Cervical Cancer Control in Latin America and the Caribbean

Book excerpt: Worldwide, more than half a million women are diagnosed with cervical cancer annually and more than 300,000 die from the disease. At least 85% of the deaths occur in low-middle income countries (LMICs)and almost 10% of them in Latin America (LATAM) and the Caribbean, where mortality rates are almost five times higher than in high-income areas. Infection with high-risk subtypes of the Human Papillomavirus (HPV) is a necessary, but not sufficient cause of cervical cancer. The natural history of the disease involves persistent high-risk HPV infections, followed by the development of precancerous cervical lesions, and progression to invasive cervical cancer, in a process that usually occurs throughout many years. The long natural history of the disease provides a window of opportunity for secondary prevention with screening tests, which identify women infected with HPV or with cytologic abnormalities indicative of precancerous lesions. These lesions can be successfully treated when diagnosed early. Besides, the existence of a primary infectious etiologic agent allows for primary prevention with prophylactic HPV vaccines capable of reducing the incidence of causative infections. Thus, cervical cancer is considered a preventable and treatable disease, but, despite that, it continues to be the third cause of cancer in women in the region.