Short Communication
Situation of the Cervical Cancer in Latin America
Vargas Hernandez Victor Manuel*
Department of Gynecology Service, Hospital Juarez de Mexico, Nápoles, México
*Corresponding author: Vargas Hernandez Victor Manuel, Department of Gynecology Service, Hospital Juarez de Mexico, Nápoles, México
Published: 17 Jun, 2018
Cite this article as: Manuel VHV. Situation of the Cervical
Cancer in Latin America. Clin Oncol.
2018; 3: 1478.
Short Communication
Latin America and the Caribbean (LAC) are made up of 41 countries, which vary in size and
population, 8 of 24 Caribbean countries had less than 100,000 inhabitants in 2009. Brazil is the
largest territorial and population and Mexico the second, with 191 and 110 million inhabitants in
2010 respectively. The Federation of Saint Kitts and Nevis are the small country, with less than 50
thousand inhabitants. The population of LAC has tripled from 1950 to 2010, from 167 million to 588
million inhabitants, constituting 8.5% of the world population and it is estimated that it will reach
730 million in 2050, with 13.7% of the population in extremely poor [1,2] According to the new
Multidimensional Poverty Index (MPI), there are large variations 2% in Uruguay to 57% in Haiti.
In LAC, the epidemiological transition has occurred unevenly and now infectious-contagious
diseases share an increase with chronic noncommunicable diseases, such as cancer, which represents
the second most common cause of death after cardiovascular diseases; cancer is one of the main
causes [3,4] and if the current incidence rates remain unchanged, it will increase by 75% in 2025;
however, the notable demographic changes, which have decreased mortality and fertility rates, from
8.72 to 6.06 per 1000 people and 4.47 to 2.09, respectively, with life expectancy that increased 9
years, from 65 to 74 years; and 6 years apart in favor of women compared to men [5]. The LAC
countries are classified by the World Bank as low or middle income countries and reports that being
indigenous increases the probability that a person lives in poverty with less education and access to
medical care [6,7].
Cancer affects more than one million in LAM each year; worldwide more than half of new cases
and more than two thirds of cancer deaths occur in emerging countries [7]. Cervical Cancer (CaCu)
is the leading cause of death in these women, which is common in women without social security,
in other groups, due to the association with the higher prevalence of Human Papillomavirus (HPV)
infection, earlier age at first sexual intercourse, greater number of births and low socioeconomic
level.
The Mortality Rate (MT) and incidence of cancer in LAC is 0.59, higher than the European
Union (0.43) and the United States (0.35), indicating these regions have greater support for cancer
management compared to LAC where it is more unequal worldwide, practically unmovable since
70's, being 65% higher than in developed countries, 36% above the Far East and 18% above sub-
Saharan Africa; Brazil, Mexico and Colombia, the most populated countries of LAC, have poverty
rates of 8.5, 4 and 9.2%, respectively [2,8-11]. Differences in wealth, education and health correlate
with greater exposure to infections and the risk of developing cancers [12]; adequate financing
is a global challenge, only 6% is for cancer, it causes the TM and incidence; is responsible for
46.1% of new cancer cases worldwide; health expenditures are low in many countries, in LAC;
historically, these expenditures were directed to infectious and contagious diseases, leaving chronic
noncommunicable diseases, such as cancer, in a secondary position. In Mexico in 2008, of the total
spent on health, 52% went to the private sector, which covers only 5% of the entire population [13];
Chemotherapy the cost of medicines varies from one country to another; in emerging countries
(LMIC) they charge higher prices than in HIC, and corruption within the system is common, most
drugs must be imported, and this is determined by who orders the drugs and who pays them [7,14-
16].
The consequences of the increase in cancer incidence and TM increase the economic burden
that affects health systems. Unequal allocation of resources, concentration of specialists and cancer
centers in large cities and lack of investment in equipment and infrastructure, lead to socioeconomic
inequalities in cancer care. The rural population travels to these for comprehensive oncological
management; the cultural differences of LAC indigenous patients within the health system is well
documented, such as lack of transportation and adequate housing, impede access to cancer care and
treatment services [7,13]; that generate diagnostic and therapeutic delays, affecting their prognosis
compared with patients in urban centers; you need organized and
planned cancer services in these countries, decentralization will
reduce access inequalities important strategy to reduce the incidence,
there are still several obstacles to oncological management, such
as primary prevention, secondary prevention or early detection,
diagnosis, treatment, rehabilitation, monitoring and palliative care;
mainly lack of national health plans that establish public policies for
cancer control. Prevention, early diagnosis and treatment worldwide
would reduce new cases and cancer deaths. The improvement of
eating habits, prevention of obesity, reduction of tobacco and alcohol
consumption, application of vaccines against Human Papillomavirus
(HPV) and hepatitis B, increased physical activity would significantly
reduce the incidence and mortality rates. Modern methods of
diagnosis, chemotherapy (Qt) widely available would increase the cure
rate and reduce cancer mortality [17-19]. Funds, insurance coverage,
doctors, health workers, resources and equipment were distributed
very unequally between and within countries; the scarcity of cancer
registries hampered the design of credible cancer registries [20]. With
reference to the quality of care, there are no mechanisms or systems
in LAC that allow evaluating or measuring its impact, the three key
points for priority actions to improve the cancer control in LAC: first,
strengthen screening and early detection of the disease and strengthen
the education of health professionals, (levels of primary and secondary
care). Second, improve access to treatment within the healthcare
systems, ensuring that treatment occurs in the correct and timely
manner. Third, to promote holistic care and treatment by defining
standards of best practices, protocols or guidelines for diagnosis and
treatment adapted to LAC, encouraging multidisciplinary support
and introducing and supporting access to palliative care for cancer
patients as a public policy. 6 Establish acknowledged about the real
impact of the incidence, TM and survival in LACe is a challenge.
The adopted strategies, outside the rhythm of the increase of the
socioeconomic development are programs to improve the control of
the Cancer for example for CaCu, even before the vaccine against the
VPH is adopted of routine way in all the countries. Early diagnosis
and prevention are necessary, but it still requires evaluation,
follow-up and reevaluations, through epidemiological measures of
population incidence, MT and survival. LAC represents 2% of the
global investment in research and development; Brazil leads this list
of LAC, with more than 31,000 publications in the Science Citation
Index (SCI) (representing 2.32%), Mexico (0.64%), Argentina (0.49%)
and Chile (0.27%). %) These four countries contribute about 90% of
the total investment in research and development in LAC and they
are close to 2% of the national budget of public health in research
[21-30], In the Human Development Index, it classifies the countries
according to a social indicator that includes life expectancy, education
and income, in turn, it is associated with the incidence and prevalence
of certain types of cancer; LAC needs to increase knowledge for the
implementation and evaluation of preventive policies and early
detection. Barriers are bureaucratic obstacles, lack of information
and adequate administration, underutilization of available public
resources. The majority of gynecological cancer information is related
to CaCu and this is a general overview of the cancer situation in LAC.
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