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[巴西的宫颈癌筛查:使用巴西癌症信息系统进行的覆盖率分析]

[Cervical cancer screening in Brazil: a coverage analysis using the Brazilian Cancer Information System].

作者信息

Ribeiro Caroline Madalena, Claro Itamar Bento, Tomazelli Jeane Glaucia, Dias Maria Beatriz Kneipp

机构信息

Instituto Nacional de Câncer, Rio de Janeiro, Brasil.

出版信息

Cad Saude Publica. 2025 Aug 22;41(8):e00152224. doi: 10.1590/0102-311XPT152224. eCollection 2025.

Abstract

This study aimed to analyze the coverage of cervical cancer screening in Brazil and its Federative Units (UF, acronym in Portuguese) using secondary data from the Brazilian Cancer Information System (SISCAN, acronym in Portuguese), and to compare it with the index of exam rate in females, classically used as a proxy for coverage, and to estimate the possible coverage, if the national guidelines recommended by the Brazilian Ministry of Health were properly followed by health professionals. Cytopathological tests performed between 2021 and 2023 in women up to 64 years old, registered in SISCAN and in the Outpatient Information System of the SUS (SIA/SUS, acronym in Portuguese), were selected. Coverage and ratio indicators were calculated by UF of residence. The estimated screening coverage was estimated by adding up all the tests performed in the period in women up to 64 years old and dividing by the target population (25-64 years). The estimated screening coverage for Brazil was 35.6%, which is lower than the values of the index of exam rate (47.4 and 47.8 per 100 women according to SISCAN and SIA/SUS, respectively). It was found that by directing the tests to the appropriate age group and periodicity, coverage could reach 53.9% in Brazil and exceed 70% in Espírito Santo, Paraná and Santa Catarina. It was concluded that the rate index overestimates coverage by approximately 35% and that screening coverage is far below the 70% recommended by the World Health Organization. However, the sensitization of professionals regarding the guidelines of the Brazilian Ministry of Health can change this scenario, optimizing resources and generating a positive impact on cervical cancer incidence and mortality.

摘要

本研究旨在利用巴西癌症信息系统(SISCAN)的二手数据,分析巴西及其联邦单位(UF,葡萄牙语缩写)的宫颈癌筛查覆盖率,并将其与传统上用作覆盖率代理指标的女性检查率指数进行比较,同时估计如果卫生专业人员严格遵循巴西卫生部推荐的国家指南,可能达到的覆盖率。研究选取了2021年至2023年期间在SISCAN以及SUS(SIA/SUS,葡萄牙语缩写)门诊信息系统中登记的64岁及以下女性进行的细胞病理学检查。按居住的联邦单位计算覆盖率和比率指标。估计的筛查覆盖率通过将该期间对64岁及以下女性进行的所有检查相加,再除以目标人群(25 - 64岁)得出。巴西的估计筛查覆盖率为35.6%,低于检查率指数的值(根据SISCAN和SIA/SUS分别为每100名女性47.4次和47.8次)。研究发现,若将检查针对适当的年龄组和周期进行,巴西的覆盖率可达到53.9%,在圣埃斯皮里图州、巴拉那州和圣卡塔琳娜州可超过70%。研究得出结论,该比率指数高估覆盖率约35%,且筛查覆盖率远低于世界卫生组织推荐的70%。然而,提高专业人员对巴西卫生部指南的认识可改变这一局面,优化资源,并对宫颈癌的发病率和死亡率产生积极影响。

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