Parâmetros para a programação de procedimentos da linha de cuidado do câncer do colo do útero no Brasil

Ribeiro, Cláudio P.; Dias, Maria Beatriz Kneipp; Sole, Maria Asunción; Corrêa, Flávia Miranda; Russomano, Fábio Bastos; Tomazelli, Jeane Gláucia

doi:10.1590/0102-311x00183118

Cited by 12 publications

(13 citation statements)

References 14 publications

(11 reference statements)

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“…Our analysis is one of the few publications documenting individual-level colposcopy and treatment follow-up within SUS. We observed compliance far below a recent analysis of country-wide health services utilization data extrapolated that 93% of all colposcopies and 73% of required treatments were performed [30]. Due to the lack of a unified medical records system, follow-up activities are not linked nor tracked, making it difficult to identify procedures and necessitating extensive record review [19].…”

Section: Plos Onementioning

confidence: 65%

Moving towards a strategy to accelerate cervical cancer elimination in a high-burden city—Lessons learned from the Amazon city of Manaus, Brazil

Torres

Rondon

Martins³

et al. 2021

PLoS ONE

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The World Health Organization Call to Eliminate Cervical Cancer resonates in cities like Manaus, Brazil, where the burden is among the world’s highest. Manaus has offered free cytology-based screening since 1990 and HPV immunization since 2013, but the public system is constrained by many challenges and performance is not well-defined. We obtained cervical cancer prevention activities within Manaus public health records for 2019 to evaluate immunization and screening coverage, screening by region and neighborhood, and the annual Pink October screening campaign. We estimated that among girls and boys age 14–18, 85.9% and 64.9% had 1+ doses of HPV vaccine, higher than rates for age 9–13 (73.4% and 43.3%, respectively). Of the 90,209 cytology tests performed, 24.9% were outside the target age and the remaining 72,230 corresponded to 40.1% of the target population (one-third of women age 25–64). The East zone had highest screening coverage (49.1%), highest high-grade cytology rate (2.5%) and lowest estimated cancers (38.1/100,000) compared with the South zone (32.9%, 1.8% and 48.5/100,000, respectively). Largest neighborhoods had fewer per capita screening locations, resulting in lower coverage. During October, some clinics successfully achieved higher screening volumes and high-grade cytology rates (up to 15.4%). Although we found evidence of some follow-up within 10 months post-screening for 51/70 women (72.9%) with high-grade or worse cytology, only 18 had complete work-up confirmed. Manaus has successfully initiated HPV vaccination, forecasting substantial cervical cancer reductions by 2050. With concerted efforts during campaigns, some clinics improved screening coverage and reached high-risk women. Screening campaigns in community locations in high-risk neighborhoods using self-collected HPV testing can achieve widespread coverage. Simplifying triage and treatment with fewer visits closer to communities would greatly improve follow-up and program effectiveness. Achieving WHO Cervical Cancer Elimination goals in high-burden cities will require major reforms for screening and simpler follow-up and treatment.

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Section: Plos Onementioning

confidence: 65%

Moving towards a strategy to accelerate cervical cancer elimination in a high-burden city—Lessons learned from the Amazon city of Manaus, Brazil

Torres

Rondon

Martins³

et al. 2021

PLoS ONE

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“…Tendo em vista um programa de rastreamento organizado com cobertura de 100% da população-alvo, estimou-se que a necessidade de exames citopatológicos de rastreamento corresponde a 39,8% das mulheres na faixa etária alvo. (Ribeiro et al, 2019) No entanto, de acordo com Ribeiro et al, (2019) o Brasil ainda não possui um programa de rastreamento organizado, as ações são predominantemente oportunísticas.…”

Section: Discussionunclassified

Detecção precoce do câncer do colo do útero no Brasil: um estudo dos indicadores de cobertura e adesão às diretrizes técnicas nacionais

Silva

Knupp

Dantas

et al. 2022

RSD

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Objetivo: Analisar os indicadores relacionados a cobertura e adesão às diretrizes para controle do Câncer de Colo de útero no Brasil no período de 2015 a 2020. Método: Estudo ecológico, de abordagem quantitativa, elaborado com dados contidos no Sistema de Informação do Câncer e no Sistema de Informação Ambulatorial. Utilizou-se também dados provenientes do censo demográfico do Instituto Brasileiro de Geografia e Estatística e do Instituto Nacional de Câncer. A análise dos dados foi realizada por meio do cálculo dos indicadores no programa Excel e os resultados foram dispostos na forma de tabelas. Resultados: A Razão de exames citopatológicos do colo do útero em mulheres de 25 a 64 anos e a população feminina da mesma faixa etária no período estudado, apresentou tendência de queda em todas as regiões do país. Na proporção de exames citopatológicos do colo do útero na faixa etária alvo, verificou-se que as maiores proporções foram alcançadas entre regiões norte e sudeste, e as menores proporções nas regiões Sul e Centro Oeste. Quanto a proporção de exames citopatológicos do colo do útero sem citologia anterior, observou-se um padrão de queda em todas as regiões do Brasil e na proporção de exames citopatológicos do colo do útero com periodicidade trienal, as regiões Norte e Nordeste apresentaram os melhores desempenhos. Conclusão: As tendências de queda evidenciadas nos indicadores de cobertura e adesão às diretrizes nacionais podem refletir no aumento da incidência, morbidade e mortalidade do câncer do colo do útero.

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“…This calculation was based on the number of Pap smears performed that year and their known positivity rate 25 . However, using different -and potentially more robust -parameters to estimate the necessity for colposcopies in 2017, a second study found that the number of colposcopies performed nationally was 7% less than the required 26 .…”

Section: Figurementioning

confidence: 99%

Access to colposcopy in the State of São Paulo, Brazil: probabilistic linkage study of administrative data

Buss

Cury²,

Ribeiro

et al. 2022

Cad. Saúde Pública

Self Cite

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Cervical cancer screening is a multistage process, therefore access to both the primary test and subsequent diagnostic procedures is essential. Considering women undergoing screening on the public health system in the State of São Paulo, Brazil, we aimed to estimate the proportion of women accessing colposcopy within six months of an abnormal smear result. We retrieved records from two administrative databases, the Information System on Uterine Cervical Cancer (SISCOLO) that contains smear results and the Outpatient Information System of the Brazilian Unified National Health System (SIA/SUS) that records colposcopies. A reference cohort consisted of women, aged 25 years or older, with an abnormal smear result between May 1, 2014, and June 30, 2014. We excluded prevalent cases. We linked the reference cohort and records in the SIA/SUS extending to December 31, 2014. After excluding prevalent cases, 1,761 women with abnormal cytology results were left. A total of 700 (39.8%) women were linked to a colposcopy record within the follow-up period; this dropped to 671 (38.1%) women when follow-up was censored at six months. We could notice a slightly higher attendance in women living in the metropolitan region of São Paulo compared with residents of the rest of the state. We found no association between colposcopy attendance and age or cytology class. These results emphasize that access to colposcopy in the public health system in São Paulo is limited. This compromises the quality of screening, and the issue needs to be prioritized in service planning.

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Parâmetros para a programação de procedimentos da linha de cuidado do câncer do colo do útero no Brasil

Cited by 12 publications

References 14 publications

Moving towards a strategy to accelerate cervical cancer elimination in a high-burden city—Lessons learned from the Amazon city of Manaus, Brazil

Moving towards a strategy to accelerate cervical cancer elimination in a high-burden city—Lessons learned from the Amazon city of Manaus, Brazil

Detecção precoce do câncer do colo do útero no Brasil: um estudo dos indicadores de cobertura e adesão às diretrizes técnicas nacionais

Access to colposcopy in the State of São Paulo, Brazil: probabilistic linkage study of administrative data

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