Neoplasia Intraepitelial Cervical em Pacientes do Centro de Saúde-Escola Murialdo: Prevalência e Seguimento

Abstract

Introdução: O câncer de colo uterino é passível de prevenção e cura, apesar disso mantém uma alta taxa de mortalidade no mundo. A citologia realizada de rotina e associada à colposcopia e à biópsia cervical compõe o seguimento capaz de identificar lesões precursoras do câncer e de diminuir a incidência dessa patologia. Objetivos: Identificar pacientes com neoplasia intraepitelial cervical, a prevalência dessas alterações, conforme a faixa etária, e definir qual o acompanhamento realizado por elas no Centro de Saúde-Escola Murialdo. Materiais e Métodos: Estudo coorte retrospectivo de dados secundários das pacientes com lesão intraepitelial de baixo e alto grau, identificando a realização da colposcopia, biópsia e repetição da citologia após a primeira alteração citológica. Introduction: Although cervical cancer can be prevented and cured, it still presents a high mortality rate worldwide. The routine cytology, associated with colposcopy and cervical biopsy can identify precursor injuries of cancer and decrease the incidence of this pathology. Objectives: To identify patients with Cervical Intraepithelial Neoplasia, the prevalence of these changes, according to the patient age group and to define which monitoring treatment they were submitted to at Murialdo Health School Center. Materials and Methods: Retrospective cohort study of secondary data of patients with intraepithelial injuries of low and high degrees, identifying execution of the colposcopy, biopsy and repetition of the cytology after the first cytological alteration. Results: 372 women between 13 and 82 years old had their tests evaluated between 1997 and 2008, resulting in prevalence of 70.2% of low degree injuries and 29.8% of high degree injuries and invasive cancer; 68.2% of the total patients had an colposcopy, 48.1% had a biopsy and 8.8% of the patients oriented to repeat the CP did it in less than a year. In the follow-up, 20.7% had a cervical conization, 1.9% went through hysterectomy and 78.2% of the low degree alterations had normal cytology when recollected. Conclusions: There is a low cancer screening on this population that presents high HPV prevalence and infections that make the cervical epithelium vurnerable. Yet, with the easiness of colposcopy, there is super evaluation of the changes and probably the cancer mortality rate has decreased. It is urgent to enlarge the surveillance in women's health until the health units be organized and actives.