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[Trends in Cervical Cancer Screening Coverage Through Papanicolaou Smear. Chile, 2002-2023]
Sebastián Lavanderos1, Arantxa Valenzuela-Rocuant1, Benjamín Moraga-Arias1
1Escuela de Medicina, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile.
Abstract:
Cervical cancer (CC) is the fourth most common cancer in women worldwide and a major public health issue in Chile, where it ranks third in both incidence and mortality. Despite the national target of reaching 80% coverage of Papanicolaou (Pap smear) screening, previous studies suggest insufficient coverage with marked territorial disparities.
Aim:
To describe and analyze cervical cancer screening coverage through Pap smears in Chile between 2002 and 2023, identifying territorial differences and their relationship with socioeconomic indicators.
Methods:
We conducted an observational, longitudinal, and retrospective study using annual records from the National Municipal Information System and population projections from the National Institute of Statistics. Pap smear coverage was calculated per municipality, and temporal trends, geographic variations at municipal, provincial, and regional levels, and correlations with poverty and dependence on the Municipal Common Fund (MCF) were analyzed.
Results:
A total of 6,616 records from 345 municipalities were analyzed. The national median coverage increased from 35.3% in 2002 to 51.1% in 2023, with no significant linear trend (R2= 0.14; p= 0.08). Only 2% of municipal records reached the 80% target. Wide territorial disparities were observed: Magallanes increased its coverage by 259%, while Atacama decreased by 42%. No region achieved the national goal. At the municipal level, coverage ranged from 0% to 98.5%. Correlations with poverty and MCF dependence were positive but weak, suggesting the influence of additional local factors.
Conclusions:
Despite increased Pap smear coverage, Chile has not yet met the proposed targets. Territorial disparities highlight the need for tailored interventions to improve screening coverage. Ensuring data quality and reliability is essential for informed public health decision-making, which is key to advancing toward the elimination of cervical cancer as a public health problem in Chile.
