The path to eradicating cervical cancer in South America by 2030

Abstract

Background: In 2021, the World Health Organization (WHO) introduced the 90-70-90 strategy aimed at eradicating cervical cancer (CC) by 2030. This initiative's primary goal is to reduce both the incidence and mortality associated with this disease, setting a target of fewer than 4 cases per 100 000 women.

Development: cervical cytology is the most commonly used technique for detecting cervical cancer. Over the past five years, the average screening coverage has been 27,5 %. Among South American countries, Guyana reports the lowest coverage at 16 %, while Paraguay achieves the highest at 84 %. The crude incidence rate of cervical cancer in the region is 25,7 per 100 000 women, with Bolivia having the highest rate (34,1) and Uruguay the lowest (15,2). Regarding mortality, the median in South America is 14,5 per 100.000 women; Bolivia leads with 19, while Chile shows the lowest rate at 8,5.

In contrast, countries progressing toward the elimination of cervical cancer, such as the United States, Switzerland, and Australia, report screening coverages exceeding 84 % during the same period. These nations report incidence rates below 8,1 and mortality rates under 3,5 per 100 000 women, reflecting the impact of more effective prevention and detection strategies.

Conclusions: Despite efforts, South America still faces significant challenges in achieving cervical cancer elimination goals. Incidence and mortality rates remain high compared to countries further along this path. Governments must evaluate the cost-effectiveness of screening programs and incorporate more sensitive and accepted methods for early detection. Additionally, expanding HPV vaccination strategies to include young males and females up to at least 26 years of age is crucial to strengthening long-term prevention.