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Instituto Nacional de Salud Pública

2018, Number 6

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salud publica mex 2018; 60 (6)

New strategies for the prevention and control of cervical cancer in Chile

Ferreccio C

Language: Spanish
References: 35
Page: 713-721
PDF size: 546.75 Kb.


ABSTRACT

Objective. To discuss cervical cancer (CC), Human Papilloma Virus (HPV), CC control program and propose alternatives for Chile. Materials and methods. We analyzed the national program of CC 1966-2015 and the clinical CC guideline 2015-2020; HPV prevalence in women and in cases of CC; HPV infection and serology; the self-vaginal sample; the accuracy and cost-effectiveness of screening with HPV versus Papanicolaou, and triage options among HPV-AR positives. Results. 600 women die of CC each year in Chile, mainly from low resources. Papanicolaou coverage is ‹70%; Papanicolaou sensitivity is much lower than HPV test. Change from Papanicolaou to HPV test is cost-effective. Since 2015, girls under 13 have been vaccinated against HPV. Conclusions. There are the technical and economic conditions for a substantial improvement of CC in Chile: replacement of the Papanicolaou by HPV; screening every five years, with the option of self-sampling, and triage based on HPV 16/18 or Papanicolaou typing.


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