[Gakidou E, Nordhagen S, Obermeyer Z 2008 Coverage of Cervical Cancer Screening in 57 Countries: Low Average Levels and Large Inequalities. PLoS Med 5(6): e132 doi:10.1371/journal.pmed.0050132]
- The large declines in cervical cancer mortality in developed countries have been attributed to widespread screening, but it is unclear whether this success can be replicated in the developing world.
- It is generally assumed that screening coverage in the developing world is low; in this paper we substantiate this claim with evidence from 57 countries, thus contributing to the evidence base for formulation of effective policies.
- Our analysis of population-based surveys indicates that coverage of cervical cancer screening in developing countries is on average 19%, compared to 63% in developed countries, and ranges from 1% in Bangladesh to 73% in Brazil.
- Older and poor women, who are at the highest risk of developing cervical cancer, are least likely to be screened.
- Strategies for improving cervical cancer prevention must be adapted to meet the specific needs of individual countries: expanded screening may be a viable option where sufficient infrastructure and health system access exists, but novel strategies need to be considered in other settings