Novais Iria Riberio, Coelho Camila Olegario, Carvalho Carla Fabrine, Surita Fernanda, Vale Diama Bhadra
Department of Obstetrics and Gynecology, University of Campinas. Rua Vital Brasil, 80. CEP 13083-888, Campinas, São Paulo, Brazil.
Prev Med Rep. 2024 Dec 24;49:102955. doi: 10.1016/j.pmedr.2024.102955. eCollection 2025 Jan.
To review the epidemiological evidence of cervical cancer among Indigenous women living in Latin America.
We conducted a systematic review of the evidence contained in 10 databases spanning 2003-2019. Two reviewers independently compared papers' titles and abstracts against the inclusionary criteria, and a third reviewer resolved discrepancies. Blinded reviewers performed the selection. The articles were organized into the following categories: rates, access, and screening; prevalence of precursor lesions; prevalence and genotypes of Human papillomavirus (HPV); and HPV coinfections.
Of the 874 manuscripts we reviewed, 25 were included in the final analysis. We found that cervical cancer is the leading cancer in terms of incidence and mortality among Indigenous women; it presents in advanced stages and is associated with poor survival rates. The prevalence of precursor lesions was higher in women who were geographically isolated. Screening appears to improve outcomes, but women may experience delays in their diagnosis and treatment. Some studies reported populations with a very high prevalence of high-risk Human papillomavirus (hrHPV), and the most frequent genotypes were not different from those of the general population. was significantly associated with HPV infection.
The data suggested a lack of indicators regarding cervical cancer and its precursor lesions, HPV infection, and cancer indicators. Health policies should target this vulnerable population.
回顾拉丁美洲原住民女性宫颈癌的流行病学证据。
我们对2003年至2019年期间10个数据库中的证据进行了系统评价。两名评审员独立对照纳入标准比较论文的标题和摘要，第三名评审员解决分歧。由不知情的评审员进行筛选。文章被分为以下几类：发病率、可及性和筛查；癌前病变的患病率；人乳头瘤病毒（HPV）的患病率和基因型；以及HPV合并感染。
在我们评审的874篇手稿中，25篇被纳入最终分析。我们发现，宫颈癌是原住民女性中发病率和死亡率最高的癌症；它多在晚期出现，且生存率较低。地理上孤立的女性中癌前病变的患病率更高。筛查似乎能改善结果，但女性可能在诊断和治疗上出现延迟。一些研究报告高危人乳头瘤病毒（hrHPV）患病率非常高的人群，且最常见的基因型与普通人群无异。 与HPV感染显著相关。
数据表明缺乏关于宫颈癌及其癌前病变、HPV感染和癌症指标的指标。卫生政策应针对这一弱势群体。
