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Silva KSDBE, Leite AFB, Silva DMDC, Tanaka OY, Louvison MCP, Bezerra AFB. Cervical cancer prevention in Pernambuco: improvements for whom? Inequity scenario in the state of the Northeast Region. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2020. [DOI: 10.1590/1806-93042020000200018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to analyze the access to cervical cancer preventive examination in Pernambuco between 2002 and 2015 by cytopathological exam coverage. Methods: public data from SUS Computer Department were used, then processed by Tabnet and Excel and calculated the slope of the over time coefficient trend by simple regression techniques. Afterwards, they were plotted in thematic maps covering cytopathological exams on Terraview app 4.2.2. Results: Pernambuco State presented an increase of exam coverage trend in all the health regions until 2010. Since that year it started to have stabilization and decreased the tendency. Comparing the coverage of the two first years, in 2002, 42.7% of the cities coverage was below 0.2 and in 2015 the scenario changed, 41.1% of the cities coverage was above 0.6. We emphasize that even in that same year 13.5% of the cities still had a low or too low coverage (less than 0.4). The over time trends in increase and decline were strongly meaningful. Conclusions: this study revealed that all health regions presented a coverage lower than recommended, in some period or in all of them, even with the State growth tendency it demonstrated an unequal and heterogeneous characteristic.
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Nuche-Berenguer B, Sakellariou D. Socioeconomic determinants of cancer screening utilisation in Latin America: A systematic review. PLoS One 2019; 14:e0225667. [PMID: 31765426 PMCID: PMC6876872 DOI: 10.1371/journal.pone.0225667] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 11/08/2019] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Cancer incidence and mortality in Latin America are rising. While effective cancer screening services, accessible to the whole population and enabling early cancer detection are needed, existing research shows the existence of disparities in screening uptake in the region. OBJECTIVE We conducted a systematic review to investigate the socioeconomic determinants for the disparities in the use of breast, cervical and colorectal cancer screening services in Latin America. METHODS We searched for studies reporting on socioeconomic determinants impacting on access to breast, cervical and colorectal cancer screening, published from 2009 through 2018. The studies that qualified for inclusion contained original analyses on utilisation of breast, cervical and colorectal cancer screening across socioeconomic levels in Latin America. For each study, paired reviewers performed a quality analysis followed by detailed review and data extraction. RESULTS Twenty-four articles that met the eligibility criteria and were of sufficient quality were included in this review. Thirteen of the included articles were written in English, eight in Portuguese and three in Spanish, and they reported on the use of breast or cervical cancer screening. No studies were found on the socioeconomic determinants regarding the utilisation of colorectal cancer screening in Latin America. Low income, low education level, lack of health insurance and single marital status were all found to be determinants of underuse of breast and cervical cancer screening services. CONCLUSIONS Cancer screening programs in the region must prioritize reaching those populations that underuse cancer screening services to ensure equitable access to preventive services. It is important to develop national screening programmes that are accessible to all (including uninsured people) through, for example, the use of mobile units for mammography and self-screening methods.
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Affiliation(s)
| | - Dikaios Sakellariou
- School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom
- * E-mail:
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Fernandes NFS, Galvão JR, Assis MMA, Almeida PFD, Santos AMD. [Access to uterine cervical cytology in a health region: invisible women and vulnerable bodies]. CAD SAUDE PUBLICA 2019; 35:e00234618. [PMID: 31596403 DOI: 10.1590/0102-311x00234618] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 04/15/2019] [Indexed: 11/22/2022] Open
Abstract
This article evaluates access to the Papanicolaou test in the Family Health Strategy (FHS) in municipalities in a health region. Cervical cancer control depends on a well-organized Family Health Strategy, so assessment of access to the Papanicolaou test reflects the quality of care at this level. This is a qualitative study with data produced in 10 focus groups, totaling 70 participants in four municipalities. We analyzed the organizational, symbolic, and technical dimensions of access to the Pap test, with cervical cancer control as the marker. The results indicate that living in rural areas was a barrier to access to the Papanicolaou test and exacerbated the inequalities. Nurses were the principal reference for access to the Pap test. The absence of necessary items for collecting cervical cytopathology specimens was a barrier to access in all the municipalities. There were obstacles to access for women with disabilities and lesbian women, with care that was fragmented and out of sync with individual characteristics. The numerous obstacles to access to the Papanicolaou test exposed the selectiveness of the Family Health Strategy in the health region, since it reproduced the invisibility of women with greater social vulnerability and exacerbated the existing inequalities.
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Lopes VAS, Ribeiro JM. Fatores limitadores e facilitadores para o controle do câncer de colo de útero: uma revisão de literatura. CIENCIA & SAUDE COLETIVA 2019; 24:3431-3442. [DOI: 10.1590/1413-81232018249.32592017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 02/18/2018] [Indexed: 11/22/2022] Open
Abstract
Resumo Este artigo revisa os fatores limitadores e facilitadores do acesso aos serviços públicos de saúde no Brasil na área da atenção ao câncer de colo de útero (CCU). Nesta revisão, foram utilizadas a base de dados bibliográficos Medline (interface com Biblioteca Virtual de Saúde/BVS e PubMed) e os portais Lilacs e SciELO. Buscou-se publicações referentes ao período 2011-2016, a partir do uso de termos específicos das fontes consultadas, relativos a ‘neoplasias do colo do útero’ e ‘acesso aos serviços de saúde’. Foram inicialmente encontrados 704 artigos, mas, considerando os critérios adotados, foram selecionados 31 artigos, dos quais foram incluídos 19. Foram mencionados aspectos facilitadores do acesso como ampla cobertura do exame Papanicolaou e de biopsias equivalente ao número de preventivos alterados. Entretanto, aspectos limitadores de acesso como periodicidade inadequada do Papanicolau, dificuldades para agendamento de consultas e exames, alto índice de estadiamento avançado e atrasos no diagnóstico e no início de tratamento, também foram apresentados.
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Açucena Vieira Alves S, Schiaveto de Souza A, Weller M, Pires Batiston A. Differential Impact of Education Level, Occupation and
Marital Status on Performance of the Papanicolaou Test among
Women from Various Regions in Brazil. Asian Pac J Cancer Prev 2019; 20:1037-1044. [PMID: 31030471 PMCID: PMC6948916 DOI: 10.31557/apjcp.2019.20.4.1037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: In Brazil, little is known regarding the underlying causes of differences among populations regarding socio-economic variables that affect women’s cervical cancer screening behavior. The present study focused on socio-economic variables that affect women’s performance of the Papanicolaou test, comparing two distinct Brazilian populations. Methods: We collected data regarding performance of the Papanicolaou test and socio-economic variables from 559 women in Mato Grosso do Sul (MS), in the Central East region, and 338 women in Paraíba (PB), in the Northeast region of Brazil. Nominal logistic regression modeling was performed to identify independent variables for both groups of data. Results: Of the women interviewed from MS and PB, 116 out of 599 (19.37%) and 94 out of 338 (27.81%), respectively, had not performed the Papanicolaou test within the last three years (p = 0.025). Low educational level characterized 570 (95.16%) and 203 (60.06%) of women from MS and PB, respectively (p = 0.000). Women in PB who had a low educational level and were unemployed had a 2.96-fold (OR = 0.338; 95% CI: 0.121 - 0.939) and 2.40-fold (OR = 0.416; 95% CI: 0.199 - 0.869) lower chance, respectively, to have performed the Papanicolaou test ≥ three times, or once within the last three years (p = 0.029; p = 0.014). The chance of women in MS who did not live in a stable relationship to have performed the test ≥ three times was 1.79-fold (OR = 0.560; 95% CI: 0.348 – 0.901) lower compared to women who reported a stable relationship (p = 0.039). Conclusions: High educational level, employment, and having a stable interpersonal relationship positively associated with performance of the Papanicolaou test among women in PB and MS. Despite having predominantly a low educational level, women in MS performed the Papanicolaou test more frequently than those in PB.
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Affiliation(s)
| | - Albert Schiaveto de Souza
- Institute of Biosciences, Federal University of Mato Grosso do Sul (UFMS), Campo Grande- Mato Grosso do Sul, Brazil
| | - Mathias Weller
- Postgraduate Program in Public Health, State University of Paraíba (UEPB), Campina Grande, Paraíba, Brazil.
| | - Adriane Pires Batiston
- Instituto Integrado de Saúde, Federal University of Mato Grosso do Sul (UFMS), Campo Grande- Mato Grosso do Sul, Brazil
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Terlan RJ, Cesar JA. Não realização de citopatológico de colo uterino entre gestantes no extremo sul do Brasil: prevalência e fatores associados. CIENCIA & SAUDE COLETIVA 2018; 23:3557-3566. [DOI: 10.1590/1413-812320182311.35162016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 01/08/2017] [Indexed: 11/22/2022] Open
Abstract
Resumo O câncer do colo do útero é o terceiro tumor mais frequente na população feminina e o teste citopatológico (CP) a principal estratégia para o rastreamento. Este estudo mediu a prevalência e os fatores associados à não realização de CP entre gestantes maiores de 25 anos, durante o pré-natal, no município de Rio Grande, RS, em 2013. A análise multivariável utilizou regressão de Poisson avaliada por meio de razão de prevalências (RP). Dentre as 1474 gestantes incluídas no estudo, 21,6% (IC95% 19,5%-23,7%) não realizaram CP nos últimos três anos. Na análise ajustada, a RP para não realização entre puérperas com escolaridade entre 0-4 anos foi 2,14 (IC95%:1,35-3,38) em comparação àquelas com 12 anos ou mais. Ter referido aborto prévio e consumido álcool durante a gestação mostrou RP = 1,38 (1,10-1,73) e 1,39 (1,04-1,84) de não fazê-lo em relação às demais, respectivamente. Realizar 1-5 consultas de pré-natal conferiu RP = 1,35 (1,03-1,77) em relação às demais. Evidencia-se proporção expressiva de não realização de CP e não cumprimento de recomendação básica do Ministério da Saúde. Os profissionais de saúde deveriam reforçar a necessidade de realização deste exame, bem como busca ativa na comunidade das gestantes com o perfil aqui descrito.
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Costa RFA, Longatto-Filho A, de Lima Vazquez F, Pinheiro C, Zeferino LC, Fregnani JHTG. Trend analysis of the quality indicators for the Brazilian cervical cancer screening programme by region and state from 2006 to 2013. BMC Cancer 2018; 18:126. [PMID: 29394915 PMCID: PMC5797416 DOI: 10.1186/s12885-018-4047-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 01/24/2018] [Indexed: 11/21/2022] Open
Abstract
Background Quality indicators for the Brazilian cervical cancer screening programme can provide a perspective on its effectiveness in Brazilian macro-regions and states. The aim of this study was to perform a trend analysis of the cervical cancer screening program’s quality indicators, according to Brazilian regions and states, from 2006 to 2013. Methods Using information from approximately 62,000,000 exams obtained from the Information System of Cervical Cancer Screening (SISCOLO), joinpoint analysis was used to calculate the Annual Percentage Change (APC). Results The estimated number of women in the target age group (25–64 years) who underwent Pap testing over a three-year interval was lower than that recommended by international guidelines in the North, Northeast and Midwest regions, and the trends for this indicator remained stationary over the years in all regions of Brazil. Overall, the index of positivity in Brazilian regions and states is below that preconized by the Brazilian National Cancer Institute (INCA). Additionally, the frequencies of unsatisfactory cases are in line with international guidelines but above those preconized by INCA guidelines. All positive cytological diagnoses were lower than those preconized by INCA. Conclusions The results show that the cervical cancer screening programme is still far from efficient because most of the quality indicators in Brazilian regions and states are outside of the parameters preconized by national and international organizations. Electronic supplementary material The online version of this article (10.1186/s12885-018-4047-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ricardo Filipe Alves Costa
- Graduate Program on Oncology, Barretos Cancer Hospital, Barretos, São Paulo, 14784-400, Brazil. .,Barretos School of Health Sciences Dr. Paulo Prata - FACISB, Avenida Loja Maçonica Renovadora 68, N° 100, Bairro Aeroporto, Barretos, SP, 14785-002, Brazil.
| | - Adhemar Longatto-Filho
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, 14784-400, Brazil.,Laboratory of Medical Investigation (LIM 14), Faculty of Medicine São Paulo University, FMUSP, São Paulo, 01246-903, Brazil.,Life and Health Sciences Research Institute, ICVS, School of Health Sciences, Uminho University, 4710, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, 4710, Braga/Guimarães, Portugal
| | - Fabiana de Lima Vazquez
- Research and Teaching Institute, Barretos Cancer Hospital, Barretos, São Paulo, 14784-400, Brazil
| | - Céline Pinheiro
- Barretos School of Health Sciences Dr. Paulo Prata - FACISB, Avenida Loja Maçonica Renovadora 68, N° 100, Bairro Aeroporto, Barretos, SP, 14785-002, Brazil.,Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, 14784-400, Brazil
| | - Luiz Carlos Zeferino
- School of Medical Sciences, Women's Hospital CAISM, Unicamp, Campinas, São Paulo, 13081-940, Brazil
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Nogueira Dias Genta ML, Martins TR, Mendoza Lopez RV, Sadalla JC, de Carvalho JPM, Baracat EC, Levi JE, Carvalho JP. Multiple HPV genotype infection impact on invasive cervical cancer presentation and survival. PLoS One 2017; 12:e0182854. [PMID: 28829791 PMCID: PMC5567480 DOI: 10.1371/journal.pone.0182854] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 07/24/2017] [Indexed: 12/03/2022] Open
Abstract
Background Invasive cervical cancer (ICC) is the third most common malignant neoplasm affecting Brazilian women. Little is known about the impact of specific HPV genotypes in the prognosis of ICC. We hypothesized that HPV genotype would impact ICC clinical presentation and survival. Methods Women diagnosed with ICC at the Instituto do Câncer do Estado de São Paulo (ICESP) between May 2008 and June 2012 were included in the study and were followed until December 2015. HPV genotype was detected from formalin-fixed paraffin-embedded (FFPE) tumor tissue samples using Onclarity™ system (BD Viper™ LT automated system). Results 292 patients aged 50±14 years were analyzed. HPVDNA was detected in 84% of patients. The HPV genotypes studied were: HPV16 (64%), HPV18 (10%), HPV33-58 (7%), HPV45 (5%), HPV31 (4%) and other high-risk HPV genotypes (11%). HPV genotypes showed different distributions regarding histological type and clinical stage. Patients were followed for 35±21 months. The overall survival at 5 years after diagnosis of cervical cancer was 54%. Age, clinical staging, histological type and multiple HPV genotypes infection detected in the same tumor specimen were associated with poorer overall survival on multivariate Cox proportional hazard analysis (p<0.05). No specific HPV genotype affected survival. Conclusion Multiple HPV genotype infection was associated with poorer ICC survival in our study, compared with single genotype infection. HPV genotyping from FFPE tumor tissue using an automated assay such as the Onclarity BD™ assay provides a simpler alternative for routine clinical use. Impact This is the largest study employing an automated HPV genotyping assay using FFPE of ICC. Multiple HPV genotype infection adversely influenced survival.
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Affiliation(s)
- Maria Luiza Nogueira Dias Genta
- Gynecological Oncology Department, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- * E-mail:
| | - Toni Ricardo Martins
- Virology Laboratory, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Rossana V. Mendoza Lopez
- Centro de Investigação Translacional em Oncologia, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - José Carlos Sadalla
- Gynecological Oncology Department, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - João Paulo Mancusi de Carvalho
- Gynecological Oncology Department, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Edmund Chada Baracat
- Division of Gynecologic Clinic, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - José Eduardo Levi
- Virology Laboratory, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Jesus Paula Carvalho
- Gynecological Oncology Department, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Vasconcelos CTM, Pinheiro AKB, Nicolau AIO, Lima TM, Barbosa DDFF. Comparison among the efficacy of interventions for the return rate to receive the pap test report: randomized controlled clinical trial. Rev Lat Am Enfermagem 2017; 25:e2857. [PMID: 28301035 PMCID: PMC5363331 DOI: 10.1590/1518-8345.1337.2857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 11/14/2016] [Indexed: 12/30/2022] Open
Abstract
Objective: to test the effects of a behavioral, an educative and a comparative intervention on women's adherence to the return appointment to receive the pap test report. Methods: randomized controlled clinical trial at a Primary Health Care Service, involving three groups: EG (educative session and test demonstration), BG (recall ribbon) and standard intervention (card containing the return appointment - graphical reminder), called comparative group here (CG). To select the sample, the following was established: having started sexual activity and undergoing the pap smear during the study, resulting in 775 women. Results: among the 775 women, 585 (75.5%) returned to receive the test result within 65 days. The educative group presented the highest return rate (EG=82%/CG=77%/BG=66%), statistically significant only when compared to the behavioral group (p=0.000). The educative group obtained the smallest interval (p<0.05) concerning the mean number of days of return to receive the test result (EG:M=43days/BG:M=47.5days/CG:M=44.8 days). Conclusion: the educative group reached higher return rates and the women returned earlier, but the behavioral intervention showed to be the least effective. Brazilian Clinical Trial Register: RBR-93ykhs.
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Affiliation(s)
| | | | | | - Thaís Marques Lima
- PhD, Adjunct Professor, Centro Universitário Estácio, Fortaleza, CE, Brazil
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Ribeiro L, Bastos RR, Vieira MDT, Ribeiro LC, Teixeira MTB, Leite ICG. [Opportunistic screening versus missed opportunities: non-adherence to Pap smear testing in women attending prenatal care]. CAD SAUDE PUBLICA 2016; 32:S0102-311X2016000605003. [PMID: 27333137 DOI: 10.1590/0102-311x00001415] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 02/22/2016] [Indexed: 05/29/2023] Open
Abstract
The objectives were to estimate the prevalence of non-adherence to Pap smear testing in women attending prenatal care and to identify associated factors. This was a cross-sectional population-based study in 308 women from a rural municipality (county) in Minas Gerais State, Brazil. Complex stratified cluster sampling was used. Statistical analysis used the chi-square test and logistic regression model with the variables that presented p-value ≤ 0.05 in the bivariate model. Prevalence of lack of Pap smear test was 21.3%. Among women 25 years or older, prevalence was 15.1%. Non-adherence was more common in young, single women and those with low schooling. Low schooling remained associated with non-performance of Pap smear (OR = 0.41), indicating that women with more schooling enjoyed higher odds of testing. Contact with the prenatal clinic did not determine guaranteed access to the test, thus indicating missed opportunities when opportunistic screening is employed.
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Affiliation(s)
- Luciane Ribeiro
- Universidade Federal de Viçosa, Viçosa, Brasil., Universidade Federal de Viçosa, Universidade Federal de Viçosa, Viçosa , Brazil
| | - Ronaldo Rocha Bastos
- Universidade Federal de Juiz de Fora, Juiz de Fora, Brasil., Universidade Federal de Juiz de Fora, Universidade Federal de Juiz de Fora, Juiz de Fora , Brazil
| | - Marcel de Toledo Vieira
- Universidade Federal de Juiz de Fora, Juiz de Fora, Brasil., Universidade Federal de Juiz de Fora, Universidade Federal de Juiz de Fora, Juiz de Fora , Brazil
| | - Luiz Cláudio Ribeiro
- Universidade Federal de Juiz de Fora, Juiz de Fora, Brasil., Universidade Federal de Juiz de Fora, Universidade Federal de Juiz de Fora, Juiz de Fora , Brazil
| | - Maria Teresa Bustamante Teixeira
- Universidade Federal de Juiz de Fora, Juiz de Fora, Brasil., Universidade Federal de Juiz de Fora, Universidade Federal de Juiz de Fora, Juiz de Fora , Brazil
| | - Isabel Cristina Gonçalves Leite
- Universidade Federal de Juiz de Fora, Juiz de Fora, Brasil., Universidade Federal de Juiz de Fora, Universidade Federal de Juiz de Fora, Juiz de Fora , Brazil
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Silveira NSP, Vasconcelos CTM, Nicolau AIO, Oriá MOB, Pinheiro PNDC, Pinheiro AKB. Knowledge, attitude and practice of the smear test and its relation with female age. Rev Lat Am Enfermagem 2016; 24:S0104-11692016000100336. [PMID: 27305183 PMCID: PMC4916975 DOI: 10.1590/1518-8345.0700.2699] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 08/11/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to verify the association among the knowledge attitude and practice of women in relation to the smear test and the age range. METHOD a cross-sectional research was undertaken, associated with the knowledge, attitude and practice survey at a Primary Health Care service. The sample consisted of 775 women, distributed in three age ranges: adolescent, young and elderly. RESULTS although high rates of inappropriate knowledge were found in all age ranges, it was significantly higher among the adolescents (p=0.000). A similar trend was found in the attitude component, with percentages of inappropriateness in adolescence that drop as age advances (p=0.000). Nevertheless, no statistical difference among the groups was found in terms of practice (p=0.852). CONCLUSION the study demonstrated a relation between the age range and knowledge, attitude and practice of the smear test. OBJETIVO verificar a associação entre o conhecimento, atitude e prática de mulheres em relação ao exame colpocitológico e a faixa etária. MÉTODOS trata-se de pesquisa de corte transversal associada ao inquérito conhecimento, atitude e prática, em uma Unidade de Atenção Primária à Saúde. A amostra foi composta por 775 mulheres, distribuídas em três faixas etárias: adolescentes, jovens e idosas. RESULTADOS embora o conhecimento inadequado tenha tido altas taxas em todas as faixas etárias, foi significativamente superior entre as adolescentes (p=0,000). Tendência semelhante no componente atitude por apresentar percentuais de inadequabilidade na adolescência e decair com o avançar da idade (p=0,000). Todavia, não houve diferença estatística entre os grupos quanto à prática (p=0,852). CONCLUSÃO o estudo demonstrou relação entre a faixa etária e o conhecimento, a atitude e a prática do exame colpocitológico. OBJETIVO verificar la asociación entre el conocimiento, la actitud y práctica de mujeres con relación a la prueba colpocitológica y el rango de edad. MÉTODO se trata de investigación trasversal asociada a la encuesta conocimiento, actitud y práctica, en una Unidad de Atención Primaria de Salud. La muestra abarcó a 775 mujeres, distribuidas en tres rangos de edad: adolescentes, jóvenes y ancianas. RESULTADOS aunque el conocimiento inadecuado tenga mostrada altas tasas en todos los rangos de edad, fue significativamente superior entre las adolescentes (p=0,000). Tendencia semejante en el componente actitud, debido a porcentajes de inadecuación en la adolescencia, disminuyendo con el avance de la edad (p=0,000). Sin embargo, no fue encontrada diferencia estadística entre los grupos respecto a la práctica (p=0,852). CONCLUSIÓN el estudio demostró relación entre el rango de edad y el conocimiento, la actitud y la práctica de la prueba colpocitológica.
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Affiliation(s)
- Nara Sibério Pinho Silveira
- Mestrando, Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brasil., Universidade Federal do Ceará, Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza CE , Brazil, Brasil
| | - Camila Teixeira Moreira Vasconcelos
- PhD, Professor Adjunto, Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brasil., Universidade Federal do Ceará, Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza CE , Brazil
| | - Ana Izabel Oliveira Nicolau
- Doutorando, Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brasil., Universidade Federal do Ceará, Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza CE , Brazil
| | - Mônica Oliveira Batista Oriá
- PhD, Professor Adjunto, Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brasil., Universidade Federal do Ceará, Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza CE , Brazil
| | - Patricia Neyva da Costa Pinheiro
- PhD, Professor Adjunto, Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brasil., Universidade Federal do Ceará, Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza CE , Brazil
| | - Ana Karina Bezerra Pinheiro
- PhD, Professor Associado, Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brasil., Universidade Federal do Ceará, Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza CE , Brazil
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12
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Leite FMC, Amorim MHC, Primo CC, Gigante DP. Violence against women and cervical cancer screening: a systematic review. J Clin Nurs 2016; 26:2126-2136. [DOI: 10.1111/jocn.13328] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2016] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Cândida Caniçali Primo
- Departament of Nursing; Federal University of Espirito Santo; Vitoria Espírito Santo Brazil
| | - Denise Petrucci Gigante
- Study Center of Epidemiology; Federal University of Pelotas; Pelotas Rio Grande do Sul Brazil
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13
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Wohlmeister D, Vianna DRB, Helfer VE, Gimenes F, Consolaro MEL, Barcellos RB, Rossetti ML, Calil LN, Buffon A, Pilger DA. Association of human papillomavirus and Chlamydia trachomatis with intraepithelial alterations in cervix samples. Mem Inst Oswaldo Cruz 2016; 111:106-13. [PMID: 26841046 PMCID: PMC4750450 DOI: 10.1590/0074-02760150330] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 12/23/2015] [Indexed: 11/21/2022] Open
Abstract
The influence of different infectious agents and their association with human papillomavirus (HPV) in cervical carcinogenesis have not been completely elucidated. This study describes the association between cytological changes in cervical epithelium and the detection of the most relevant aetiological agents of sexually transmitted diseases. Samples collected from 169 patients were evaluated by conventional cytology followed by molecular analysis to detect HPV DNA, Chlamydia trachomatis, herpes simplex virus 1 and 2,Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, andTreponema pallidum, besides genotyping for most common high-risk HPV. An association between cytological lesions and different behavioural habits such as smoking and sedentariness was observed. Intraepithelial lesions were also associated with HPV and C. trachomatis detection. An association was also found between both simple and multiple genotype infection and cytological changes. The investigation of HPV and C. trachomatisproved its importance and may be considered in the future for including in screening programs, since these factors are linked to the early diagnosis of patients with precursor lesions of cervical cancer.
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Affiliation(s)
| | - Débora Renz Barreto Vianna
- Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Virgínia Etges Helfer
- Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Fabrícia Gimenes
- Laboratório de Citologia Clínica, Universidade Estadual de Maringá, Maringá, PR, Brasil
| | | | - Regina Bones Barcellos
- Centro de Desenvolvimento Científico e Tecnológico, Fundação Estadual de Produção e Pesquisa em Saúde, Porto Alegre, RS, Brasil
| | - Maria Lucia Rossetti
- Centro de Desenvolvimento Científico e Tecnológico, Fundação Estadual de Produção e Pesquisa em Saúde, Porto Alegre, RS, Brasil
| | - Luciane Noal Calil
- Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Andréia Buffon
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
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14
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Costa RFA, Longatto-Filho A, Pinheiro C, Zeferino LC, Fregnani JH. Historical Analysis of the Brazilian Cervical Cancer Screening Program from 2006 to 2013: A Time for Reflection. PLoS One 2015; 10:e0138945. [PMID: 26402737 PMCID: PMC4581862 DOI: 10.1371/journal.pone.0138945] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 09/05/2015] [Indexed: 12/22/2022] Open
Abstract
Background The Cervical Cancer Database of the Brazilian National Health Service (SISCOLO) contains information regarding all cervical cytological tests and, if properly explored, can be used as a tool for monitoring and managing the cervical cancer screening program. The aim of this study was to perform a historical analysis of the cervical cancer screening program in Brazil from 2006 to 2013. Material and Methods The data necessary to calculate quality indicators were obtained from the SISCOLO, a Brazilian health system tool. Joinpoint analysis was used to calculate the annual percentage change. Results We observed important trends showing decreased rates of low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and an increased rate of rejected exams from 2009 to 2013. The index of positivity was maintained at levels below those indicated by international standards; very low frequencies of unsatisfactory cases were observed over the study period, which partially contradicts the low rate of positive cases. The number of positive cytological diagnoses was below that expected, considering that developed countries with low frequencies of cervical cancer detect more lesions annually. Conclusions The evolution of indicators from 2006 to 2013 suggests that actions must be taken to improve the effectiveness of cervical cancer control in Brazil.
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Affiliation(s)
- Ricardo Filipe Alves Costa
- Graduate Program of Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Barretos School of Health Sciences Dr. Paulo Prata – FACISB, Barretos, São Paulo, Brazil
- * E-mail:
| | - Adhemar Longatto-Filho
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Laboratory of Medical Investigation (LIM 14), Faculty of Medicine, São Paulo University, FMUSP, São Paulo, Brazil
- Life and Health Sciences Research Institute, ICVS, School of Health Sciences, Minho University, Braga, Portugal
- ICVS/3B’s - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Céline Pinheiro
- Barretos School of Health Sciences Dr. Paulo Prata – FACISB, Barretos, São Paulo, Brazil
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Luiz Carlos Zeferino
- School of Medical Sciences, Women’s Hospital CAISM, Unicamp, Campinas, São Paulo, Brazil
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