Monteiro Denise Leite Maia, Trajano Alexandre José Baptista, Silva Kátia Silveira da, Russomano Fábio Bastos
Centro Universitário Serra dos Orgãos, Teresópolis, Brasil.
Cad Saude Publica. 2009 May;25(5):1113-22. doi: 10.1590/s0102-311x2009000500018.
This study aimed to estimate the incidence and types of cervical cytopathological findings in adolescents who were treated in public health services between 1993 and 2006. This is a cohort study, with the following inclusion criteria: < 20 years of age, sexually-active, without cervical lesions upon entry into the study or sexually active < 1 year. The data were collected from 403 adolescents' medical records. Incidence density of cytopathological alterations was estimated and the actuarial method was used to calculate the 5-year incidence during follow-up after sexual initiation. In the first year of sexual activity, the incidence of cervical lesions was 24.1%. The incidence decreased to 3-8% over the following 4 years. The incidence density was 4.7 cases per 100 persons per year. The first abnormal cytological diagnosis showed atypical squamous cells of undetermined significance (ASCUS) in 5.5% (22) of patients, low-grade squamous intra-epithelial lesions (LSIL) in 28% (113), and high-grade squamous intraepithelial lesions (HSIL) in 3% (12). Eight (67%) cases of HSIL occurred during the first year of sexual activity. The incidence of cytopathological findings at beginning of sexual life is high, suggesting the importance of including sexually-active adolescents in cervical cancer prevention programs.
本研究旨在估算1993年至2006年间在公共卫生服务机构接受治疗的青少年宫颈细胞病理学检查结果的发生率及类型。这是一项队列研究，纳入标准如下：年龄<20岁、有性行为、在进入研究时无宫颈病变或性行为活跃<1年。数据收集自403名青少年的病历。估算细胞病理学改变的发病密度，并采用精算方法计算性开始后随访期间的5年发病率。在性活动的第一年，宫颈病变的发生率为24.1%。在接下来的4年中，发病率降至3 - 8%。发病密度为每年每100人中有4.7例。首次异常细胞学诊断显示，5.5%（22例）的患者为意义不明确的非典型鳞状细胞（ASCUS），28%（113例）为低级别鳞状上皮内病变（LSIL），3%（12例）为高级别鳞状上皮内病变（HSIL）。8例（67%）HSIL病例发生在性活动的第一年。性生活开始时细胞病理学检查结果的发生率较高，这表明将有性行为的青少年纳入宫颈癌预防计划具有重要意义。
