Cervical cancer prevention: the case of developing countries.

T his special issue of Salud Publica de Mexico presents an overview of the latest findings on prevention and screening of cervical cancer (CC), as well as new possible approaches to early diagnosis and intervention for controlling this neoplastic disease. Similar to other developing countries, CC persists in Mexico as a serious public health problem. Three main components to the burden of disease include: the suffering and grief of patients and their families, the side effects of therapy, and its related costs. A positive note in the presence of the high morbidity and mortality caused by CC is that it clearly shows how interdisciplinary cancer research is the best tool to control this disease. The cause of CC is now known. The presence of human papillomavirus (HPV) in cervical epithelial cells can be unequivocally identified. We now know which viral types pose a risk and the likelihood of neoplasia development. Also, an international effort is ongoing to develop a vaccine that will prevent infection due to HPV oncogenic types. In Latin America primary prevention is not directed at women only, but also at their sexual partners, who should also take part in health education programs. Only then will control of HPV transmission be possible. It should be highlighted that inadequate prevention and untimely diagnosis further complicate control of the disease in advanced stages. Evidence observed in various clinical studies shows that patients with cervical cancer should receive chemotherapy together with radiotherapy. This approach results in higher costs and morbidity associated with therapy in advanced disease and compels to conducting cost-benefit studies of this disease. The different papers included in this issue on CC prevention and screening emphasize the benefits of HPV DNA testing and its high sensitivity. A negative predictive value of 100% invites to a discussion on how EDITORIAL Cervical cancer prevention: The case of developing countries