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Objective. To describe current cervical cancer screening program guidelines in Latin America. Materials and methods. We searched official recommendations for the general population and women living with HIV (WLHIV) by reviewing official sources from 19 countries; these data were supplemented with a consultation carried out by the WHO with the Ministries of Health. Results. Screening policies vary significantly in regard to target populations, primary tests, and screening intervals. Sixteen countries have recently updated their recommendations; however, cytology remains the primary screening test for most countries. Eleven countries have introduced HPV tests, and eight countries have implemented screen-and-treat algorithms; only three countries have developed evidence-based guidelines. All countries but Costa Rica have specific recommendations for WLHIV. Conclusions. Although most countries have updated their screening policies, only a few are properly alig­ned with the WHO elimination strategy. Recommendations for WLHIV require better integration with cervical cancer screening programs.

Description: The COVID-19 pandemic poses an unprecedented challenge for urologic oncology and radiotherapy. Radiation oncology departments and international collaboration groups are sharing their management adaptations made in response to the pandemic. The present narrative review summarizes the current recommendations. Relevance:  There is a need to define which patients are candidates for safe treatment delay until the pandemic is over or controlled, to reduce exposure to the virus in the healthcare personnel and patients.   Conclusions:  Telemedicine is recommended for follow-up visits. Active surveillance is the preferred treatment for patients with favorable intermediate risk. In greater risk disease, hormone therapy safely postpones radiotherapy up to 7 months. Radiosurgery is suggested in centers that have the necessary technology and previous experience.  A moderately hypofractionated regimen is recommended if radiosurgery/ultra-hypofractionation is not available. Hypofractionation should be implemented if image-guided radiation therapy is already in place. Countries with low and middle-income economies face challenges in adopting the recommendations for prostate cancer management during the pandemic. Postponing treatment may result in the overwhelming of radiation oncology center capacity, after the pandemic.

We carried out a systematic review to summarize available data regarding prevalence of high-risk human papillomavirus (HR-HPV) among women living with HIV (WLHIV) in Latin America and the Caribbean (LAC). A literature search in PubMed and LILACS was conducted and supplemented with cross-referencing and grey literature. The primary outcome was prevalence of HR-HPV by age as a major determinant of HPV infection. Pooled prevalence and weighted averages were obtained. A random effects meta-analysis conducted for HPV- and HIV-associated factors. In total, 6157 women from 19 cross-sectional studies were included. Weighted prevalence of HR-HPV in WLHIV was 51.0% (95% CI 42.8–59.1, I2 = 97.4%) with a bimodal trend by age. No association between antiretroviral therapy and HR-HPV prevalence was observed, but low CD4 cell count was associated (PR 1.64, 95% CI 1.07–2.52). Although not significant, a higher HR-HPV prevalence was observed with Hybrid Capture 2 versus PCR. The high prevalence of HR-HPV among WLHIV in LAC underlines the need for improved cervical cancer prevention and early detection in this vulnerable population. Moreover, the high prevalence across age groups, and particularly in young women, deserves careful consideration for defining target populations of HPV-based screening and HPV immunization programs.

Mobile health (m-health) has shown positive effects on disease prevention; however, several factors might influence its effectiveness, particularly in low- and middle-income countries. Randomized trials provide data with high internal validity but no major information on population impact. We conducted a pilot population-based study to assess the feasibility of cancer prevention through m-health in a Latin American population. A sample of affiliates to a health insurance company in Colombia was randomly selected and assigned to receive a short message service (SMS) or voice messages (VMS) during 4 weeks; weekly frequencies 2 and 7. Baseline and post-intervention surveys were conducted. Overall, 797 affiliates were contacted (SMS 393, VMS 404) but only 15.3% and 24.8% enrolled, respectively. Over 80% acceptability was observed among participants for all items evaluated (usefulness, understandability, timing, and frequency); however, 2-VMS per week was the only frequency consistent with the declared number of messages received and listened. Other frequencies resulted in high reception recall but low willingness to read/listen the messages. The willingness to be part of future programs was 20.0%. The gap between declared acceptability and practice, low participation rates, and low willingness to read/listen messages indicate m-health should be part of multicomponent interventions and should not be conceived as the sole intervention.