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Instituto Nacional de Salud Pública

2018, Número 6

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salud publica mex 2018; 60 (6)


Nuevas estrategias de prevención y control de cáncer de cuello uterino en Chile

Ferreccio C

Idioma: Español
Referencias bibliográficas: 35
Paginas: 713-721
Archivo PDF: 546.75 Kb.


RESUMEN

Objetivos. Discutir el cáncer cervicouterino (CC), el virus del papiloma humano (VPH), el programa de control del CC y proponer alternativas para Chile. Material y métodos. Se analiza el programa nacional del CC 1966-2015 y la guía clínica 2015-2020, la prevalencia de VPH en mujeres y en casos de CC; la infección y serología de VPH; la autotoma; la precisión y rentabilidad del tamizaje con VPH contra el Papanicolaou y las opciones de triaje en VPH AR positivas. Resultados. En Chile mueren 600 mujeres (principalmente de bajos recursos) al año por CC. La cobertura del Papanicolaou es ‹ 70%, sensibilidad muy inferior al test de VPH, por lo que el cambio es rentable. Desde 2015 se vacuna contra VPH a niñas menores de 13 años. Conclusiones. Las condiciones técnicas y económicas existen en Chile para lograr una mejoría sustancial del CC: se sugiere el reemplazo del Papanicolaou por el examen de VPH; tamizaje cada cinco años con opción de autotoma; triaje con base en la tipificación de VPH 16/18 o Papanicolaou.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Murillo R, Herrero R, Sierra MS, Forman D. Cervical cancer in Central and South America: Burden of disease and status of disease control. Cancer Epidemiol. 2016;44(supl 1):S121-30. https://doi.org/10.1016/j. canep.2016.07.015

  2. Ferreccio C, Barriga MI, Lagos M, Ibáñez C, Poggi H, González F, et al. Screening trial of human papillomavirus for early detection of cervical cancer in Santiago, Chile. Int J Cancer. 2013;132(4):916-23. https://doi. org/10.1002/ijc.27662. Fe de erratas en: Int J Cancer. 2013;133(2):E1.

  3. Sepúlveda C, Prado R. Effective cervical cytology screening programmes in middle-income countries: the Chilean experience. Cancer Detect Prev. 2005;29(5):405-11. https://doi.org/10.1016/j.cdp.2005.07.001

  4. Ministerio de Salud de Chile. Porcentaje de cobertura de mujeres beneficiarias de 25 a 64 años con PAP Vigente, por Servicio de Salud, 2010 - 2011. Santiago: Minsal. Disponible en http://www.deis.cl/wp-content/ uploads/2013/05/CoberturaPAPOficial_SS2010_2011.pdf

  5. Ministerio de Desarrollo Social. Santiago: Encuesta de Caracterización Socioeconómica Nacional (CASEN) 2016. [Internet] [aproximadamente 4 pantallas]. Chile: Mindes, c2018- [citado febrero 4, 2018]. Disponible en: http://observatorio.ministeriodesarrollosocial.gob.cl/casen-multidimensional/ casen/casen_2015.php

  6. Ferreccio C, Prado RB, Luzoro AV, Ampuero SL, Snijders PJ, Meijer CJ, et al. Population-based prevalence and age distribution of human papillomavirus among women in Santiago, Chile. Cancer Epidemiol Biomarkers Prev. 2004;13(12):2271-6.

  7. Lazcano-Ponce E, Herrero R, Muñoz N, Cruz A, Shah KV, Alonso P, et al. Epidemiology of HPV infection among Mexican women with normal cervical cytology. Int J Cancer. 2001;91:412-20. https://doi.org/10.1002/1097- 0215(20010201)91:3<412:AID-IJC1071>3.0.CO;2-M

  8. Herrero R, Hildesheim A, Bratti C, Sherman ME, Hutchinson M, Morales J, et al. Population-based study of human papillomavirus infection and cervical neoplasia in rural Costa Rica. J Natl Cancer Inst. 2000;92(6):464- 74. https://doi.org/10.1093/jnci/92.6.464

  9. Molano M, Posso H, Weiderpass E, van den Brule AJ, Ronderos M, Franceschi S, HPV Study Group. Prevalence and determinants of HPV infection among Colombian women with normal cytology. Br J Cancer. 2002;87(3):324-33. https://doi.org/10.1038/sj.bjc.6600442

  10. Ferreccio C, Corvalán A, Margozzini P, Viviani P, González C, Aguilera X, et al. Baseline assessment of prevalence and geographical distribution of HPV types in Chile using self-collected vaginal samples. BMC Public Health. 2008;8:78. https://doi.org/10.1186/1471-2458-8-78

  11. Castro FA, Dominguez A, Puschel K, Van De Wyngard V, Snijders PJ, Franceschi S, et al. Serological prevalence and persistence of high-risk human papillomavirus infection among women in Santiago, Chile. BMC Infect Dis. 2014;14:361. https://doi.org/10.1186/1471-2334-14-361

  12. Ferreccio C, Van De Wyngard V, Olcay F, Domínguez MA, Puschel K, Corvalán AH, et al. High-risk HPV infection after five years in a population- based cohort of Chilean women. Infect Agent Cancer. 2011;6(1):21. https://doi.org/10.1186/1750-9378-6-21

  13. Roa JC, Garcia P, Gomez J, Fernández W, Gaete F, Espinoza A, et al. HPV genotyping from invasive cervical cancer in Chile. Int J Gynaecol Obstet. 2009;105(2):150-3. https://doi.org/10.1016/j.ijgo.2008.12.017

  14. Terrazas S, Ibáñez C, Lagos M, Poggi H, Brañes J, Barriga MI, et al. Examen de detección de virus papiloma humano en el tamizaje de cáncer cervicouterino en un Servicio de Salud de Santiago, Chile. Rev Med Chil. 2015;143(1):56-62. https://doi.org/10.4067/S0034-98872015000100007

  15. Léniz-Martelli J, Van De Wyngard V, Lagos M, Barriga MI, Puschel-Illanes K, Ferreccio-Readi C. Detección precoz del cáncer cervicouterino en Chile: tiempo para el cambio. Rev Med Chil. 2014;142(8):1047-55. https:// doi.org/10.4067/S0034-98872014000800012

  16. Lagos M, Van De Wyngard V, Poggi H, Cook P, Viviani P, Barriga MI, et al. HPV16/18 genotyping for the triage of HPV positive women in primary cervical cancer screening in Chile. Infect Agent Cancer. 2015;10:43. https:// doi.org/10.1186/s13027-015-0038-5

  17. Benoy IH, Broeck DV, Ruymbeke MJ, Sahebali S, Arbyn M, Bogers JJ, et al. Prior knowledge of HPV status improves detection of CIN2 by cytology screening. Am J Obstet Gynecol. 2011;205(6):569.e1-7. https:// doi.org/10.1016/j.ajog.2011.06.101

  18. Arrossi S, Ramos S, Straw C, Thouyaret L, Orellana L. HPV testing: a mixed-method approach to understand why women prefer self-collection in a middle-income country. BMC Public Health. 2016;16:832. https://doi. org/10.1186/s12889-016-3474-2

  19. Léniz J, Barriga MI, Lagos M, Ibáñez C, Puschel K, Ferreccio C. HPV vaginal self-sampling among women non-adherent to Papanicolaou screening in Chile. Salud Publica Mex. 2013;55(2):162-9. https://doi.org/10.1590/ S0036-36342013000200007

  20. Franco-Figueira S, Cachoeira CV, Souza FH, Kano BY, Silva M, Poulios N. Cost-effectiveness analysis for cervical cancer screening using Hpv Tests in Chile. Value Health. 2015;18(7):A805-6. https://doi.org/10.1016/j. jval.2015.09.077

  21. Franco-Figueira S, Cachoeira CV, Souza FH, Kano BY, Silva M, Poulios N. Budget Impact model for cervical cancer screening using Hpv Tests in Chile. Value Health. 2015;18(7):A858. https://doi.org/10.1016/j. jval.2015.09.474

  22. Broberg G, Gyrd-Hansen D, Miao Jonasson J, Ryd ML, Holtenman M, Milsom I, et al. Increasing participation in cervical cancer screening: offering a HPV self-test to long-term non-attendees as part of RACOMIP, a Swedish randomized controlled trial. Int J Cancer. 2014;134(9):2223-30. https://doi.org/10.1002/ijc.28545

  23. C Kitchener H, Canfell K, Gilham C, Sargent A, Roberts C, Desai M, et al. The clinical effectiveness and cost-effectiveness of primary human papillomavirus cervical screening in England: extended follow-up of the ARTISTIC randomized trial cohort through three screening rounds. Health Technol Assess. 2014;18(23):1-196. https://doi.org/10.3310/hta18230

  24. Naber SK, Matthijsse SM, Rozemeijer K, Penning C, de Kok IM, van Ballegooijen M. Cervical cancer screening in partly HPV vaccinated cohorts – A cost-effectiveness analysis. PLoS One. 2016;11(1):e0145548. https:// doi.org/10.1371/journal.pone.0145548

  25. Chow IH, Tang CH, You SL, Liao CH, Chu TY, Chen CJ, et al. Costeffectiveness analysis of human papillomavirus DNA testing and Pap smear for cervical cancer screening in a publicly financed health-care system. Br J Cancer. 2010;103(12):1773-82. https://doi.org/10.1038/sj.bjc.6605974

  26. Balasubramanian A, Kulasingam SL, Baer A, Hughes JP, Myers ER, Mao C, et al. Accuracy and cost-effectiveness of cervical cancer screening by high-risk human papillomavirus DNA testing of self-collected vaginal samples. J Low Genit Tract Dis. 2010;14(3):185-95. https://doi.org/10.1097/ LGT.0b013e3181cd6d36

  27. Valdez M, Jeronimo J, Bansil P, Qiao YL, Zhao FH, Chen W, et al. Effectiveness of novel, lower cost molecular human papillomavirus-based tests for cervical cancer screening in rural china. Int J Cancer. 2016;138:1453- 61. https://doi.org/10.1002/ijc.29877

  28. Ministerio de Salud de Chile. Guía Clínica AUGE. Cáncer Cervicouterino (CaCu). Santiago: Minsal, 2015. Disponible en: http://web.minsal.cl/ wp-content/uploads/2015/09/GPC-CaCU.pdf

  29. Balanda M, Quiero A, Vergara N, Espinoza G, Martín HS, Rojas G, Ramírez E. Prevalence of human papillomavirus infection among women presenting for cervical cancer screening in Chile, 2014-2015. Med Microbiol Immunol. 2016;205(6):585-94. https://doi.org/10.1007/s00430-016-0473-y

  30. Djemli A, Khetani K, Case BW, Auger M. Correlation of cytotechnologists’ parameters with their performance in rapid prescreening of Papanicolaou smears. Cancer. 2006;108(5):306-10. https://doi.org/10.1002/cncr.22166

  31. Jeronimo J, Bansil P, Lim J, Peck R, Paul P, START-UP Study Group, et al. A multicountry evaluation of careHPV testing, visual inspection with acetic acid, and papanicolaou testing for the detection of cervical cancer. Int J Gynecol Cancer. 2014;24(3):576-85. https://doi.org/10.1097/ IGC.0000000000000084

  32. López-Alegría F, Lorenzi DR, Poblete OQ. Follow-up of women with inadequate Pap smears: a prospective cohort study. Sao Paulo Med J. 2015;133(1):20-7. https://doi.org/10.1590/1516-3180.2013.7070004

  33. Naber SK, de Kok IM, Matthijsse SM, van Ballegooijen M. The potential harms of primary human papillomavirus screening in over-screened women: a microsimulation study. Cancer Causes Control. 2016;27(4):569-81. https://doi.org/10.1007/s10552-016-0732-7

  34. Comisión Nacional de Vacunas y Estrategias de Vacunación (CAVEI). Vacuna contra el virus del papiloma humano (VPH). Santiago de Chile: Minsal, 2012 [citado febrero 4, 2018]. Disponible en: http://www.minsal.cl/ sites/default/files/files/VPHCAVEIRecomendacionOctubre2012.pdf

  35. Schiffman M. Cervical cancer screening: Epidemiology as the necessary but not sufficient basis of public health practice. Prev Med. 2017;98:3-4. https://doi.org/10.1016/j.ypmed.2016.12.028




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