Cervical cancer screening programs in Latin America: current recommendations for facing elimination challenges.

ABSTRACT

OBJECTIVE: To describe current cervical cancer screening program guidelines in Latin America. MATERIALS AND METHODS: We searched official recommendations for the general population and women living with HIV (WLHIV) by reviewing official sources from 19 countries; these data were supplemented with a consultation carried out by the WHO with the Ministries of Health. RESULTS: Screening policies vary significantly in regard to target populations, primary tests, and screening intervals. Sixteen countries have recently updated their recommendations; however, cytology remains the primary screening test for most countries. Eleven countries have introduced HPV tests, and eight countries have implemented screen-and-treat algorithms; only three countries have developed evidence-based guidelines. All countries but Costa Rica have specific recommendations for WLHIV. CONCLUSIONS: Although most countries have updated their screening policies, only a few are properly alig-ned with the WHO elimination strategy. Recommendations for WLHIV require better integration with cervical cancer screening programs.