title: [Challenges to implement strategies for the primary and secondary prevention of cervical cancer in Mexico].
abstract: Mortality due to cervical cancer (CC) has decreased in developed countries given extensive screening and effective coverage. In developing countries mortality rates due to CC remain high. Since the mid-nineties there has been a decrease in mortality due to CC in Mexico, which can be attributed to the increase in coverage of the Papanicolaou (PAP) (beta -.195, IC95% -.274, -.117) and the decrease in the birth rate (beta -.407, IC95% -.632, -.182). The use of the PAP in conjunction with an HPV test within the early CC detection program would have a synergistic effect; HPV testing should be combined with the Pap test. Primary prevention of CC is possible with the HPV vaccine. This vaccine will be an additional tool for reducing CC-related morbidity and mortality, but will not replace screening and treatment. To adopt a prevention policy that includes an HPV vaccine we will need to: determine the burden of HPV-related disease; have sufficient epidemiological evidence and data about technical aspects of the vaccine; take into account the psyschosocial and ethical aspects of the vaccine and guarantee good organization of vaccine implementation.
authors.affiliation: Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lazcano-Ponce
authors.forename: Betania
authors.initials: B
authors.lastname: Allen
authors.forename: Lina Sofia
authors.initials: LS
authors.lastname: Palacio-Mejía
authors.forename: Mauricio
authors.initials: M
authors.lastname: Hernández-Avila
mesh_terms: D005260:Female; D006801:Humans; D008800:Mexico; D053918:Papillomavirus Vaccines; D011322:Primary Prevention; D055502:Secondary Prevention; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control*
chemical_list: D053918:Papillomavirus Vaccines