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Nuevas estrategias de prevención y control de cáncer de cuello uterino en Chile / New strategies for the prevention and control of cervical cancer in Chile
Ferreccio, Catterina.
  • Ferreccio, Catterina; Pontificia Universidad Católica de Chile. Escuela de Medicina. Centro Avanzado de Enfermedades Crónicas ACCDiS. Santiago. CL
Salud pública Méx ; 60(6): 713-721, Nov.-Dec. 2018. graf
Article in Spanish | LILACS | ID: biblio-1020936
RESUMEN
Resumen

Objetivos:

Discutir el cáncer cervicouterino (CC), el virus del papiloma humano (VPH), el programa de control del CC y proponer alternativas para Chile. Material y

métodos:

Se analiza el programa nacional del CC 1966-2015 y la guía clínica 2015-2020, la prevalencia de VPH en mujeres y en casos de CC; la infección y serología de VPH; la autotoma; la precisión y rentabilidad del tamizaje con VPH contra el Papanicolaou y las opciones de triaje en VPH AR positivas.

Resultados:

En Chile mueren 600 mujeres (principalmente de bajos recursos) al año por CC. La cobertura del Papanicolaou es < 70%, sensibilidad muy inferior al test de VPH, por lo que el cambio es rentable. Desde 2015 se vacuna contra VPH a niñas menores de 13 años.

Conclusiones:

Las condiciones técnicas y económicas existen en Chile para lograr una mejoría sustancial del CC se sugiere el reemplazo del Papanicolaou por el examen de VPH; tamizaje cada cinco años con opción de autotoma; triaje con base en la tipificación de VPH 16/18 o Papanicolaou.
ABSTRACT
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.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Uterine Cervical Neoplasms / Early Detection of Cancer Type of study: Diagnostic study / Practice guideline / Observational study / Prognostic study / Risk factors / Screening study Limits: Adult / Female / Humans Country/Region as subject: South America / Chile Language: Spanish Journal: Salud pública Méx Journal subject: Public Health Year: 2018 Type: Article Affiliation country: Chile Institution/Affiliation country: Pontificia Universidad Católica de Chile/CL

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Full text: Available Index: LILACS (Americas) Main subject: Uterine Cervical Neoplasms / Early Detection of Cancer Type of study: Diagnostic study / Practice guideline / Observational study / Prognostic study / Risk factors / Screening study Limits: Adult / Female / Humans Country/Region as subject: South America / Chile Language: Spanish Journal: Salud pública Méx Journal subject: Public Health Year: 2018 Type: Article Affiliation country: Chile Institution/Affiliation country: Pontificia Universidad Católica de Chile/CL