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Salud Pública de México

versión impresa ISSN 0036-3634

Resumen

FERRECCIO, Catterina. New strategies for the prevention and control of cervical cancer in Chile. Salud pública Méx [online]. 2018, vol.60, n.6, pp.713-721.  Epub 22-Ago-2019. ISSN 0036-3634.  https://doi.org/10.21149/8577.

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.

Palabras llave : cervical cancer; human papilloma virus; cost-effectiveness; cervical screening; vaginal self-sampling.

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