title: [New paradigms and challenges in cervical cancer prevention and control in Latin America].
abstract: Cervical cancer continues to be a significant health problem in Latin America. The use of conventional cytology to detect precancerous cervical lesions has had almost no major impact on reducing cervical cancer incidence and mortality rates, which are still high in the region. The availability of new screening tools to detect precancerous lesions provide great opportunities for cervical cancer prevention in the region, as do highly efficacious HPV vaccines able to prevent nearly all lesions associated with HPV-16 and -18 when applied before viral exposure. This paper summarizes the scientific evidence and regional experiences related to: i) the use of HPV testing and visual inspection after the application of acetic acid (VIA) in primary screening and ii) the implementation of adolescent HPV vaccination programs. Finally, we outline a number of recommendations for different resource settings. The feasibility of implementing successful and sustainable national cervical cancer prevention programs in Latin American countries in the region will depend on health priorities and the availability of infrastructure and health personnel--as determined by rigorous local situational analysis.
authors.affiliation: Cancer Research UK, Centre for Epidemiology, Mathematics & Statistics, Wolfson Institute of Preventive Medicine, Queen Mary University, London, UK. m.almonte@qmul.ac.uk
authors.forename: Maribel
authors.initials: M
authors.lastname: Almonte
authors.forename: Raúl
authors.initials: R
authors.lastname: Murillo
authors.forename: Gloria Inés
authors.initials: GI
authors.lastname: Sánchez
authors.forename: José
authors.initials: J
authors.lastname: Jerónimo
authors.forename: Jorge
authors.initials: J
authors.lastname: Salmerón
authors.forename: Catterina
authors.initials: C
authors.lastname: Ferreccio
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lazcano-Ponce
authors.forename: Rolando
authors.initials: R
authors.lastname: Herrero
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D052685:Alphapapillomavirus / Q000302:isolation & purification / Q000472:pathogenicity; D003906:Developing Countries; D005240:Feasibility Studies; D005260:Female; D006078:Government Programs / Q000458:organization & administration; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008403:Mass Screening / Q000458:organization & administration; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission; D053918:Papillomavirus Vaccines; D010808:Physical Examination; D011230:Precancerous Conditions / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D015397:Program Evaluation; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D002575:Uterine Cervicitis / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D014611:Vaccination; D014626:Vaginal Smears
chemical_list: D053918:Papillomavirus Vaccines