Critérios de positividade para cervicografia digital: melhorando a sensibilidade do diagnóstico do câncer cervical Digital cervicography criteria: improving sensitivity in uterine cervical cancer diagnosis

O objetivo deste trabalho foi validar critérios de positividade para cervicografia digital. Estudo realizado com 300 mulheres submetidas a protocolo clínico composto por exame citológico, uma avaliação por meio de cervicografia digital sem ampliação de imagem (Avaliação 1), e outra avaliação também usando cervicografia digital mas com ampliação adicional de imagem e os critérios de positividade propostos neste estudo (Avaliação 2). A idade média das mulheres foi de 27,6 anos. Os critérios de positividade para cervicografia digital foram identificados em 111 casos (100%) dos testes positivos para lesões precursoras do câncer do colo uterino e em 8 casos (2,6%) considerados falso-positivos. As avaliações 1 e 2 classificaram os exames como positivos (163; 54,3%) e suspeitos (146; 48,6%), respectivamente. Os resultados revelam que a cervicografia digital foi mais sensível (99,1%) e a citologia mais específica (100%). O desempenho alcançado pela cervicografia digital, quando aplicado os critérios de positividade, alcançou sensibilidade 4,5 vezes superior ao desempenho da citologia oncológica, além do baixo custo, sugerindo ser uma técnica factível.<br>This study aimed to validate the scoring criteria for digital cervicography. The study enrolled 300 women submitted to a clinical protocol using cytological examination alone, digital cervicography without image magnification (Evaluation 1), and digital cervicography plus additional image magnification and considering the positive criteria (Evaluation 2). Women's mean age was 27.6 years. Positive criteria for digital cervicography were identified in 111 positive cases with pre-cancerous cervical lesions (100%) and in 8 cases classified as false positives (2.6%). Evaluations 1 and 2 classified the tests as positive (163; 54.3%) and suspected (146; 48.6%), respectively. According to the findings, digital cervicography was more sensitive (99.1%) and cytology more specific (100%). Digital cervicography sensitivity increased by 4.5 times when the positive criteria were applied as compared to cytology alone, besides involving low cost, thus suggesting that it is a viable technique

Motivations and experiences of women who accessed “see and treat” cervical cancer prevention services in Zambia

BACKGROUND: In Zambia, a country with a generalized HIV epidemic, age-adjusted cervical cancer incidence is among the highest worldwide. In 2006, the UAB-Center for Infectious Disease Research in Zambia and the Zambian Ministry of Health launched a visual inspection with acetic acid (VIA)-based “see and treat” cervical cancer prevention program in Lusaka. All services were integrated within existing government-operated primary health care facilities. OBJECTIVE: Study aims were to: 1) identify women's motivations for cervical screening; 2) document women's experiences with screening; and 3) describe the potentially reciprocal influences between women undergoing cervical screening and their social networks. DESIGN & METHODS: Focus group discussions (FGD) and in-depth interviews (IDI) were conducted with women who accepted screening and with care providers. Low-level content analysis was performed to identify themes evoked by participants. Between September, 2009 and July, 2010, 60 women and 21 care providers participated in 8 FGD and 10 IDI. RESULTS: Women presented for screening with varying needs and expectations. A majority discussed their screening decisions and experiences with members of their social networks. Key reinforcing factors and obstacles to VIA screening were identified. CONCLUSIONS: Interventions are needed to gain support for the screening process from influential family members and peers