Keywords
age-group
Pap test
cervix smears
How to Cite
Abstract
The aim of the present study was to identify the age - group of women who referred to Health Centers and were classified as SIL, HSIL and cervical neoplasia, and also to evaluate whether the age-group recommended by the Brazilian Health Ministry for being enrolled in the Cancer Screening Program is adequate. A total of 30,910 cervical smears collected by conventional Pap test were analyzed. For 14.779 women at age-group <34 years old, 841 (5.7%) were diagnosed as atypical cellular alteration (AEA). Among these women, 74 (8.8%) presented high-grade squamous intraepithelial lesions (HSIL), 38(4.5%) atypical squamous cells of which the high - grade squamous intraepithelial lesion (ASC-H) cannot be excluded, and 369 (43.9%) showed low-grade squamous intraepithelial lesions (LSIL). Of 9,710 women at age-group of 35-49 years old, 442 (4.6%) were diagnosed as AEA, and among them 41 (9.3 %) were HSIL, 29 (6.3%) were ASC-H, 94 (21.2%) were LSIL and carcinoma was evidenced in 2 (0.5%). The age-group >50 years old was composed by 6,421 women, and among them 327 (5.1%) were diagnosed as AEA, of them 35 (10.7%) were HSIL, 23 (7.0%) were ASC-H, 26 (8.0%) were LSIL and 8 (2.4%) had carcinoma. These findings evidenced that particular and specific attention should be addressed to young women and teenager in accomplishing the Cervical Cancer Screening Programs.References
1. Incidencia de câncer no Brasil: Estimativa 2008. Instituto Nacional do Câncer. [cited 2008 marc 14]. Disponível em:http://www.inca.gov.br/estimativa/2008/index.asp
2. Arcuri RA, Cunha KCF, Alves EC, Castro AA, Maciel RA, Rosmanino AC, Silva PL, Xavier GC. Controle interno da qualidade em citopatologia ginecológica: um estudo de 48.355casos. J Bras Patol Med Lab. 2002, 38(2): 141-7.
3. Kitchener HC, Castle PE, Cox JT. Achievements andlimitations of cervical cytology screening. Vaccine. 2006;24(suppl 3): S63-S70.
4. CDC. Sexually Transmitted Diseases Treatment Guidelines,2006. MMWR. 2006; 55 (N°. RR-11): 1-94. [cited 2007 nov22]. Available from: http://www.cdc.gov/mmwR/preview/mmwrhtml/rr5511a1.htm
5. Weinstock H, Berman S, Cates W Jr. Sexually transmitteddiseases among American youth: incidence and prevalenceestimates, 2000. Perspect Sex Reprod Health. 2004; 36(1): 6-10.
6. Ault KA. Epidemiology and natural history of Human Papillomavirus infections in the female genital tract. Infect Dis Obstet Gynecol. 2006; 14: 1-5.
7. Ho GY, Bierman R, Beardsley L, Chang CJ, Burk RD. Naturalhistory of cervicovaginal papillomavirus infection asmeasured by repeated DNA testing in adolescent and youngwomen. N Engl J Med. 1998; 338(7): 423-8.
8. Moscicki AB, Hills N, Shiboski S, Powell K, Jay N, HansonE, Miller S, Clayton L, Farhat S, Broering J, Darragh T,Palefsky J. Risks for incident human papillomavirusinfection and low-grade squamous intraepithelial lesiondevelopment in young females. JAMA. 2001; 285(23):2995-3002.
9. Woodman CB, Collins S, Rollason TP, Winter H, Bailey A,Yates M, Young LS. Human papillomavirus type 18 and rapidlyprogressing cervical intraepithelial neoplasia. Lancet. 2003;361(9351): 40-3.
10. National Institutes of Health (NIH). NIH Consensusstatement: Cervical Cancer. 1996; 14:1-38.
11. Schlect NF, Kulaga S, Robitaille J. Persistent humanpapillomavirus infection as a predictor of cervicalintraepithelial neoplasia. JAMA. 2001; 286: 3106-3114.
12. Santos ALF, Derchain SFM, Martins MR, Sarian LO, MartinezEZ, Syrjänen KJ. Human papillomavirus viral load inpredicting high-grade CIN in women with cervical smearsshowing only atypical squamous cells or low-gradesquamous intraepithelial lesion. Sao Paulo Med J 2003; 121:238-43.
13. Thomas C, Wright Jr. Cervical Cancer Screening in the 21stCentury: Is it time to retire the Pap smear? Clin ObstetGynecol. 2007; 50(2): 313-23.
14. Hein K, Schreiber K, Cohen MI, Koss LG. Cervical cytology:the need for routine screening in the sexually activeadolescent. J Pediatr. 1989; 91: 123 -6.
15. Moscicki A, Winkler B, Irwin CE Jr, Schachter J. Differencesin biologic maturation, sexual behavior, and sexuallytransmitted disease between adolescents with and withoutcervical intraepithelial neoplasia. 1989; 115: 487-93.
16. Leiden WA, Manos MM, Geiger AM, Weinmann S,Mouchawar J, Bischoff K. Cervical cancer in women withcomprehensive health care acess: attributable factors in thescreening process. J Natl Cancer Inst. 2005; 97(9): 675-83.
17. Liu S, Semenciw R, Mao Y. Cervical cancer: the increasingincidence of adenocarcinoma and adenosquamouscarcinoma in younger women. CMAJ. 2001; 164(8): 1151–2.
18. Instituto Nacional do câncer. Viva mulher. Câncer do colo doútero: Informações técnico-gerenciais e ações desenvolvidas. Rio de Janeiro: Instituto Nacional do Câncer; 2002.
19. Guimarães EM, Pires J, Peli LB, Aguiar RSF. Evolução dedisplasia leve diagnosticada por citopatologia: Analiseretrospectiva de 155 casos. J Bras Patol. 1999; 35: 136-40.
20. Wright JD, Davila RM, Pinto KR, Merritt DF, Gibb RK, RaderJS, Mutch DG, Gao F, Powell MA. Cervical dysplasia inadolescents. Obstet Gynecol. 2005; 106(1): 115-20.
21. Solomon D, Davey DD, Kurman R, Moriarty A, O’Connor D,Prey M, Raab S, Sherman M, Wilbur D, Wright T Jr, Young N;Forum Group Members; Bethesda 2001 Workshop. The 2001 Bethesda system: terminology for reporting results of cervicalcytology. JAMA 2002; 287: 2114-9.
22. WHO (World Health Organization). Cytological screening in thecontrol of cervical cancer: technical guidelines. Genebra; 1988.
23. Linos A, Riza E. Comparisons of cervical cancer programmesin the European Union. Eur J Cancer 2000; 36: 2260-5.
24. Mayor S. NHS cervical screening programme to introduceliquid based cytology. BMJ. 2003; 327(7421): 948.
25. Brasil. Ministério da Saúde. Secretaria Nacional deAssistência à Saúde. Instituto Nacional do Câncer. Estimativas da incidência e mortalidade por câncer no Brasil2000. Rio de janeiro: INCA; 2000.
26. Nascimento CM, Eluf-Neto J, Rego RA. Cobertura do testede Papanicolaou no Município de São Paulo e característicasdas mulheres que realizaram o teste. Bol Ofic Sanit Panam.1996; 121: 491-9.
27. Pinho AA, Fatores associados à realização do teste de Papanicolaou entre mulheres em idade reprodutiva nomunicípio de São Paulo. [dissertação de Mestrado]. SãoPaulo: Faculdade de Saúde Pública; 2002.
28. Vetrano G, Lombardi G, Di Leone G, Parisi A, Scardamaglia P,Pate G, Verrico M, Corosu R. Cervical intraepithelial neoplasia:risk factors for persistence and recurrence in adolescents.Eur J Gynaecol Oncol. 2007;28(3):189-92.
29. Copel K, Paul C, Cox B. An evaluation of the National CervicalScreening Programme Otago site. N Z Med. 2000; 113: 48-51.
30. Bano F, Kolhe S, Zamblera D, Jolaoso A, Folayan O, Page L,Norton J. Cervical screening in under 25s: a high-risk young population. Eur J Obstet Gynecol Reprod Biol. 2007; doi: 101016/j.ejogrb.2007.08.020
31. Yamamoto LSU, Saito S, Pereira SMM, Utagawa ML,Longatto-Filho A. Uterine cytopathology in a public healthlaboratory: impact from 20 years data (1984-2003). Rev Inst Adolfo Lutz. 2006; 65(2): 141-5.
32. Berstrom C, Sparen P, Adami HO. Trends in cancer of thecervix uteri in Sweden following cytological screening. BJCancer. 1999; 81: 159-66.
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