Salud pública y cáncer cervicouterino en América Latina: impacto del gasto y legislación en la prevención en tres países

OBJECTIVE: To assess the association between public health expenditure, legal frameworks, and indicators of cervical cancer incidence, mortality, and female life expectancy in Chile, Colombia, and Nicaragua from 2012 to 2022. DESIGN: Descriptive and correlational ecological study based on nationally aggregated data. SETTING: Three Latin American countries with information from the Pan American Health Organization (PAHO). PARTICIPANTS: General female population. INTERVENTIONS: Review of national health legislation and policies, including screening, vaccination, and financing mechanisms. MAIN MEASUREMENTS: Public health expenditure (% GDP), female life expectancy at birth, and cervical cancer incidence and mortality rates per 100,000 women. Ten-year averages and Pearson correlation coefficients were calculated. RESULTS: In 2022, Chile showed the highest life expectancy (82.0years) and the lowest mortality (11.3/100,000) with spending of 8.9% of GDP. Colombia reached 79.6years of life expectancy, mortality of 12.7/100,000, and spending of 6.4%, while Nicaragua had the lowest investment (5.8%), lowest life expectancy (74.8years), and highest incidence (20.6) and mortality (11.5). Strong negative correlations were found between life expectancy and incidence (r=-0.97) and mortality (r=-0.81), but weak correlation with public spending (r≈-0.13). CONCLUSIONS: The effectiveness of cervical cancer prevention programs depends less on investment volume than on legal strength and strategic direction. Strengthening legislation, prioritizing primary care, and expanding screening and vaccination are key to eliminating this preventable disease in Latin America.