Cervical cancer represents one of the most pressing yet preventable crises in global health. It remains the fourth most common cancer among women worldwide, with 94% of deaths occurring in low- and middle-income countries, a stark testament to the role that inequality plays in who survives this disease. Indigenous women bear a disproportionate share of this burden, with some of the highest incidence rates concentrated in Central America.

Positively, vaccines for this disease are extremely effective, when administered at a young age HPV vaccine prevents infection, cervical cancer and other HPV-related disorders. The World Health Organization (WHO) has the goal to reduce the number of annual cases of cervical cancer to fewer than four per 100,000 women. Despite having such effective vaccines, a major issue lies with the accessibility and distribution of diagnostic tests and the subsequent intervention provision.

Cervical Cancer in Latin America

While the WHO’s elimination goal is ambitious, the reality for Latin America tells a different story – cervical cancer deaths in the region are projected to surpass 51,500 by 2030, with 89% of those occurring in Latin America and the Caribbean. Women across the region feel the burden. In El Salvador, 2.53 million women aged 15 and older are at risk of developing cervical cancer, representing a significant proportion of the country’s 6.3 million population.

The picture is similarly concerning in Guatemala, where 6.10 million women face the same risk out of a population of 18.6 million. Compounding this, HPV vaccination coverage in Guatemala stands at just 35%, with only 15% of individuals completing their final dose. El Salvador fares only marginally better at 43%, a figure that still falls well short of the WHO’s 90% target.

An example of how improved vaccination rates reduce prevalence and mortality together can be observed from Costa Rica. Here the Crude incidence rates sit at 14.4 for females with HPV-related cancers.

Prevention

A recurring challenge across the region is lack of awareness surrounding HPV, its link to cervical cancer, and the safety of available vaccines. In many indigenous and rural communities, misinformation and limited access to health education contribute to the low vaccination uptake seen in countries like Guatemala and El Salvador. Addressing this through community-led outreach and culturally sensitive health programs could be a foundational step towards closing the gap.

The Cervical Cancer Foundation works in collaboration with non-profits to lobby for legislative change and vitally provide health training to educate communities on the importance of HPV screening and available vaccines. Crucially, they provide cervical cancer prevention strategies within Latin America to aid in the reduction of this gap. With financial support from the Union of International Cancer Control, they aim to train more than 200 health educators from El Salvador to Costa Rica.

Screening

Yet even when education and vaccination efforts improve, a separate challenge remains: screening. The WHO’s elimination framework calls for screening of 70% of women with high-performance tests by the age of 35 and again by 45. In much of Latin America, this target is still far due to a shortage of trained gynaecologists, limited clinical infrastructure and the geographic remoteness of many at-risk communities. This is where an emerging technology may offer a meaningful solution- the diagnostic tampon.

A recent and applicable advancement for HPV has been analysed and assessed for usage in other LMIC’s. For example, in Tanzania, the use of diagnostic tampons has emerged as a promising, accurate method for cervical cancer screening. This reduces the need for trips to far or inaccessible hospitals for rural communities and those most at risk.

Studies comparing the accuracy of diagnostic tampons with clinician-collected samples for detecting HPV further corroborate this, demonstrating that use of diagnostic tampons has an overall accuracy of 95%, proving an easily implementable and highly specific screening tool.

Looking ahead

The diagnostic tampon is not a standalone solution. Eliminating cervical cancer in Latin America could require sustained investment across the entire health care system- from early education and vaccine distribution mechanisms to clinical infrastructure. However, this diagnostic tampon does represent significant advancements: practical and high-accuracy screening tools which meet women where they are rather than navigating systems which have historically excluded them. Thus, integrating this screening tool into existing public health frameworks, further backed by education, political will and adequate funding, offers a credible path towards turning the tide on one of the more preventable cancers.

– Juliette Dall’Aglio

Juliette is based in London, UK and focuses on Technology and Global Health for The Borgen Project.

Photo: Flickr