called a Pap smear or cervical cytology. A small sample of cells is taken from the cervix and checked in a laboratory for abnormal cells.

HPV test

An HPV test looks for high-risk HPV in cells taken from the cervix. A WHO fact sheet says that when the HPV test is the main screening test, it is done from age 30 and repeated every 5 to 10 years. Your doctor will tell you which test suits you and when to come back.

Test	What it looks for
VIA	Changes seen on the cervix after acetic acid is applied
Pap test	Abnormal cells, checked in a laboratory
HPV test	High-risk HPV infection

If your screening result is positive

Please do not skip the follow-up visit. In Bangladesh’s national programme, the next step after a positive VIA result is often colposcopy, a closer examination of the cervix. Programme data show that not every woman with a positive VIA result goes on to have colposcopy. WHO says precancer can be treated before it becomes cancer. Your doctor will explain which treatment is right for you.

Symptoms of cervical cancer

The UK National Health Service (NHS) lists these symptoms of cervical cancer:

vaginal bleeding that is unusual for you, such as bleeding during or after sex, between periods or after the menopause, or periods that are heavier than usual
changes in vaginal discharge
pain during sex
pain in the lower back, the pelvis (between the hip bones) or the lower tummy

Other conditions, such as fibroids or endometriosis, can cause symptoms like these. The NHS advises getting checked by a doctor if your symptoms change, get worse or do not feel normal for you.

Warning signs: when to get care

See a doctor without delay if you have:

any vaginal bleeding after the menopause
bleeding during or after sex, or bleeding between periods
periods that are heavier than usual for you
changes in your vaginal discharge
pain during sex
pain in the pelvis, lower back or lower tummy

Go to the nearest hospital emergency department straight away if you have very heavy vaginal bleeding, or bleeding with dizziness, fainting, a racing heartbeat or severe pain.

If you are unsure what to do, you can call Shastho Batayon 16263, the government health call centre listed by DGHS. You can talk to a doctor 24 hours a day.

Which doctor should you see?

For screening: a trained nurse or doctor at a government screening centre, or a gynaecologist (a doctor who specialises in women’s reproductive health).
After a positive screening test, or if you have symptoms: a gynaecologist, often listed as an obstetrician and gynaecologist. They can arrange colposcopy and further tests.
If cancer is confirmed: a gynaecological oncologist (a specialist in cancers of the female reproductive organs), and a clinical oncologist or radiation oncologist. A team of specialists will explain the treatment options for each woman.
For the HPV vaccine: your daughter’s school, your local EPI centre or the upazila health complex.

Key points

WHO says almost all cervical cancer is caused by long-lasting HPV infection, and that it can largely be prevented.
Since 2025 the HPV vaccine has been part of Bangladesh’s routine immunisation programme for girls.
Women aged 30 to 60 can have VIA screening at government health facilities.
If you get a positive result, always go for the follow-up test.
Unusual bleeding, changes in discharge, pain during sex or pelvic pain should be checked by a doctor.

This article is general information and does not replace advice from a doctor who knows your health.

Find a doctor

Browse Gynecology doctors in Bangladesh on ratings.com.bd, with chambers and, where listed, visiting hours and phone numbers.

Sources

This article is general information, not medical advice. It was written by AI from the sources above. It did not pass the automatic check, and an administrator chose to publish it; no doctor or editor has reviewed it. For a diagnosis or treatment, see a registered doctor.