Geographical inequities in cervical cancer screening coverage in Bolivia

A spatial nationwide ecological study

Bibliographic Data

ID14968765
AuthorsCarla Huanca Challgua (Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden Biomedical and Social Research Institute, Faculty of Medicine, Universidad Mayor de San Simón, Cochabamba, Plurinational State of Bolivia, corresponding author), Ida Linander (0000-0001-6401-889X, Umeå University), I Goicolea (0000-0002-8114-4705, Umeå University), Daniel Eid Rodríguez (0000-0002-3324-6555, Universidad Mayor de San Simón), Daniel Eid (0000-0001-8145-0967, Universidad Mayor de San Simón), Osvaldo Fonseca-Rodríguez (0000-0002-0253-5928, Umeå University)
Year2025
Volume49
Pages1
Publication date2025-05-27
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueRevista Panamericana de Salud Pública (JOURNAL)
Journal identifiersISSN: 1020-4989 • E-ISSN: 1680-5348
PublisherPan American Health Organization (PUBLISHER • US)
DOI10.26633/rpsp.2025.44
PMID40433197
OpenAlexW4410777135
LanguageEN
References cited16

Objectives. To estimate cervical cancer screening (CCS) coverage rates and assess the spatial distribution and clustering between departments and municipalities in Bolivia. Methods. Standardized CCS coverage rates were calculated using the direct standardization method. The global Moran’s I test was used to investigate the existence of spatial autocorrelation of CCS coverage, and the Getis-Ord Gi* was used to identify the spatial clustering of municipalities with high (hot spot) or low (cold spot) coverage. Results. Overall coverage was low. Around 14% of women aged 20–69 years were screened in Bolivia in 2022. Large geographical inequities in CCS coverage rates were identified both between departments and between municipalities. At the municipal level, CCS showed large differences, ranging from 59% to below 1%. Hot spots were identified in northwestern and southeastern Bolivia; specifically, in Pando, Chuquisaca, and Tarija departments. Cold spots were identified in Beni and Santa Cruz departments. Conclusions. Bolivia is still a long way from achieving the World Health Organization target of 70% screening coverage. The present results indicate where the screening program must be reinforced to improve the responsiveness of Bolivia’s health system to women’s reproductive health needs

Cancer · Cervical cancer · Cold spot · Ecological study · Environmental health · Geography · Physical geography · Population · Remote sensing · Socioeconomics · Spatial analysis · Demography · Global Cancer Incidence and Screening · Global Public Health Policies and Epidemiology · Medicine · Public Health Policies and Education

Tools

Open DOIOpen Access