Researchers from the are examining how vaccination, screening and health system factors are shaping cervical cancer trends in Panama, offering new insights into progress toward eliminating the disease.
The study, "," led by , associate professor in the , analyzes national data on human papillomavirus (HPV) vaccination coverage, cervical cancer incidence and mortality, and screening practices across Panama. The research provides a baseline for understanding long-term trends and identifying gaps that may affect prevention efforts moving forward.
Cervical cancer remains a major public health concern in Latin America, where it is the second leading cause of cancer-related deaths among women. Panama has emerged as a regional leader in prevention efforts, becoming the first country in Latin America to include the HPV vaccine in its national immunization program.
Arlene Calvo, PHD, MPH (Photo courtesy of Calvo)
Calvo said her longstanding interest in the connection between infectious diseases and cancer helped inspire the research.
鈥淚鈥檝e always been interested in the etiology of infectious diseases and related cancers,鈥 she said. 鈥淚n this aspect, the human papilloma virus, which can cause cervical cancer, is an important infectious agent that is widely spread.鈥
The analysis revealed a complex picture. While Panama has maintained strong HPV vaccination coverage, often exceeding 85 percent in recent years, and cervical cancer incidence has steadily declined since the 1990s, mortality rates remain high.
Researchers believe the disparity may be tied to delayed diagnosis and barriers to screening.
鈥淭he high mortality is important because it denotes non-medical factors that are affecting the outcome,鈥 Calvo said. 鈥淭his is where the merge of epidemiology and social sciences is important.鈥
Based on conversations with oncologists in Panama, Calvo said many women seek care only after the disease has progressed to advanced stages, when treatment is less effective.
The study also found that screening rates remain low, with only about 10 to 12 percent of women receiving Pap tests. Understanding why women are not accessing screening services will be critical to reducing deaths from cervical cancer, researchers say.
Humberto Lopez Castillo, MD, PhD, CPH, CMI (Photo courtesy of Lopez Castillo)
Dr. Humberto L贸pez Castillo, a alumnus who contributed to the research, said the findings highlight both progress and continuing challenges in prevention efforts.
鈥淭he seeming contradiction of findings: while Panama presents with a success model for vaccination implementation and coverage, other preventative and screening strategies are lagging,鈥 L贸pez Castillo said.
L贸pez Castillo, now an associate professor in the Department of Health Sciences at the University of Central Florida, said cultural norms and access barriers may be contributing to low screening participation.
鈥淭his and prior research show that there are cultural norms preventing women from regular gynecological care, which includes HPV prevention and early detection strategies,鈥 he said.
At the same time, the success of vaccination campaigns could offer a model for expanding other prevention efforts.
鈥淭hinking strategically, health authorities could separate the success elements in the vaccination campaigns and adapt them to further support campaigns supporting Pap smears,鈥 L贸pez Castillo said.
Jonathan Andreadakis, MPH (Photo courtesy of Andreadakis)
Jonathan Andreadakis, a alumnus who contributed to the study as a student researcher, said analyzing decades of data helps researchers begin to see how early interventions influence population health over time.
鈥淥ften the effects of interventions like the HPV vaccine are not immediate,鈥 Andreadakis said. 鈥淭he vaccine is typically administered during childhood, however cervical cancer does not typically develop until much later in life.鈥
Since graduating, Andreadakis has been working as a research associate at Tampa General Hospital studying acute myeloid leukemia and will begin medical school at the University of Florida College of Medicine this fall.
He said the global effort to reduce cervical cancer continues to inspire the next generation of researchers.
鈥淎round the world, and in Panama especially, I am increasingly impressed with the dedication and fervor driving cancer researchers to reduce and eliminate cervical cancer,鈥 he said.
Despite progress, researchers say additional work is needed to strengthen screening access, improve data systems and better understand the social and cultural factors that influence women鈥檚 health decisions.
Calvo hopes the findings will encourage policymakers to expand prevention strategies that support women across the entire continuum of care.
鈥淭his is a call to the attention of policymakers to develop interventions that can help women in Panama,鈥 she said.