Discacciati Michelle Garcia, Barboza Bárbara Maria Santos, Zeferino Luiz Carlos
Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, SP, Brasil.
Instituto de Ciências da Saúde, Universidade Paulista, Campinas, SP, Brasil.
Rev Bras Ginecol Obstet. 2014 May;36(5):192-7. doi: 10.1590/s0100-7203201400050002.
To analyze the prevalence of cervical cytopathological results for the screening of cervical cancer with regard to women's age and time since the last examination in Maceió and Rio de Janeiro, Brazil, among those assisted by the Brazilian Unified Health System.
Cervical cytopathological results available in the Information System of Cervical Cancer Screening for the year 2011 were analyzed, corresponding to 206,550 for Rio de Janeiro and 45,243 for Maceió.
In Rio de Janeiro, examination at one and two year intervals predominated, while in Maceió examination at one and three year intervals had a higher predominance. Women who underwent cervical smear screening in Maceió were older than those in Rio de Janeiro. The prevalence of invasive squamous cell carcinoma was similar for the two cities, but all the other results presented a higher prevalence in Rio de Janeiro: ASCUS (PR=5.32; 95%CI 4.66-6.07); ASCH (PR=4.27; 95%CI 3.15-5.78); atypical glandular cells (PR=10.02; 95%CI 5.66-17.76); low-grade squamous intraepithelial lesions (PR=6.10; 95%CI 5.27-7.07); high-grade squamous intraepithelial lesions (PR=8.90; 95%CI 6.50-12.18) and adenocarcinoma (PR=3.00; 95%CI 1.21-7.44). The rate of unsatisfactory cervical samples was two times higher in Maceió and that of rejected samples for analysis was five times higher in Maceió when compared to Rio de Janeiro.
The prevalence rates of altered cervical cytopathological results was significantly higher in Rio de Janeiro than in Maceió. There is no objective information that may justify this difference. One hypothesis is that there may be a difference in the diagnostic performance of the cervical cancer screening, which could be related to the quality of the Pap smear. Thus, these findings suggest that it would be necessary to perform this evaluation at national level, with emphasis on the performance of cervical cancer screening in order to improve the effectiveness of cervical cancer control.
分析巴西马塞约和里约热内卢地区，在巴西统一卫生系统协助下的女性中，宫颈癌筛查的宫颈细胞病理学结果的患病率与女性年龄及上次检查时间的关系。
对2011年宫颈癌筛查信息系统中可获取的宫颈细胞病理学结果进行分析，里约热内卢有206,550例，马塞约有45,243例。
在里约热内卢，每隔一年和两年进行一次检查的情况占主导，而在马塞约，每隔一年和三年进行一次检查的情况占比更高。在马塞约接受宫颈涂片筛查的女性比在里约热内卢的女性年龄更大。两个城市的浸润性鳞状细胞癌患病率相似，但里约热内卢的所有其他结果患病率更高：意义不明确的非典型鳞状细胞（PR = 5.32；95%CI 4.66 - 6.07）；非典型鳞状细胞不能排除高级别鳞状上皮内病变（PR = 4.27；95%CI 3.15 - 5.78）；非典型腺细胞（PR = 10.02；95%CI 5.66 - 17.76）；低级别鳞状上皮内病变（PR = 6.10；95%CI 5.27 - 7.07）；高级别鳞状上皮内病变（PR = 8.90；95%CI 6.50 - 12.18）和腺癌（PR = 3.00；95%CI 1.21 - 7.44）。与里约热内卢相比，马塞约不满意宫颈样本的比例高出两倍，被拒收用于分析的样本比例高出五倍。
里约热内卢宫颈细胞病理学结果异常的患病率显著高于马塞约。没有客观信息可以解释这种差异。一种假设是宫颈癌筛查的诊断性能可能存在差异，这可能与巴氏涂片的质量有关。因此，这些发现表明有必要在国家层面进行此项评估，重点是宫颈癌筛查的性能，以提高宫颈癌控制的有效性。
