title: Implementation of HPV testing in Latin America.
abstract: Cervical cancer is one of the leading killers among women in Latin America, a region where most countries have not been successful in implementing population-level cytology-based screening programs. This disease is caused by persistent infection with oncogenic HPV; in recent years, more HPV tests have become available and prices have dropped significantly, making it possible for countries to adopt these technologies. Pilot programs that took place in Nicaragua, Mexico, and Argentina showed a high level of efficacy in detecting precancerous cervical lesions and good feasibility and acceptance of self-sampling. El Salvador, Guatemala, Honduras, and Nicaragua are beginning to institutionalize HPV testing at the population level. The experience from the different countries has created rich information about the barriers and requirements for implementing HPV screening at large scale in these resource-constrained countries. There are several challenges for implementation, including a need to update screening guidelines, strengthen treatment capacity, and develop a comprehensive quality assurance plan for the HPV testing. At the same time, there are several opportunities in Latin America that make the process more feasible and faster than in other regions of the world: most Latin American countries already have screening programs funded by their national governments, several countries in the region are already implementing HPV testing, and there is a regional pooled procurement mechanism that could facilitate the purchase of HPV tests at an accessible price. We envision that most countries in the region will include HPV testing in their national program within the next three to five years.
authors.affiliation: PATH, 2201 Westlake Ave., Seattle, WA 98121, USA. Electronic address: jjeronimo@path.org.
authors.forename: Jose
authors.initials: J
authors.lastname: Jeronimo
authors.affiliation: PATH, 2201 Westlake Ave., Seattle, WA 98121, USA.
authors.forename: Francesca
authors.initials: F
authors.lastname: Holme
authors.affiliation: PATH, 2201 Westlake Ave., Seattle, WA 98121, USA.
authors.forename: Rose
authors.initials: R
authors.lastname: Slavkovsky
authors.affiliation: Instancia por la Salud y el Desarrollo de las Mujeres, Edificio Valsari, 7mo nivel, oficina 702, 6 Calle 1-36, Zona 10, Guatemala City, Guatemala.
authors.forename: Claudia
authors.initials: C
authors.lastname: Camel
mesh_terms: D003127:Colposcopy; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D060005:Genotyping Techniques; D006078:Government Programs / Q000458:organization & administration*; D017408:Guidelines as Topic; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008403:Mass Screening / Q000458:organization & administration*; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology
keywords: Cancer prevention; Cervical cancer; HPV testing; Latin America; Self-sampling