Evaluation of cervical cancer screening programs in the State of Rio Grande do Sul - Southern Brazil

OBJETIVO: Comparar duas modalidades de screening de câncer de colo uterino por exame citopatológico (CP) desenvolvidas no Estado do Rio Grande do Sul: uma, sazonal e isolada, promovida pelo Ministério da Saúde em 1998; outra, regular, promovida pela Secretaria da Saúde do Estado do Rio Grande do Sul no período de 1991 a 1996. MATERIAIS E MÉTODOS: avaliou-se retrospectivamente os resultados obtidos com a coleta de exames citopatológicos de colo uterino da campanha do Ministério da Saúde e do programa regular da Secretaria da Saúde do Estado do Rio Grande do Sul RESULTADOS: Comparando-se o percentual de alterações nos exames coletados pela Secretaria da Saúde em 1996 com os exames coletados pelo Ministério da Saúde em 1998, obteve-se, respectivamente: NIC I - 0,55% / 0,29%; NIC II - 0,25% / 0,15%; NIC III - 0,16% / 0,14%; carcinoma - 0,04% / 0,04%. Quanto aos exames coletados pela Secretaria da Saúde no período 1991-1996, 58,64% não eram representativos da junção escamo-colunar (JEC). Sobre estes, somente 13,74% das lesões de alto grau encontravam-se em CPs não representativos da JEC, enquanto 85,22% das lesões de alto grau encontravam-se nos CPs representativos da JEC (1,04% dos resultados ignorados). CONCLUSÕES: A campanha sazonal do Ministério da Saúde no Rio Grande do Sul apresentou desempenho desfavorável quando comparada ao programa regular da Secretaria da Saúde, sugerindo que rastreamentos isolados tenham eficácia menor que rastreamentos planejados e contínuos. O próprio rastreamento regular possui falhas que devem ser corrigidas, como a baixa representatividade da junção escamo-colunar.OBJECTIVE: To compare two modalities of cervical cancer screening using Pap Smear that were carried out in the state of Rio Grande do Sul - Southern Brazil. The first one is a seasonal and isolated campaign that was promoted by the Brazilian Ministry of Health in 1998; the second one is a regular screening program promoted by the Rio Grande do Sul State Department of Health from 1991 to 1996.MATERIAL AND METHODS: We carried out a retrospective study of the results of the two screening campaigns. RESULTS: Comparison of the Pap smear sample alterations verified from 1991 to 1996 by the State Department of Health with the Pap smear sample alterations verified in 1998 by the Ministry of Health allowed for the following data, respectively: CIN 1 - 0.55%/0.29%; CIN 2 - 0.25%/0.15%; CIN 3 - 0.16%/0.14%; carcinoma - 0.04%/0.04%. Out of the samples collected by the State Department of Health, 58.64% were not representative for squamous columnar junction (SCJ), out of which 13.74% of highgrade lesions were not representative for SCJ and 85.22% of high-grade lesions were representative for ECJ (1.04% of results were ignored). CONCLUSIONS: The isolated campaign of the Brazilian Ministry of Health in the state of Rio Grande do Sul presented poorer results when compared to the regular screening program promoted by the Rio Grande do Sul State Department of Health, suggesting, thus, that isolated screening efforts do not offer results that are as good as those of planned and continuous screening programs. However, the regular screening program has faults that need to be corrected, such as that in the reduced number of Pap smear samples representative of squamous columnar junction

Infection by the human papillomavirus (HPV)

A infecção pelo HPV é extremamente prevalente e transformou-se em queixa freqüente tanto na prática ginecológica como em outras especialidades, como dermatologia, urologia e proctologia. O objetivo deste trabalho é esclarecer sobre este agente viral. A compreensão de sua importância é fundamental tanto para o controle e erradicação de outras doenças sexualmente transmissíveis, entre as quais a infecção pelo HIV, quanto para o controle do câncer de colo uterino, uma neoplasia freqüente, principalmente em países em desenvolvimento, como é o caso do Brasil.Infection by the human papillomavirus (HPV) is a prevalent case of infection and is frequently the reason for complaints in Gynecology services as well as in those of other branches of specialization, such as Dermatology, Urology, and Proctology. The objective of this study is to contribute to the understanding of this viral agent, which is fundamental for both the control and eradication of other sexually transmitted diseases, including infection by the HIV, and the control of collum cancer, a common neoplasia, especially in developing countries such as Brazil

POP-Brazil study protocol : a nationwide cross-sectional evaluation of the prevalence and genotype distribution on human papillomavirus (HPV) in Brazil

Introduction Human papillomavirus (HPV) is associated with the development of genital warts and different types of cancer, including virtually all cervical cancers and a considerable number of penile, anal and oropharyngeal cancers. Data regarding the prevalence of HPV infection in Brazil are limited and fragmented. We aim to determine HPV prevalence in sexually active women and men aged 16–25 years and to investigate regional differences in virus prevalence and types. Methods and analysis This is a nationwide, multicentric, cross-sectional, prospective study that will include participants aged 16–25 years from all Brazilian capital cities. Recruitment will occur in primary health units by trained health professionals who will be responsible for collecting biological samples and interviewing the volunteers. After signing informed consent, all participants will answer a questionnaire that will collect sociodemographic and behavioural data All samples will be processed in a certified central laboratory, and strict quality control will be performed by many different procedures, including double data entry, training and certification of primary care health professionals responsible for data collection, simulation of interviews, and auditing and monitoring of visits. The sample size will be standardised based on the population distribution of each capital using SAS and R statistical software. Ethics and dissemination The project was approved by the research ethics committee of the main institution and the corresponding ethics committees of the recruitment sites. This will be the first Brazilian nationwide study to determine overall HPV prevalence and to examine regional differences and social, demographic and behavioural factors related to HPV infection. Critical analysis of the study results will contribute to epidemiological knowledge and will set a baseline for future evaluation of the impact of the National HPV Vaccination Program

Rastreamento de câncer de colo uterino em funcionárias assintomáticas de uma fábrica do Rio Grande do Sul

08

Prevalência de HPV no sul do Brasil

24