Results of screening for cervical cancer among pregnant and non‐pregnant women in Brazil

Xavier‐Júnior, José Cândido Caldeira; Vale, Diama Bhadra; Vieira, Luiz Fernando Fonseca; Lima, Marcelo T.; Zeferino, Luíz Carlos; Düfloth, Rozany Mucha

doi:10.1016/j.ijgo.2015.01.016

Cited by 5 publications

(4 citation statements)

References 22 publications

(47 reference statements)

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“…One might argue that therefore the pregnant women group might contain more early lesions with potentially benign biologically behavior. On the other hand, a recent study compared screening results in pregnant and non-pregnant women and could not detect any difference between CIN incidence [ 35 ]. Follow-up algorithms slightly differed between pregnant and non-pregnant women.…”

Section: Discussionmentioning

confidence: 99%

Natural history of cervical intraepithelial neoplasia in pregnancy: postpartum histo-pathologic outcome and review of the literature

Mailáth-Pokorny

Schwameis

Grimm

et al. 2016

BMC Pregnancy Childbirth

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BackgroundTo study the natural history of cervical intraepithelial neoplasia (CIN) during pregnancy and to compare the rates of persistence, progression and regression of CIN by colposcopically guided biopsy (CGB) during pregnancy with outcome in non-pregnant-women.MethodsA retrospective analysis of all pregnant women diagnosed with CIN at our outpatient clinic between 2005 and 2010 was performed. A CGB for histo-pathological analysis was obtained in all participants and observational management was performed. The histo-pathologic findings of initial and postpartum visits were collected. Rates of persistence, progression and regression of CIN were assessed. Results were compared to a matched control group of non-pregnant women where observational management was performed for at least three months. In addition a review of the literature and pooled analysis of published data was performed.ResultsA total of 51 pregnant women with CIN were included into analysis. CIN 1, 2, and 3 was diagnosed by CGB in 33.3, 13.7 and 52.9 % of all pregnant women, respectively. The postpartum histo-pathologic evaluation of the pregnant cohort revealed a significantly higher tendency to spontaneous regression (56.9 versus 31.4 %, p = 0.010) and a considerably, but not significantly higher complete remission rate (41.2 versus 27.5 %, p = 0.144) when compared to the non-pregnant cohort. In addition, we observed a significantly lower CIN persistence rate than in the non-pregnant cohort (39.2 versus 58.8 %, p = 0.048). The progression rate was notably low in the pregnant cohort (3.9 %) and no progression to invasive cancer was observed.ConclusionsCIN lesions show considerably high spontaneous regression rates postpartum. Once presence of invasive cancer is ruled out definitive treatment can be deferred to the postpartum period.

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Section: Discussionmentioning

confidence: 99%

Natural history of cervical intraepithelial neoplasia in pregnancy: postpartum histo-pathologic outcome and review of the literature

Mailáth-Pokorny

Schwameis

Grimm

et al. 2016

BMC Pregnancy Childbirth

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“…Despite some alterations in sexual behavior over the last years, 1 changes in screening programs have postponed the age of the first screening tests, 1 5 and the influence of age at first sexual intercourse as a risk factor is in discussion. 7 15 16 19 20 After that, the amount of cancers at age 25 has increased dramatically; however, these cases are micro-invasive, with excellent prognosis 5 6 and rare deaths. 7 Therefore, there is doubt if screening women aged 20–24 years can impact the incidence of cancer in those under 30 years.…”

Section: Discussionmentioning

confidence: 99%

“…2,4 In addition, the treatment for precursor lesions in this age group is related to an increased risk of premature labor due to the anatomical damage that occurs during the procedure. 1,8 It has been suggested that early sexual intercourse can be a risk factor for cervical cancer in young women, 1,14,15 since it is a risk factor for HPV infection. 16 On the other hand, screening patients under the recommended age may impact the efficiency of a program through the improper use of the logistic and human resource structures.…”

Section: Introductionmentioning

confidence: 99%

“…It has been suggested that early sexual intercourse can be a risk factor for cervical cancer in young women, 1 14 15 since it is a risk factor for HPV infection. 16 On the other hand, screening patients under the recommended age may impact the efficiency of a program through the improper use of the logistic and human resource structures.…”

Section: Introductionmentioning

confidence: 99%

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Early Age at First Sexual Intercourse is Associated with Higher Prevalence of High-grade Squamous Intraepithelial Lesions (HSIL)

Xavier‐Júnior

Düfloth

Vale

et al. 2017

Rev Bras Ginecol Obstet

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Objective To evaluate the association of age at first sexual intercourse with the results of the cervicovaginal cytology. Study Design Observational analytical study about the prevalence of altered cervicovaginal cytology results in women aged between 18 and 34 years from a densely populated area in Brazil, during 10 years. The patients were stratified into 2 categories according to their age at first sexual intercourse (13-16 years and 17-24 years).Results From the total of 2,505,154 exams, 898,921 tests were in accordance with the inclusion criteria. Considering women with 4 years or less from the first sexual intercourse as a reference, those with 5 to 9 years and 10 years or more showed a higher prevalence of high-grade squamous intraepithelial lesions (HSILs). Women with an earlier onset of sexual intercourse (13-16 years) showed higher prevalence ratios for atypical squamous cells (ASC), low-grade squamous intraepithelial lesion (LSIL) and HSIL. The prevalence ratio for HSIL adjusted by age at diagnosis and by age at first sexual intercourse was higher only for women with an earlier onset of sexual intercourse. Conclusions The age of first sexual intercourse could be a variable that might qualify the selection among young women who are really at a higher risk for HSIL. ResumoObjetivo Avaliar a associação entre idade de início da atividade sexual e os resultados de citologia cervico-vaginal. Métodos Estudo observacional sobre a prevalência dos resultados de citologia cervico-vaginal alterados em mulheres com idade entre 18 e 34 anos na região de

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Evaluation of uterine cervical cancer in pregnancy: A cross-sectional study

Vasques

Carramenha

Basílio

et al. 2020

European Journal of Obstetrics & Gynecology and Reproductiv

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Results of screening for cervical cancer among pregnant and non‐pregnant women in Brazil

Abstract: Mandatory cervical cytology screening does not seem to be necessary for pregnant women; protocols in place for non-pregnant women should be followed.

Cited by 5 publications

References 22 publications

Natural history of cervical intraepithelial neoplasia in pregnancy: postpartum histo-pathologic outcome and review of the literature

Natural history of cervical intraepithelial neoplasia in pregnancy: postpartum histo-pathologic outcome and review of the literature

Early Age at First Sexual Intercourse is Associated with Higher Prevalence of High-grade Squamous Intraepithelial Lesions (HSIL)

Evaluation of uterine cervical cancer in pregnancy: A cross-sectional study

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