Monitoramento externo da qualidade dos exames citopatológicos cervicais realizados pelo Sistema Único de Saúde (SUS) no Estado de Mato Grosso do Sul

Freitas, Hilda Guimarães de; Thuler, Luiz Cláudio Santos

doi:10.1590/s0100-72032012000800002

Cited by 6 publications

(4 citation statements)

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“…Additionally, as some studies show the importance of external quality control of laboratories in the improvement of professionals’ skills in detecting cervical cancer precursor lesions, a systematic improved external control should be implemented at all cytopathology laboratories that provide services to the public health system. The current external system of quality control implemented by the Brazilian Government is limited to a small number of samples in selected laboratories examined periodically [ 29 , 30 ], which may result in an unrealistic panorama of the laboratories’ performances.…”

Section: Discussionmentioning

confidence: 99%

Historical Analysis of the Brazilian Cervical Cancer Screening Program from 2006 to 2013: A Time for Reflection

et al. 2015

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BackgroundThe 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 MethodsThe 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.ResultsWe 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.ConclusionsThe 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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Section: Discussionmentioning

confidence: 99%

Historical Analysis of the Brazilian Cervical Cancer Screening Program from 2006 to 2013: A Time for Reflection

et al. 2015

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“…In this regard, the results found in the present study were better than the results described in studies performed in Mato Grosso do Sul (11.4%), Goiânia (21.0%), and São Paulo (3.8%) and were surpassed only by studies performed in Paraná (1.8%). [17][18][19][20] This data may reflect the good technical quality of the team performing the cervix cytopathological exams in the Municipal Units of Primary Health Care, the continuing education and effectiveness of the External, Internal Quality Monitoring program in improving the quality of these exams.…”

Section: Discussionmentioning

confidence: 99%

External Quality Monitoring of the Cervical Cytopathological Exams in the Rio de Janeiro City

Rocha

Malfacini

Gomes

et al. 2018

Rev Bras Ginecol Obstet

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Objective To discuss the implementation and contributions of the External Quality Monitoring in the city of Rio de Janeiro and to analyze the performance of the main providers of cervical cytopathology in this city from September 2013 to March 2017, here referred to as "Alpha laboratory" and "Beta laboratory." Methods Observational, cross-sectional, retrospective study using information from the Cervical Cancer Control Information System (SISCOLO, in the Portuguese acronym), municipal coordination module, External Quality Monitoring report. The proportions of false positives, false negatives, unsatisfactory samples and rejected samples were estimated. The agreement among the observers was analyzed through the Kappa index and the reduction of disagreements in the period for each laboratory studied, comparing the results of each cycle. Results A total of 19,158 examinations were selected, of which 19,130 (99.85%) were monitored, 16.649 (87, 03%) were reviewed by the External Quality Monitoring Unit, 2,481 (12,97%) were rejected and 441 (2,65%) were considered unsatisfactory. The "Beta laboratory" presented excellent concordance in all cycles; the "Alpha laboratory" had good concordance in the first two cycles (K ¼ 0.76 and 0.79), becoming excellent in the following four cycles. The average Kappa index was 0.85, with median of 0.86. The percentage of diagnostic disagreement was 6.63% of the reviewed exams, of which 5.38% required a change of conduct Conclusion External Quality Monitoring is an exercise in diagnostic improvement, and its implementation was fundamental to ensure the reliability of the cytopathological exams in the city of Rio de Janeiro. ResumoObjetivo Discutir a implementação e as contribuições do Monitoramento Externo da Qualidade na cidade do Rio de Janeiro e analisar o desempenho dos principais

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“…Nesse estudo, 41,4% das amostras apresentaram diagnóstico dentro do limite da normalidade, achado semelhante ao encontrado nos estudos realizados no Mato Grosso do Sul e São Paulo (21,22) . Por sua vez, as alterações celulares benignas foram as mais frequentes com destaque para as inflamações e os achados citopatológicos, assim como em outros estudos (8,23) .…”

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Fatores Associados À Representatividade Da Zona De Transformação Em Exames Citopatológicos Do Colo Uterino

et al. 2016

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Objetivou-se analisar os fatores associados à representatividade da Zona de Transformação em exames citopatológicos para controle do câncer do colo do útero.Trata-se de um estudo retrospectivo de caráter quantitativo realizado por meio das análises dos exames citopatológicos registrados no Sistema de Informação do Câncer em 2014. A amostra final resultou em 1.157 laudos. Para a análise dos dados foi utilizado o software Statistical Package for the Social Sciences. Do total de exames, 96,88% foram realizados para o controle e rastreamento da doença e 24,3% não apresentaram a zona de transformação. Os fatores que influenciaram a representatividade da zona de transformação foram idade entre 25 a 64 anos, uso de contraceptivo oral, terapia de reposição hormonal e epitélio metaplásico. Tais fatores podem ser considerados facilitadores para a captação de uma amostra satisfatória com a possível diminuição de resultados falso-negativos, o que acarretaria o retardo do tratamento precoce do câncer do colo uterino.

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Monitoramento externo da qualidade dos exames citopatológicos cervicais realizados pelo Sistema Único de Saúde (SUS) no Estado de Mato Grosso do Sul

Abstract: These results emphasize the feasibility of the External Quality Control of cytopathology at the state level and its implementation results in improvement in the diagnoses performed in the SUS network.

Cited by 6 publications

References 4 publications

Historical Analysis of the Brazilian Cervical Cancer Screening Program from 2006 to 2013: A Time for Reflection

Historical Analysis of the Brazilian Cervical Cancer Screening Program from 2006 to 2013: A Time for Reflection

External Quality Monitoring of the Cervical Cytopathological Exams in the Rio de Janeiro City

Fatores Associados À Representatividade Da Zona De Transformação Em Exames Citopatológicos Do Colo Uterino

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