Tracking of cervical cancer in 7,519 patients: a study of the prevalence of altered cytologies

Purpose: To evaluate the outcome and adherence of 535 patients with cytological changes. Materials and Methods: Study of 7519 smear tests harvested in 2007. Results: Of the 7,519 (100%) patients analyzed, 6,964 (92.6%) had cytology negative for intraepithelial lesion or malignancy, 535 (7.1%) abnormalities in epithelial cells, and 20 (0.3%) were unsatisfactory. Of these 535 (100%) patients, 511 (95.5%) were referred to the outpatient clinic and colposcopic exam submitted and 24 (4.5%) did not return to the clinic. The group participated in the ambulatory visits, 302 (59.1%) underwent colposcopy-guided biopsy, and the remaining 209 (40.9%) examinations were negative. Conclusion: The cytological examination remains the method of choice for cervical cancer screening. It includes low costs, is effective, and well-accepted. Early diagnosis minimises the cost of research. Universities have an important role in the training of health professionals and also in the development of research.

Uterine cervical neoplasm; Biopsy; Cytopathology; Screening.

[1] Papanicolaou G.N., Traut H.F.: “The diagnostic value of vaginal smears in carcinoma of the uterus”. Am. J. Obstet. Gynecol., 1941, 42, 193.

[2] INCA – (Instituto Nacional de Câncer), 2012: “Estimativa 2012 – Incidência de Câncer no Brasil”. Available at: http://portal.saude.sp.gov.br/resources/ses/perfil/gestor/homepage/estimativas-deincidencia-de-cancer-2012/estimativas_incidencia_cancer_2012.pdf

[3] Union for International Cancer Control (UICC): “Global Cancer Control – Programmes - Cancer Cervical initiative (CCI)”. Available at: http://www.uicc.org/programmes/cci

[4] Meisels A., Morin C.: “Human papillomavirus and cancer of the uterine cervix”. Gynecol. Oncol., 1981, 12, S111.

[5] Zür Hausen H., Villiers E.M., Gissmann L.: “Papillomavirus infection and human gentital cancer”. Gynecol. Oncol., 1981, 12, 124.

[6] Pater M.M., Pater A.: “Human papillomavirus types 16 and 18 sequences in carcinoma cell lines of the cervix”. Virology, 1985, 145, 313.

[7] Zür Hausen H.: “Human pathogenic papillomaviruses”. Curr. Top. Microbiol. Immunol., 1991, 186, 634.

[8] Restrepo H.E., González J., Roberts E., Litvak J.: “Epidemiologia y control del cáncer del cuello uterino en América Latina y el Caribe”. Bol. Oficin. Sanit. Panam., 1987, 102, 578.

[9] Lazcano-Ponce E.C., Hernández-Avila M., López-Carrillo L., Alonso de Ruiz P., Torres-Lombaton A., Gonzales-Lira G., Rumieu I.: “Reproductive risk factors and sexual history associated with cervical cancer in Mexico”. Rev. Invest. Clin., 1995, 47, 377.

[10] Caetano R., Caetano C.M.M.: “Custo-efetividade no diagnóstico precoce do câncer de colo uterino no Brasil: Um estudo exploratório, 2005”. Available at: http://www.inca.gov.br/inca/Arquivos/HPV/relatorio

[11] Programa Nacional de Controle do Câncer do Colo do Útero. Available at: http://www2.inca.gov.br/wps/wcm/connect/9ab3788046aa6903a610ff0d18967bc0/pdf_pncc_coloutero.pdf?MOD=AJPERES&CACHEID=9ab”3788046aa6903a610ff0d18967bc0

[12] David A.S.: Rastreamento e Detecção Precoce”. In: Pollock R.E., Doroshow J.H., Khayat D., Nakao A., O’Sullivan B. (eds). Manual de Oncologia Clínica da UICC. 8th ed. São Paulo: John Wiley, Fundação Oncocentro de São Paulo, 2006, 139.

[13] Linard A.G., Dantas e Silva F.A., Silva R.M.: “Mulheres submetidas a tratamento para câncer de colo uterino – percepção de como enfrentam a realidade”. Rev. Bras. Cancerol., 2002, 48, 493.

[14] Medeiros V.C.R.D., Medeiros R.C., Moraes L.M., Menezes Filho J.B., Ramos E.S.N., Saturnino A.C.R.D.: “Câncer de colo uterino: Análise Epidemiológica e Citopatológica no Estado do Rio Grande do “. RBAC, 2005, 37, 227.

[15] Rama C., Roteli-Martins C., Derchain S., Longatto-Filho A., Gontijo R., Sarian L., et al.: “Rastreamento anterior para câncer de colo uterino em mulheres com alterações citológicas ou histológicas”. Rev. Saúde Pública, 2008, 42, 411.

[16] Aquino E.M.L., Carvalho A.I., Faerstein E., Ribeiro D.C.S.: “Situação atual da detecção precoce do câncer cérvico-uterino no Brasil”. Cad. Saúde Pública, 1986, 2, 53.

[17] Ostor A.G.: “Natural history of cervical intraepithelial neoplasia: a critical review”. Int. J. Gynecol. Pathol., 1993, 12, 186.

[18] Hutchinson M.L., Berger B.M., Farber F.L.: “Clinical and cost implications of new technologies for cervical cancer screening: the impact of test sensitivity”. Am. J. Manag. Care, 2000, 6, 766.

[19] Ministerio da Saúde, Brasil / Instituto Nacional de Câncer, 2002: “Falando sobre câncer de colo uterino, Rio de Janeiro”. Available at: http://bvsms.saude.gov.br/bvs/publicações/inca/falando_cancer_colo_utero.pdf

[20] Thuler L.C.S., Zardo L.M., Zeferino L.C.: “Perfil dos laboratórios de citopatologia do Sistema Único de Saúde”. J. Bras. Patol. Lab., 2007, 43, 103.