The experience of the National Program on Cervical Cancer Prevention in Argentina: A comprehensive approach

ARROSSI S

Congreso; 5to. Congreso Internacional de Control de Cáncer; 2013

In Argentina, cytological screening has been available for more than 50 years, with very limited effect in modifying mortality rates, steady for the last 30 years. The National Program on Cervical Cancer Prevention (NPCCP) was re-launched in 2008, with the objective of strengthening provincial programs, achieving high screening/diagnosis/treatment coverage, and developing an information/monitoring/evaluation system. Agreements between national and provincial governments were signed in 10 provinces in order get consensus about the political priority of cervical cancer prevention and to coordinate activities. Communication/information strategies were designed for women from different regions and social background. Special emphasis was put in working with health professionals and authorities to increasing adherence to program guidelines (i.e. age/interval of screening, laboratory centralization). Citology laboratories were newly equipped, in-service training took place in 12 laboratories from 8 provinces, involving more than 95 staff. A team of navigators was implemented to provide support to women with precancerous lesions through the diagnosis/treatment process. SITAM (Information and Monitoring System for Screening) was implemented to monitor/evaluate program performance, currently in use in 19 provinces. In 5 provinces main labs have duplicated the number of read smears, decreased the percentage of unsatisfactory Paps and improved turnover-time. In 2011 the country initiated a demonstration project to introduce HPV-test for primary screening, as part of an integrated approach to prevent cervical cancer that also includes HPV-vaccination for girls aged 11. The goal is to HPV-screen 22000 women annually during three years, to reach 80% coverage. During 2012, 22589 women aged 30+ were screened, with a positivity rate of 12,7%. Among those, 921 had an abnormal Pap smear. Based on these results, HPV testing is being extended to other provinces. The work carried out by the NPCCP demonstrates that an important impact can be achieved in cervical cancer prevention through an integrated approach.