Antonio Reyna Sevilla

Spatial Epidemiology of Human Papillomavirus Screening Coverage in Mexico, 2013-2019

We aimed to assess the coverage of a Human Papillomavirus (HPV) screening program for each of the 32 federal states of Mexico, as well as the spatial patterns for HPV infections from 2013 to 2019. We conducted an exploratory, ecological study on data from a national health program in Mexico during 2013-2019. Adjusted rates per 100,000 females aged 25-64 years were estimated and georeferenced at the national and state level to assess the coverage of the screening program and positive detections of HPV infections. Cluster analysis was used to identify the location, magnitude, and trends of spatial patterns (p <0.05) by year and state. 2,529,819 screening tests for HPV detection were analyzed (2013-2019). A prevalence of HPV positivity of 11.1% (n= 228,582) was estimated. The number of HPV screening tests decreased from 2,835.4 (2013) to 0.8 (2019) per 100,000 females aged 25 to 64. HPV detection also showed a downward trend. A cluster (p <0.05) associated with a higher probability of detecting HPV infections was identified, comprised of territorially close states. A decreased coverage of the HPV screening program and geographic differences were identified, suggesting that the existing strategies to prevent and detect HPV infections to accelerate cervical cancer elimination in Mexico need to be further reconsidered.