qualidade e desempenho das colpocitologias na prevenção de câncer de colo uterino quality and performance of pap smears in the cervical cancer screening program in a city of southern brazil

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2009
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Abstract
OBJETIVO: Estimar a prevalência e analisar a qualidade e o desempenho das colpocitologias realizadas no Programa de Prevenção de Câncer de Colo Uterino no município de Maringá-PR. MÉTODOS: Estudo retrospectivo dos dados do SIS-Colo do Ministério da Saúde. Foram analisadas as variáveis idade, resultado de colpocitologia e procedência. As idades foram categorizadas em faixas etárias, a procedência distribuída em cinco regionais de saúde do município de Maringá; a colpocitologia foi categorizada conforme o Sistema Bethesda. Calculou-se a cobertura de colpocitologia dividindo-se o número de exames na população de 25 a 59 anos pelo número de mulheres nesta mesma faixa etária. RESULTADOS: As 17.664 colpocitologias coletadas, no ano de 2005, pela rede pública se distribuíram entre as mulheres com idade mínima de 12 e máxima de 82 anos, sendo 12.961 (73,4%) exames na faixa entre 25 e 59 anos, considerada de maior risco para o câncer. Foram negativos para neoplasia 17.458 (98,84%) exames e as alterações celulares (ASCUS/AGUS, LIEBG, LIEAG e câncer invasor) totalizaram 206 (1,16%). Encontrou-se prevalência de ASCUS de 0,85% (151), de atipias celulares 1,14% (203/17.664) e a relação ASCUS/atipias celulares 2,75% (151/55). CONCLUSÃO: A prevalência das alterações colpocitológicas e da ASCUS abaixo dos índices esperados, a relação ASCUS/atipias celulares em níveis elevados, a cobertura populacional insuficiente de colpocitologia compromete o desempenho da prevenção de câncer de colo uterino. A população de baixa condição sócio-econômica requer uma atenção especial e a população mais privilegiada deve ser orientada quanto a periodicidade do exame e faixa etária de maior risco.
OBJECTIVE: To estimate prevalence and analyze quality and performance of colpocytology carried out under the Cervical Cancer Screening Program in Maringá, Paraná, Brazil. METHODS: A retrospective study of the SIS-Colo database of the Brazilian Ministry of Health. Variables such as age, colpocytology result and origin were analyzed. Ages were divided into brackets; origin was distributed in five Regional Health Divisions of the city of Maringá; colpocytology was categorized according to the Bethesda System. Colpocytology, coverage was calculated by dividing the number of exams in the population between 25 and 59 years of age by the number of women in that same age group. RESULTS: The 17,664 colpocytology exams collected in 2005 by the public health system were distributed among women between 12 and 82 years of age, with 12,961 (73.4%) examinations in women between the ages of 25 and 59, considered at high risk for cancer. A total of 17,458 (98.84%) cytological examinations were negative for malignancy, and atypical results (ASCUS / AGUS, LSIL, HSIL and invasive cancer) totaled 206 (1.16%). The study found a prevalence of 0.85% (151) for ASCUS / AGUS, 1.14% (203/17.664) for atypical cells, and a 2.75 ASCUS / atypical cells ratio (151/55). CONCLUSION: The lower than expected prevalence of colpocytological and ASCUS alterations, the high ASCUS / atypical cells ratio and the insufficient population coverage by colpocytology jeopardized the performance of the cervical cancer prevention program. The low-income population requires special attention, and those more privileged should be advised about the frequency of examination and the age bracket with higher risks.
Reference Key
uchimura2009revistaqualidade Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Nelson Shozo Uchimura;Keiji Nakano;Lina Cavalcanti de Góes Nakano;Taqueco Teruya Uchimura
Journal acta crystallographica section e
Year 2009
DOI
10.1590/S0104-42302009000500021
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302009000500021
Keywords
cytology uterine cervical neoplasms primary prevention cervical intraepithelial neoplasia neoplasias do colo do Útero cervix neoplasms preventionmedicine (general)

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