Cervical Cancer Situation in Latin America and the Caribbean and - - PowerPoint PPT Presentation

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Nov 15, 2023 118 likes •281 views

Cervical Cancer Situation in Latin America and the Caribbean and PAHO/WHO Recommendations for the Way Forward Silvana Luciani Advisor, chronic disease prevention and control project Pan American Health Organization/World Health Organization

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Silvana Luciani Advisor, chronic disease prevention and control project Pan American Health Organization/World Health Organization

Cervical Cancer Situation in Latin America and the Caribbean and PAHO/WHO Recommendations for the Way Forward

SLIDE 2

PRESENTATION OVERVIEW

Burden of cervical cancer in Latin America

and the Caribbean (LAC)

Programmatic response to cervical cancer
PAHO/WHO strategy for comprehensive

cervical cancer prevention and control

SLIDE 3

POPULATION)

(thousands))

N.Am:))347,500) LAC:))))588,500)

HIGHLIGHTS OF LAC REGION

MATERNAL)MORTALITY) RATIO)(100,000))

N.Am:))12) LAC:))))74)

INFANT)MORTALITY)RATE)

(1,000))

N.Am:)))6.5) LAC:)))))18.7)

GROSS)NATIONAL)INCOME)

N.Am:))$46,000) LAC:)))$7,000)

Source:(PAHO(Health(Situa2on(in(the(Americas,(Basic(Indicators,(2011(

CANCER)MORTALITY)RATE) )(100,000)populaLon))

N.Am:))))186) LAC:)))))))))94)

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CERVICAL CANCER IN THE AMERICAS

Age)standardized)mortality)rate))

NORTH AMERICA:

12,300 new cases per year 4,500 deaths per year

Latin America and the Caribbean:

68,000 new cases per year 31,400 deaths per year

Source:(Globocan(2008(

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7.5 9.4 9.9 10.1 11.2 13.3 14.1 15.9 19.8 20.1 30.2 33.2 35.4 36.8 10 20 30 40 Perú Mexico Canada Belize Chile USA Brasil Colombia Paraguay Argentina CostaGRica Guatemala TrinidadG&G Tobago Honduras

HPV(PREVALENCE((%)(AMONG(WOMEN(WITH(NORMAL(CYTOLOGY(

Source:(ICO/WHO((Summary(Report(for(the(Américas,(2009(

HPV PREVALENCE IN THE AMERICAS

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Source:(Globocan(2008(

CERVICAL CANCER INCIDENCE AND MORTALITY BY AGE IN LAC

Women are in the prime of their lives when affected by cervical cancer

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COMPREHENSIVE CERVICAL CANCER PROGRAMS

COMMUNITY PRIMARY HEALTH CARE SECONDARY HEALTH CARE TERCIARY HEALTH CARE

PRIMARY(PREVENTION( ( SCREENING(&(EARLY( DETECTION (( DIAGNOSIS,(TREATMENT(&(PALLIATIVE(CARE( ( U Health(educa2on( U Counselling( U HPV(vaccina2on( UScreening(of(women(at( risk:(Pap(or(HPV(or(VIA(

UScreen(and(treat(

UCytology(Labs( UColposcopy/biopsy( UPathology(labs( UCryotherapy/LEEP( USurgery,(radiotherapy,(chemotherapy( UPallia2ve(care(

ORGANIZED)PROGRAM) coverage/quality/follow(up(

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CERVICAL CANCER MORTALITY IN CHILE 1987-2003

1987 1994 1997 2003

Source: Suarez, E. Cervical Cancer:the Chilean perspective, 2007

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TRENDS IN CERVICAL CANCER MORTALITY IN SELECTED LATIN AMERICAN COUNTRIES

2 4 6 8 10 12 14 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 rate/100,000 Argentina Brazil Colombia Costa Rica Mexico source: PAHO Mortality Database, 2012

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socio-cultural barriers

program organization limitations with cytology

BARRIERS TO EFFECTIVE PROGRAMS IN LAC

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OPPORTUNITIES TO IMPROVE PROGRAMS

HPV VACCINES)
SCREEN & TREAT APPROACH

VIA followed by cryotherapy treatment

NEW SCREENING TESTS

HPV DNA Tests, VIA

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Routine HPV vaccine should be included in national immunization programs, if:

cervical cancer prevention is a priority;
it is feasible and has sustainable financing
priority: girls aged 9-13 years
catch up: adolescent and young women (14-26)

Screening guideline:

30 years+
every 3 years
cytology
other tests (VIA, HPV, VILI) in pilot projects
cryotherapy treatment effective

WHO RECOMMENDATIONS ON CERVICAL CANCER

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1. Conduct a situation assessment
2. Intensify information, education and counseling
3. Fortify screening and pre-cancer treatment
4. Establish or strengthen information systems and cancer

registries

5. Improve access and quality of cancer treatment and of

palliative care

6. Generate evidence for decision making on HPV vaccine

introduction

7. Advocate for equitable access and affordable

comprehensive cervical cancer prevention

PAHO REGIONAL STRATEGY AND PLAN OF ACTION FOR CERVICAL CANCER PREVENTION AND CONTROL

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CERVICAL CANCER PROGRAMS IN LAC

Cytology)tesLng) )Visual)inspecLon)screening)+)cytology) HPV)DNA)tesLng) )Visual)inspecLon)screening)only)

HPV vaccines in national programs Mexico (2008) Panama (2008) Peru (2011) Argentina (2011) Colombia (2012)

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CONCLUSIONS

1. Evidence and tools are available to improve

impact of cervical cancer programs in LAC.

2. Intensified efforts are needed to:
organize programs;
introduce HPV vaccines;
improve screening and treatment.