Cancer mortality in Latin America: implications for prevention

Two papers in this issue of the Revista Panamericana de Salud Pblica/Pan American Journal of Public Health address the problem of detection and screening strategies for cancer prevention. One paper is on the diffusion of Pap smear tests for cervical cancer prevention in a high-risk area of South America (1), and the other is on prostate-specific antigen (PSA) and digital rectal examinations in the diagnosis of prostate cancer (2). A third study in this issue analyzes the incidence of cancer among Hispanic children in the United States of America, including mainly neoplasms of the lymphoid and hematopoietic system, many of which are amenable to treatment (3). These screening and diagnostic tests, as well as modern treatments for leukemias and Hodgkin's lymphomas, are largely available in developed countries, such as those of North America (Canada and the United States) and Western Europe. As illustrated by the paper by Dzuba et al. (1), there have been some delays in the adoption of organized programs and strategies for cancer prevention and treatment in some countries of Central America and South America. Even in the United States there are racial and ethnic disparities in cancer incidence and mortality (3, 4), which suggests that not all segments of the population in the country benefit equally from progress in the prevention, early detection, and treatment of cancer.