Author(s): Robles SC, White F, Peruga A
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Abstract This article presents an assessment of cervical cancer mortality trends in the Americas based on PAHO data. Trends were estimated for countries where data were available for at least 10 consecutive years, the number of cervical cancer deaths was considerable, and at least 75\% of the deaths from all causes were registered. In contrast to Canada and the United States, whose general populations had been screened for many years and where cervical cancer mortality has declined steadily (to about 1.4 and 1.7 deaths per 100,000 women, respectively, as of 1990), most Latin American and Caribbean countries with available data have experienced fairly constant levels of cervical cancer mortality (typically in the range of 5-6 deaths per 100,000 women). In addition, several other countries (Chile, Costa Rica, and Mexico) have exhibited higher cervical cancer mortality as well as a number of noteworthy changes in this mortality over time. Overall, while actual declining trends could be masked by special circumstances in some countries, cervical cancer mortality has not declined in Latin America as it has in developed countries. Correlations between declining mortality and the intensity of screening in developed countries suggest that a lack of screening or screening program shortcomings in Latin America could account for this. Among other things, where large-scale cervical cancer screening efforts have been instituted in Latin America and Caribbean, these efforts have generally been linked to family planning and prenatal care programs serving women who are typically under 30; while the real need is for screening of older women who are at substantially higher risk. PIP: Each year, approximately 52,000 new cases of cervical carcinoma occur in Latin America and the Caribbean. In contrast to developed countries, where the incidence of cervical cancer has declined over the past 30 years, there has been no such trend in Latin America. This study used Pan American Health Organization (PAHO) data to estimate cervical cancer mortality trends in the 14 countries in the Americas for which data were available for at least 10 consecutive years, the number of cervical cancer deaths was substantial, and at least 75\% of deaths from all causes were registered. Marked declines in cervical cancer mortality in the US and Canada have occurred in all age groups (especially the 40-64 year group) since 1960; by 1990, the mortality rates from this cause were 1.4 and 1.7/100,000 women, respectively. In the Latin American and Caribbean countries with available data, cervical cancer mortality has remained fairly constant since 1960 at about 5-6 deaths/100,000 women. In Mexico, Chile, and Costa Rica, cervical cancer mortality has increased over time, largely among women over 40 years of age, as a result of the concentration of screening efforts on younger women attending prenatal or family planning clinics. In some Latin American countries, declining cervical cancer mortality rates may be masked by improvements in death registration and the accuracy of death certification. In general, Latin American countries exhibit large within-country variation in cervical cancer incidence and mortality, reflecting differential access to cervical cancer screening and treatment.
This article was published in Bull Pan Am Health Organ
and referenced in Journal of Addiction Research & Therapy