Moving towards a strategy to accelerate cervical cancer elimination in a high-burden city-Lessons learned from the Amazon city of Manaus, Brazil.

The World Health Organization Call to Eliminate Cervical Cancer resonates in cities like Manaus, Brazil, where the burden is among the world's highest. Manaus has offered free cytology-based screening since 1990 and HPV immunization since 2013, but the public system is constrained by many chall...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Kátia Luz Torres, Heidy Halanna de Melo Farah Rondon, Toni Ricardo Martins, Sandro Martins, Ana Ribeiro, Taina Raiol, Carla Pintas Marques, Flavia Corrêa, Arn Migowski, Thais Tâmara Castro E Minuzzi-Souza, Mark Schiffman, Ana Cecilia Rodriguez, Julia C Gage
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/24d32b66f67a4630b0b62acab92a1612
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:24d32b66f67a4630b0b62acab92a1612
record_format	dspace
spelling	oai:doaj.org-article:24d32b66f67a4630b0b62acab92a16122021-12-02T20:16:49ZMoving towards a strategy to accelerate cervical cancer elimination in a high-burden city-Lessons learned from the Amazon city of Manaus, Brazil.1932-620310.1371/journal.pone.0258539https://doaj.org/article/24d32b66f67a4630b0b62acab92a16122021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258539https://doaj.org/toc/1932-6203The World Health Organization Call to Eliminate Cervical Cancer resonates in cities like Manaus, Brazil, where the burden is among the world's highest. Manaus has offered free cytology-based screening since 1990 and HPV immunization since 2013, but the public system is constrained by many challenges and performance is not well-defined. We obtained cervical cancer prevention activities within Manaus public health records for 2019 to evaluate immunization and screening coverage, screening by region and neighborhood, and the annual Pink October screening campaign. We estimated that among girls and boys age 14-18, 85.9% and 64.9% had 1+ doses of HPV vaccine, higher than rates for age 9-13 (73.4% and 43.3%, respectively). Of the 90,209 cytology tests performed, 24.9% were outside the target age and the remaining 72,230 corresponded to 40.1% of the target population (one-third of women age 25-64). The East zone had highest screening coverage (49.1%), highest high-grade cytology rate (2.5%) and lowest estimated cancers (38.1/100,000) compared with the South zone (32.9%, 1.8% and 48.5/100,000, respectively). Largest neighborhoods had fewer per capita screening locations, resulting in lower coverage. During October, some clinics successfully achieved higher screening volumes and high-grade cytology rates (up to 15.4%). Although we found evidence of some follow-up within 10 months post-screening for 51/70 women (72.9%) with high-grade or worse cytology, only 18 had complete work-up confirmed. Manaus has successfully initiated HPV vaccination, forecasting substantial cervical cancer reductions by 2050. With concerted efforts during campaigns, some clinics improved screening coverage and reached high-risk women. Screening campaigns in community locations in high-risk neighborhoods using self-collected HPV testing can achieve widespread coverage. Simplifying triage and treatment with fewer visits closer to communities would greatly improve follow-up and program effectiveness. Achieving WHO Cervical Cancer Elimination goals in high-burden cities will require major reforms for screening and simpler follow-up and treatment.Kátia Luz TorresHeidy Halanna de Melo Farah RondonToni Ricardo MartinsSandro MartinsAna RibeiroTaina RaiolCarla Pintas MarquesFlavia CorrêaArn MigowskiThais Tâmara Castro E Minuzzi-SouzaMark SchiffmanAna Cecilia RodriguezJulia C GagePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258539 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kátia Luz Torres Heidy Halanna de Melo Farah Rondon Toni Ricardo Martins Sandro Martins Ana Ribeiro Taina Raiol Carla Pintas Marques Flavia Corrêa Arn Migowski Thais Tâmara Castro E Minuzzi-Souza Mark Schiffman Ana Cecilia Rodriguez Julia C Gage Moving towards a strategy to accelerate cervical cancer elimination in a high-burden city-Lessons learned from the Amazon city of Manaus, Brazil.
description	The World Health Organization Call to Eliminate Cervical Cancer resonates in cities like Manaus, Brazil, where the burden is among the world's highest. Manaus has offered free cytology-based screening since 1990 and HPV immunization since 2013, but the public system is constrained by many challenges and performance is not well-defined. We obtained cervical cancer prevention activities within Manaus public health records for 2019 to evaluate immunization and screening coverage, screening by region and neighborhood, and the annual Pink October screening campaign. We estimated that among girls and boys age 14-18, 85.9% and 64.9% had 1+ doses of HPV vaccine, higher than rates for age 9-13 (73.4% and 43.3%, respectively). Of the 90,209 cytology tests performed, 24.9% were outside the target age and the remaining 72,230 corresponded to 40.1% of the target population (one-third of women age 25-64). The East zone had highest screening coverage (49.1%), highest high-grade cytology rate (2.5%) and lowest estimated cancers (38.1/100,000) compared with the South zone (32.9%, 1.8% and 48.5/100,000, respectively). Largest neighborhoods had fewer per capita screening locations, resulting in lower coverage. During October, some clinics successfully achieved higher screening volumes and high-grade cytology rates (up to 15.4%). Although we found evidence of some follow-up within 10 months post-screening for 51/70 women (72.9%) with high-grade or worse cytology, only 18 had complete work-up confirmed. Manaus has successfully initiated HPV vaccination, forecasting substantial cervical cancer reductions by 2050. With concerted efforts during campaigns, some clinics improved screening coverage and reached high-risk women. Screening campaigns in community locations in high-risk neighborhoods using self-collected HPV testing can achieve widespread coverage. Simplifying triage and treatment with fewer visits closer to communities would greatly improve follow-up and program effectiveness. Achieving WHO Cervical Cancer Elimination goals in high-burden cities will require major reforms for screening and simpler follow-up and treatment.
format	article
author	Kátia Luz Torres Heidy Halanna de Melo Farah Rondon Toni Ricardo Martins Sandro Martins Ana Ribeiro Taina Raiol Carla Pintas Marques Flavia Corrêa Arn Migowski Thais Tâmara Castro E Minuzzi-Souza Mark Schiffman Ana Cecilia Rodriguez Julia C Gage
author_facet	Kátia Luz Torres Heidy Halanna de Melo Farah Rondon Toni Ricardo Martins Sandro Martins Ana Ribeiro Taina Raiol Carla Pintas Marques Flavia Corrêa Arn Migowski Thais Tâmara Castro E Minuzzi-Souza Mark Schiffman Ana Cecilia Rodriguez Julia C Gage
author_sort	Kátia Luz Torres
title	Moving towards a strategy to accelerate cervical cancer elimination in a high-burden city-Lessons learned from the Amazon city of Manaus, Brazil.
title_short	Moving towards a strategy to accelerate cervical cancer elimination in a high-burden city-Lessons learned from the Amazon city of Manaus, Brazil.
title_full	Moving towards a strategy to accelerate cervical cancer elimination in a high-burden city-Lessons learned from the Amazon city of Manaus, Brazil.
title_fullStr	Moving towards a strategy to accelerate cervical cancer elimination in a high-burden city-Lessons learned from the Amazon city of Manaus, Brazil.
title_full_unstemmed	Moving towards a strategy to accelerate cervical cancer elimination in a high-burden city-Lessons learned from the Amazon city of Manaus, Brazil.
title_sort	moving towards a strategy to accelerate cervical cancer elimination in a high-burden city-lessons learned from the amazon city of manaus, brazil.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/24d32b66f67a4630b0b62acab92a1612
work_keys_str_mv	AT katialuztorres movingtowardsastrategytoacceleratecervicalcancereliminationinahighburdencitylessonslearnedfromtheamazoncityofmanausbrazil AT heidyhalannademelofarahrondon movingtowardsastrategytoacceleratecervicalcancereliminationinahighburdencitylessonslearnedfromtheamazoncityofmanausbrazil AT toniricardomartins movingtowardsastrategytoacceleratecervicalcancereliminationinahighburdencitylessonslearnedfromtheamazoncityofmanausbrazil AT sandromartins movingtowardsastrategytoacceleratecervicalcancereliminationinahighburdencitylessonslearnedfromtheamazoncityofmanausbrazil AT anaribeiro movingtowardsastrategytoacceleratecervicalcancereliminationinahighburdencitylessonslearnedfromtheamazoncityofmanausbrazil AT tainaraiol movingtowardsastrategytoacceleratecervicalcancereliminationinahighburdencitylessonslearnedfromtheamazoncityofmanausbrazil AT carlapintasmarques movingtowardsastrategytoacceleratecervicalcancereliminationinahighburdencitylessonslearnedfromtheamazoncityofmanausbrazil AT flaviacorrea movingtowardsastrategytoacceleratecervicalcancereliminationinahighburdencitylessonslearnedfromtheamazoncityofmanausbrazil AT arnmigowski movingtowardsastrategytoacceleratecervicalcancereliminationinahighburdencitylessonslearnedfromtheamazoncityofmanausbrazil AT thaistamaracastroeminuzzisouza movingtowardsastrategytoacceleratecervicalcancereliminationinahighburdencitylessonslearnedfromtheamazoncityofmanausbrazil AT markschiffman movingtowardsastrategytoacceleratecervicalcancereliminationinahighburdencitylessonslearnedfromtheamazoncityofmanausbrazil AT anaceciliarodriguez movingtowardsastrategytoacceleratecervicalcancereliminationinahighburdencitylessonslearnedfromtheamazoncityofmanausbrazil AT juliacgage movingtowardsastrategytoacceleratecervicalcancereliminationinahighburdencitylessonslearnedfromtheamazoncityofmanausbrazil
_version_	1718374456930336768

Moving towards a strategy to accelerate cervical cancer elimination in a high-burden city-Lessons learned from the Amazon city of Manaus, Brazil.

Ejemplares similares