Recently, the open access on-line journal ecancermedicalscience published a special report on the incidence and prevalence of cervical cancer in Latin America. The primary study, entitled “Persistent infection with high-risk human papilloma viruses: cohort study, Mérida, Venezuela,” concluded that certain subsets of the population of women in Latin America are at increased risk for cervical cancer and recognize that this could lead to a public health crisis in countries where health care resources are already limited.
According to the journal’s guest editors, Drs. María Correnti and María Eugenia Cavazza of the Central University of Venezuela, Caracas, Venezuela: “Cervical cancer is an ‘enormous burden’ for Latin American society, and the third leading cause of cancer deaths among women in the region. In contrast to other types of cancer, cervical cancer is a preventable and curable disease if it is diagnosed and treated early. But the absence of an effective prevention strategy leads to delayed diagnosis, and turns it into one of the leading causes of death among young women.”
The Pan American Health Organization estimated that cervical cancer killed 36,000 people in the Americas in 2012, with 80% of those deaths occurring in Latin America and the Caribbean.
To understand the extent of the disease burden, the authors conducted an epidemiological investigation and sampled 409 women, randomly selected, between the ages of 15 and 69, who were either sexually active or who had initiated sexual activity, and had attended the gynecology department of the Autonomous Institute University Hospital of Los Andes (IAHULA) in Venezuela during the study period. Each participant underwent a full gynecological exam that included a pap-smear with two cervical swabs, one specifically used to collect DNA. The examination was used to screen for certain types of human papilloma virus (HPV) infection, which is considered a key precursor for the development of cervical cancer, and for cervical cancer.
The primary study findings showed that of the sampled population, HPV viral DNA was detected in 37.40% of cervical specimens. Other findings with important public health implications included:
- A distinct difference in both frequency and distribution of HPV infection by age group
- 85% of HPV infections arose in women under 45 years of age
- HPV genotype prevalence found in the 153 samples was positive for infection
- Among the 85.96% of HPV detected, the majority (80.92%) corresponded to high-risk oncogenic genotypes, HPV16 and 18
- In 153 of the cervical samples, mixed infections by HPV genotype were detected
- The cumulative incidence for HPV was 10.34% (3/29)
- The incidence rate was 4.23% (3/71), which is equal to 4.23 new cases of HPV infection per 100 people, per year of follow-up
The authors concluded that within the Latin American population there is a high frequency of infection by high-risk HPV, which may lead to an increased risk for cervical cancer.