Cervical Cancer Elimination in India: Progress, Gaps, and the Priorities.

Background: Cervical cancer is the second most common cancer and cause of cancer death among women in India, with an estimated 79,000 new cases and 43,000 deaths in 2024. Following the February 2026 nationwide HPV vaccination rollout, this review assesses India's progress toward the WHO 90-70-90 elimination targets and identifies the gaps most likely to determine further progress. Methods: We conducted a critical narrative review informed by the authors' program experience and targeted searches from publicly available databases, including national program documents, government reports, national surveys and WHO guidelines until September 2026. We selected evidence relevant to vaccination, screening, and treatment in India and synthesised it thematically. Results: The national program targets over 10 million girls aged 14 years with a single HPV vaccine dose. About 8 million were vaccinated till September 2026with very few serious adverse events reported. Facility-only delivery, mandatory written consent and limited supply for additional cohorts are major barriers to achieve the 90% target. Screening coverage remains low [<2%], with continued reliance on VIA, no harmonised performance indicators and weak linkage to care. Randomised trials support primary HPV testing, and newly validated indigenous assays could make this transition affordable, although triage requirements and overtreatment need attention. Limited colposcopy, loss to follow-up and insufficient radiotherapy capacity constrain treatment. Conclusion: India has the health-system architecture, manufacturing capacity and digital tools needed for elimination, but remains substantially short of all three targets. Progress will depend mainly on: i) extending vaccination beyond facilities and to more cohorts ii) moving to organised, self-sampled HPV-based screening iii) closing the gap between screening and treatment.