Chile has the lowest age-standardized incidence and mortality rates of cervical cancer in South America: 12,8 and 6 per 100.000 women per year respectively; largely due to a long time ongoing Cervical Cancer - Early Detection Program and free cervical cancer treatment.
Cervical cancer is the sixth cause of cancer death for Chilean women after breast, gallbladder, lung, stomach and colorectal/anus cancer with an annual crude mortality rate of 8,3 per 100.000 women. It constitutes however the second cause of cancer deaths in women aged 15 – 44 years with an annual crude mortality rate of 2,6 per 100.000 women, only behind breast cancer.
Nevertheless, the screening program (Citology every 3 years for women 25 - 64 years old) that peaked a 65% coverage between the years 2000 - 2005 has been decreasing since then with an actual percentage of 59-60%, with great differences between geographic regions and/or socioeconomic groups.
Considering this facts, plus the knowledge that HPV 16/18 account for an 85% of all cervical cancers in Chile, the National Ministry of Health decided to introduce HPV vaccination Program for all Chilean girls. The program is free of charge, school-based and was started in 2014.
The quadrivalent HPV vaccine Gardasil in a 2-dose schedule at month 1 & 12 was chosen because it better addressed Chile´s necessities; first dose being given to girls in 4th grade (9 – 10 years old) and second dose at 5th grade (10 – 11 years old).
During years the 2015 and 2016 a catch-up program for girls in 6th and 7th grade is also being conducted.
During the year 2014, a total of 107.392 girls received their first dose of Gardasil. Of them, the 89.5% received the second dose during the year 2015.
During the year 2015, a total of 386.384 chilean girls got vaccinated both in the routine and the catch-up vaccination:
| Vaccination year 2015 | ||||
|---|---|---|---|---|
| type of vaccination | Routine | Routine | Catch-up | Catch-up |
| Grade | 4th | 5th | 6th | 7th |
| Dose | 1 | 2 | 1 | 1 |
| total girls (n) | 112.820 | 114.160 | 116.877 | 120.566 |
| vaccinated girls (n) | 95.987 | 96.116 | 96.398 | 97.883 |
| vaccinated girls (%) | 85,1 | 84,2 | 82,5 | 81,2 |
The coverage rate of the HPV vaccination has been as expected, due to the long ongoing tradition for school-based vaccination in the country.
Nevertheless, also in our country anti-vaccine groups are growing stronger, so an effort has to be made to reassure the Chilean families about the benefits and safety of vaccinating their girls against HPV.
Bruni L, Barrionuevo-Rosas L, Albero G, Aldea M, Serrano B, Valencia S, Brotons M, Mena M, Cosano R, Muñoz J, Bosch FX, de Sanjosé S, Castellsagué X. ICO Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in Chile. Summary Report 2015-12- 23. [Data Accessed 8-3-2016]
Chilean Ministry of Health
Chilean Ministry of Education