Prevention and early detection of cervical cancer in Chile: An updated literature review

Abstract

Introduction: Cervical cancer remains a global public health problem, despite being largely preventable. In Chile, mortality has decreased thanks to the Screening and Control Program implemented in 1987, but cervical cancer remains significant, ranking fourth in incidence and ninth in mortality, with notable gaps in Papanicolaou coverage. Objective: To compare cervical cancer prevention strategies in Chile with international recommendations, identifying gaps and opportunities for improvement to guide public health policies. Methodology: A literature review of national and international literature was conducted, including systematic reviews, meta-analyses, and articles in Spanish and English. From 311 initial documents, 21 studies were selected and analyzed regarding primary and secondary prevention, screening, and self-sampling. Result: The Papanicolaou test remains the main screening method in Chile, performed every three years for women aged 25 to 64, achieving only 66,2% coverage. The HPV test, more sensitive and cost-effective, is offered complementarily for women aged 30 to 64. HPV self-sampling has shown high acceptance, increasing participation and detecting precancerous lesions. Internationally, primary HPV screening allows greater detection and longer intervals between tests, whereas its implementation in Chile is limited. Discussion: There is a persistent lag in the adoption of cervical cancer prevention strategies. Low Papanicolaou test coverage and barriers to access highlight the need to modernize secondary prevention approaches. Conclusion: Despite progress, gaps in coverage and access persist. Expanding the use of HPV testing and self-sampling is recommended, as these are feasible, cost-effective strategies that optimize secondary prevention and promote greater equity in access.