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Rethinking Cervical Cancer Screening in Brazil Post COVID-19: A Global Opportunity to Adopt Higher Impact Strategies.
- Source :
-
Cancer prevention research (Philadelphia, Pa.) [Cancer Prev Res (Phila)] 2021 Oct; Vol. 14 (10), pp. 919-926. - Publication Year :
- 2021
-
Abstract
- The World Health Organization global call to eliminate cervical cancer encourages countries to consider introducing or improving cervical cancer screening programs. Brazil's Unified Health System (SUS) is among the world's largest public health systems offering free cytology testing, follow-up colposcopy, and treatment. Yet, health care networks across the country have unequal infrastructure, human resources, equipment, and supplies resulting in uneven program performance and large disparities in cervical cancer incidence and mortality. An effective screening program needs multiple strategies feasible for each community's reality, facilitating coverage and follow-up adherence. Prioritizing those at highest risk with tests that better stratify risk will limit inefficiencies, improving program impact across different resource settings. Highly sensitive human papillomavirus (HPV)-DNA testing performs better than cytology and, with self-collection closer to homes and workplaces, improves access, even in remote regions. Molecular triage strategies like HPV genotyping can identify from the same self-collected sample, those at highest risk requiring follow-up. If proven acceptable, affordable, cost-effective, and efficient in the Brazilian context, these strategies would increase coverage while removing the need for speculum exams for routine screening and reducing follow-up visits. SUS could implement a nationwide organized program that accommodates heterogenous settings across Brazil, informing a variety of screening programs worldwide.<br /> (©2021 American Association for Cancer Research.)
- Subjects :
- Brazil epidemiology
DNA, Viral analysis
DNA, Viral genetics
Female
Humans
Papillomavirus Infections genetics
Papillomavirus Infections virology
Uterine Cervical Neoplasms epidemiology
Uterine Cervical Neoplasms virology
COVID-19 complications
Cytodiagnosis methods
Early Detection of Cancer methods
Papillomaviridae isolation & purification
Papillomavirus Infections complications
SARS-CoV-2 isolation & purification
Uterine Cervical Neoplasms diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1940-6215
- Volume :
- 14
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Cancer prevention research (Philadelphia, Pa.)
- Publication Type :
- Academic Journal
- Accession number :
- 34607876
- Full Text :
- https://doi.org/10.1158/1940-6207.CAPR-21-0110