Control of cervical cancer in Peru: Current barriers and challenges for the future (Review)

Aguilar,Alfredo; Pinto,Joseph  A.; Araujo,Jhajaira; Fajardo,Williams; Bravo,Leny; Pinillos,Luis; Vallejos,Carlos

doi:10.3892/mco.2016.926

Control of cervical cancer in Peru: Current barriers and challenges for the future (Review)

Authors:
- Alfredo Aguilar
- Joseph A. Pinto
- Jhajaira Araujo
- Williams Fajardo
- Leny Bravo
- Luis Pinillos
- Carlos Vallejos
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Affiliations: Department of Medical Oncology, Oncosalud‑AUNA, San Borja, Lima 41, Peru, Unit of Basic and Translational Research, Oncosalud‑AUNA, San Borja, Lima 41, Peru, School of Human Medicine, St. John's Private University, Chorrillos, Lima 09, Peru, Department of Radiotherapy, Oncosalud‑AUNA, San Borja, Lima 41, Peru
Published online on: June 10, 2016 https://doi.org/10.3892/mco.2016.926
Pages: 241-245
Copyright: © Aguilar et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Cervical cancer is the leading malignant neoplasm in Peruvian women. This malignancy is a public health problem and several efforts were previously performed to develop cancer control plans. Geographical, cultural, structural, infrastructural and procedural barriers can limit the implementation of such strategies. Several previous studies have characterized human papilloma virus (HPV) epidemiology, where prevalence of high‑risk HPV in adult females is ~12% and the prevalence in cervical cancer is 90‑95%. The predominant barriers for the control of cervical cancer are lack of specialists in remote villages, education/cultural issues, loss of patients in follow‑up, lack of access to HPV testing and lack of compliance for HPV vaccination. A good strategy for the prevention and early detection of high‑risk HPV, pre‑malignant neoplasms and cervical cancer, identified by interventional studies, is the self‑sampling test, which assists with overcoming the cultural and geographic barriers. The current cancer control plan, termed ‘Plan Esperanza’, is performed with massive training of health professionals and social sensitization campaigns leading to filling the gaps regarding education and, in addition, it provides cancer care coverage for poorer individuals. In our experience at Oncosalud‑AUNA, with a cohort of ~750,000 affiliates using a pre‑paid system with annual screenings for cervical cancer for women, offered free-of-charge, a lower incidence of this malignancy (5.8/100,000) is now observed compared with the national incidence (32.7/100,000). As in other countries, the HPV vaccination can be a cost‑utility strategy to reduce the high burdens of cervical cancer in Peru, a rapid and cheap HPV molecular sub-typification is rapidly required.

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