Teixeira Julio Cesar, Maestri Carlos Afonso, Machado Helymar da Costa, Zeferino Luiz Carlos, Carvalho Newton Sérgio de
Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
Service of Lower Genital Tract Pathology, Hospital Erasto Gaertner, Curitiba, Paraná, Brazil.
Rev Bras Ginecol Obstet. 2018 Jun;40(6):347-353. doi: 10.1055/s-0038-1660841. Epub 2018 Jun 20.
The aim of this study was to assess the time trends and pattern of cervical cancer diagnosed in the period from 2001 to 2012 by means of an opportunistic screening program from two developed regions in Brazil.
An observational study analyzing 3,364 cancer records ( = 1,646 from Campinas and = 1,718 from Curitiba region) available in hospital-based cancer registries was done. An additional 1,836 records of CIN3/AIS from the region of Campinas was analyzed. The statistical analysis assessed the pooled data and the data by region considering the year of diagnosis, age-group, cancer stage, and histologic type. The Cochran-Armitage trend test was applied and < 0.05 were considered significant.
The total annual cervical cancer registered from 2001 to 2012 showed a slight drop (273-244), with an age average of 49.5 y, 13 years over the average for CIN3/AIS (36.8 y). A total of 20.6% of the diagnoses (1.6% under 25 y) were done out of the official screening age-range. The biennial rate of diagnoses by age group for the region of Campinas showed an increase trend for the age groups under 25 y ( = 0.007) and 25 to 44 y ( = 0.003). Stage III was the most recorded for both regions, with an annual average of 43%, without any trend modification. There was an increasing trend for stage I diagnoses in the region of Campinas ( = 0.033). The proportion of glandular histologic types registered had an increased trend over time ( = 0.002), higher for the region of Campinas (21.1% versus 12.5% for the region of Curitiba).
The number, pattern and trends of cervical cancer cases registered had mild and slow modifications and reflect the limited effectivity of the opportunistic screening program, even in developed places.
本研究旨在通过巴西两个发达地区的机会性筛查项目，评估2001年至2012年期间诊断出的宫颈癌的时间趋势和模式。
开展一项观察性研究，分析医院癌症登记处的3364份癌症记录（坎皮纳斯1646份，库里蒂巴地区1718份）。另外分析了坎皮纳斯地区1836份CIN3/AIS记录。统计分析考虑诊断年份、年龄组、癌症分期和组织学类型，对汇总数据和各地区数据进行评估。应用 Cochr an-Armitage趋势检验，P<0.05被认为具有显著性。
2001年至2012年登记的宫颈癌年度总数略有下降（273例至244例），平均年龄为49.5岁，比CIN3/AIS的平均年龄（36.8岁）高13岁。共有20.6%的诊断（1.6%为25岁以下）在官方筛查年龄范围之外进行。坎皮纳斯地区按年龄组划分的两年诊断率显示，25岁以下年龄组（P=0.007）和25至44岁年龄组（P=0.003）呈上升趋势。两个地区III期记录最多，年平均为43%，无任何趋势变化。坎皮纳斯地区I期诊断呈上升趋势（P=0.033）。登记的腺性组织学类型比例随时间呈上升趋势（P=0.002），坎皮纳斯地区更高（21.1%对库里蒂巴地区的12.5%）。
登记的宫颈癌病例数量、模式和趋势有轻微且缓慢的变化，反映出机会性筛查项目的有效性有限，即使在发达地区也是如此。
