Challenges faced by cervical cancer prevention programs in developing countries: a situational analysis of program organization in Argentina Retos de los programas de prevención de cáncer cervicouterino en países en desarrollo: análisis de situación de la organización del programa en Argentina

• Main Authors: Silvina Arrossi, Melisa Paolino, Rengaswamy Sankaranarayanan
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2010
• Subjects: Neoplasias del cuello uterino; prevención de cáncer de cuello uterino; servicios de salud para mujeres; análisis de la situación; programas de gobierno; sistemas de salud; Argentina; Uterine cervical neoplasms; cervix neoplasms prevention; women's health services; analysis of situation; government programs; health systems; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doaj.org/article/05d70df23a1f47ce98181791af0e96f0

OBJECTIVE: To carry out a situational analysis of cervical cancer prevention activities in Argentina, specifically regarding (a) the organizational framework of cervical cancer prevention activities; (b) Pap-smear coverage; (c) cytology laboratory organization; and (d) follow-up/treatment of women with abnormal lesions. METHODS: A situational analysis of provincial cervical cancer programs using data from an ad-hoc questionnaire sent to the leaders of cervical cancer prevention programs in Argentina's 24 provinces. In addition, the provinces' program guidelines, statistical reports, laws, and program regulations were reviewed and certain key leaders were personally interviewed. RESULTS: Data were obtained for 19 of Argentina's 24 provinces. Four of the 19 provinces had no formal program framework. Conventional cytology was the most commonly used screening test. Screening was mainly opportunistic. The recommended interval between normal tests was 3 years in most provinces. The eligible age for screening ranged from 10-70 years of age; however, annual or biannual screening was the usual practice after becoming sexually active. None of the provincial programs had data available regarding Pap-smear coverage. Most of the cytology laboratories did not have a quality control policy. The number of smears read varied greatly by laboratory (650-24 000 per year). A log of events related to screening and treatment did not exist in most provinces. CONCLUSIONS: Screening in Argentina is mainly opportunistic, characterized by an estimated low coverage, coexisting with over-screening of women with access to health services, and an absence of quality control procedures. Policies for cervical cancer screening in the provinces vary and, most often, deviate from the national recommendation of one Pap smear every 3 years for women 35-64 years of age. Ensuring compliance with national program guidelines is an essential step toward significantly reducing the burden of cervical cancer. OBJETIVO: Realizar un análisis de la situación ...