Cervical cancer in Latin America and the Caribbean: the problem and the way to solutions

Latin America and the Caribbean have one of the highest incidence and mortality rates from cervical cancer in the world. In this region, age-adjusted incidence rates range from 20 to 80 per 100,000 women per year. Overall, the mortality rates are extremely high in spite of the availability of Pap screening in several countries. Women from lower socioeconomic status, often less educated, are unaware of cervical cancer screening or have no access to it. Despite the efforts to reorganize screening programs in the region, in a few countries, only a slight decrease in cervical cancer mortality has been observed. New modalities for primary and secondary screening should be evaluated and disseminated, including HPV testing and vaccination against the most common HPV types. HPV prophylactic vaccines were approved in most Latin American countries, but only few are considering its implementation in national immunization programs. Besides cost and other logistical issues, lack of recommendation by policy makers or lawmakers is deterring the introduction of HPV vaccines in the region. Furthermore, studies conducted in the region have indicated that HPV vaccination only or vaccination supplemented with screening may be considered a cost-effective strategy to reduce mortality by cervical cancer.