{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T12:20:35Z","timestamp":1789734035529,"version":"4.0.1"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T00:00:00Z","timestamp":1607644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In 2018, WHO called for global action to eliminate cervical cancer. The complexity of the processes involved in terms of prevention is often underestimated. Low\u2010 and middle\u2010income countries do not have a robust healthcare framework to ensure high\u2010quality programs. The present article discusses how fragile healthcare systems are barriers to eliminating cervical cancer, and also reports the experience of a Brazilian prevention program. The article considers how cervical cancer can be interpreted as an indicator of inequality: how women's attitudes and access to care determine an early or late diagnosis, and how strategies combining vaccine and DNA\u2010HPV tests are crucial. New vaccine schemes, the critical analysis of local data, strengthening communication, managing sentinel events, and integrating vaccination and screening data for the health information system are some of the key activities to sustainable improvement in both access and quality of care.<\/jats:p>","DOI":"10.1002\/ijgo.13458","type":"journal-article","created":{"date-parts":[[2020,10,31]],"date-time":"2020-10-31T17:11:40Z","timestamp":1604164300000},"page":"7-11","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Elimination of cervical cancer in low\u2010 and middle\u2010income countries: Inequality of access and fragile healthcare systems"],"prefix":"10.1002","volume":"152","author":[{"given":"Diama B.","family":"Vale","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Campinas Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio C.","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Campinas Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana F.","family":"Bragan\u00e7a","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Campinas Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Derchain","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Campinas Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis O.","family":"Sarian","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Campinas Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz C.","family":"Zeferino","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Campinas Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,11]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"World Health Organization.A Global Strategy for elimination of cervical cancern.d.https:\/\/www.who.int\/activities\/a\u2010global\u2010strategy\u2010for\u2010elimination\u2010of\u2010cervical\u2010cancer. Accessed June 14 2020"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-12-34"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-012-2575-0"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2009.07.018"},{"issue":"49","key":"e_1_2_10_6_1","first-page":"3262","article-title":"Worldwide trends in cervical cancer incidence: impact of screening against changes in disease risk factors","volume":"2013","author":"Vaccarella S","year":"1990","journal-title":"Eur J Cancer Oxf Engl"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.13634"},{"key":"e_1_2_10_8_1","unstructured":"International Agency for Research on Cancer.GLOBOCAN: Cancer tomorrown.d.http:\/\/gco.iarc.fr\/tomorrow\/home. Accessed June 17 2020"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70211-5"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31043"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2014.02.003"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2018.1463976"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rccan.2015.06.005"},{"key":"e_1_2_10_15_1","unstructured":"Indian Council of Medical Research.Consolidated Report of Hospital Based Cancer Registries: 2007\u20132011n.d.http:\/\/ncrpindia.org\/ALL_NCRP_REPORTS\/HBCR_REPORT_2007_2011\/ALL_CONTENT\/Main.htm. Accessed October 19 2015"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0969141313492313"},{"key":"e_1_2_10_17_1","unstructured":"American Cancer Society.Cancer Facts & Figures for African Americans 2019\u20102021.2019."},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/CEJ.0000000000000426"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2017.08.012"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24544"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa099"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.27485"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31231"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31821-4"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2017.04.004"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70841-2"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2013.12.005"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2013-202620"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jit361"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60551-5"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiv368"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiu413"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2015.02.028"},{"key":"e_1_2_10_34_1","first-page":"CD008587","article-title":"Cytology versus HPV testing for cervical cancer screening in the general population","volume":"8","author":"Koliopoulos G","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62218-7"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djq356"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-13-0053"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2015.146"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-08688-4"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.13458","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.13458","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.13458","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T12:20:10Z","timestamp":1693830010000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.13458"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,11]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1002\/ijgo.13458"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.13458","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,11]]},"assertion":[{"value":"2020-06-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}