On the occasion of International Working Women’s Day, it is necessary to discuss a serious public health problem that requires greater efforts from our health system to reduce its impact on Costa Rican families.   Cervical cancer continues to kill our women, despite being 100% preventable. As a country, we have worked for several decades on its prevention, detection and treatment, but there is still much to do and it is time to strengthen actions and implement new policies that will lead us to the elimination of this disease.   Cervical cancer is one of the diseases that kills most women; it is responsible for nearly 1,000 deaths every day around the world. Is a cancer that predominantly affects women without access to adequate health services, relatively young, mothers of several children, and often, heads of household or immigrants. 90% of cases occur in countries, regions and human groups with fewer resources.   This cancer originates from a sexually transmitted infection caused by the human papillomavirus (HPV), which most men and women acquire near the beginning of sexual relations. The infection disappears on its own in most cases, but sometimes it persists and becomes precancerous lesions that, over time, can lead to cancer. For several years, the infection and associated lesions are detectable with tests such as cytology or Pap smears, and are generally curable with a relatively simple treatment.   Cytology screening programs have managed to reduce the burden of this disease and important progress has been made in Costa Rica, with a significant reduction in mortality over the last 20 years. However, the incidence and mortality from this cancer are still unacceptable and more than 120 women continue to die each year.   We still have work to do in the area of early detection, because we continue to use cytology as the main screening method, even when the World Health Organization, based on extensive evidence, recommends changing the screening method to the HPV detection test for people over 30 years of age, which is more accurate than cytology, since it allows a reduction in the frequency of tests and can be done by the woman herself (self-sampling).   On the other hand, detection and treatment activities require a high level of organization, quality control and information systems that are pending development in our country, in order to achieve international goals and reduce the suffering of affected families.   Institutional strengthening, specifically of reproductive health programs, as well as the continuation of efforts in sexual education, based on scientific evidence, are an essential part of this proposal.   Costa Rica has a great opportunity to become one of the first countries to achieve the elimination of cervical cancer, considering the strengths of our public health system, such as the possibility of taking centralized measures and its broad coverage. Fortunately, since 2019, vaccination of all 10-year-old girls against HPV has been introduced in our schools and health centers, with excellent coverage.   On this Women’s Day, one of the best tributes and displays of solidarity with their daily struggle is the adoption of the necessary institutional and community measures to achieve the elimination of a disease that exemplifies, like few others, the unfavorable condition of women in our society.

Dr. Rolando HerreroDirector Científico de ACIB-FUNIN