Avaliação da prevalência de alterações citológicas de mulheres atendidas em diferentes redes do sistema de saúde do brasil no período de 2011 a 2015

Abstract

Introduction: Cervical cancer morbidity and mortality rates remain high in Brazil, despite being a preventable disease with a high probability of cure if diagnosed early. Objectives: To assess the prevalence of alterations diagnosed in cervicovaginal cytologies (Papanicolaou test); to determine their distribution by age group and to compare the results between patients from the private or insured and the public health networks. Methods: Cross-sectional study of cervicovaginal cytologies results that were analysed by a Pathology laboratory between 2011 and 2015 in Belo Horizonte city, Brazil. The cytologies results were from patients assisted by the private, insured and public health networks, and were divided into the groups <25 years, 25-50 years and >50 years-old. The results were compared through x² tests. Results: 93,262 cervicovaginal smears were analysed, 84.757 (90.88%) from private or health insured patients. The overall prevalence of cytological alterations was 3.16% (2.951). There was no evidence of a difference in the prevalence of lesions between private or health insured and public patients (p=0.15). The most prevalent lesion in both networks was ASC-US, followed by LSIL. In all three age groups and in both networks, the most common lesion was ASC-US followed by LSIL, except for >50 years-old public patients (ASC-US followed by AGC). The prevalence of HSIL and ASC-H were higher among public patients compared to private or health insured ones (p=0.04 and p=0.008, respectively). Conclusion: Efforts to enhance prevention of disease should increase, especially in the public health network, which holds a higher prevalence of advanced pre-neoplastic lesions.