Health

Number of cases of cervical cancer may be higher than estimated by the Inca, says expert

01/24/2012

Rio de Janeiro - Brazil may close the year with a number of cases of cervical cancer much higher than the 17,500 estimated by the National Cancer Institute (Inca). Despite the alarming number, the director of the Institute Oncoguia Rafael Kaliks considers the conservative projection of the Inca. "There is a large variability in the number of cases per 100 000 inhabitants between the states and has no reason for a region having a much larger extent than others. There are places where the numbers are not being properly documented, "said oncologist.

Kaliks highlights, for example, the disease situation in Northern countries, where cervical cancer is still the type of cancer that kills women. "It is more common than breast cancer. If you think it is a cancer that can be prevented and that no one should die from this disease, since early detection with no cure, is a tragedy to allow this to be the leading cause of cancer death in the region. "

For the director of the institute responsible for the dissemination of information on various types of cancer, despite all the efforts the government have been doing since the 1990s, cases of the disease are increasing. Kaliks lists two reasons for the scenario set. The first is the low compliance of women to the Pap smear. "Or a pap smear is not never done or is being done improperly. The second reason is that even if a woman is diagnosed in some regions, until it is treated, may be months or even a year. And this period of delay of treatment, the disease ends up spreading or becoming intractable. When the woman comes to work she is no longer operable and she ends up dying from the disease. "

The oncologist says it is unacceptable that one woman dies from this cancer in the 20th century and endorses the inclusion of the vaccine against HPV (human papilloma virus, primarily responsible for cervical cancer) in the immunization schedule of public health. "If you have five projects to improve the tracking [examination and diagnosis of the virus] over 20 years and, despite the implementation of these five projects, the mortality is increasing, you have to be honest and say 'Let's do something else? , '"said the expert criticizing the government's position that the vaccine has not yet included in the national program.

"In addition to sex education, the vaccine would have to decrease by 90% or more the risk of developing premalignant lesions. The government relies on the argument that will occur is not known whether reduction of cancer cases is not to say that justified the incorporation of HPV vaccination in public. When the whole world is embracing this vaccine, "said Kaliks.

On the other hand, the Ministry of Health ensures that negotiations with the laboratories are in progress. "The National Immunization Program in Brazil is one of the most complete in the world. We now have three vaccines that are being analyzed [hepatitis A vaccine against chickenpox and HPV]. Before including a vaccine, the Ministry of Health has to do several studies because we need to look after the resources of the area, who are already lower than they should be, and we have to make sure that each vaccine will represent a breakthrough in health " explained Jarbas Barbosa, Secretary of Health Surveillance, Ministry of Health

By the calculations of the ministry today are spending R$ 1.6 billion around the vaccination program. Spending on the new vaccine would represent R$ 700 million the first year alone. "The vaccine has greatly reduced the price because it was a relative failure in the world. This vaccine has only been implemented in about 30 countries. In the United States, coverage is 30%, ie, with virtually no epidemiological impact. It is an injectable vaccine, which requires three doses. It is not a magic silver bullet that the person takes a dose and is protected from cancer, "Barbosa said, warning that even vaccinated women must continue to submit to periodic examinations.

The secretary pointed out that the vaccine only has an impact in 30 years, since the tests, he said, showed efficiency only among girls 9 to 12 years of age. "The vaccine would have no impact on the cases this year. Be vaccinated in 2012'd expect some impact from 2042. The concern that we have had is with the women's health. Think of the barriers that, despite advances in expanding coverage, are there? In few places is the difficulty of access, some are cultural barriers or lack of information, "mused Jarbas Barbosa.

Also according to the ministry, currently available vaccines do not cover all serotypes of HPV. "Even the manufacturers are developing new generation vaccines that cover eight to nine serotypes. In the negotiations that Brazil is already doing we want to ensure that the cost is acceptable and when does the technology transfer agreement, be assured that we will have access to this second generation of vaccines. If you do not have an old vaccine that covers less than 70% of the serotypes, "said Barbosa.

Edition: Lilian Beraldo


Source: Agency Brazil

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