Análise do perfil epidemiológico dos exames citopatológico do colo do útero em Altamira no período de 2014 a 2020: dados a partir do SISCAN / Analysis of the epidemiological profile of cervical cytopathological exams in Altamira in the period from 2014 to 2020: data from SISCAN / Análisis del perfil epidemiológico de los exámenes citopatológicos de cérvix en Altamira en el periodo de 2014 a 2020: datos del SISCAN

OBJETIVO: Este trabalho aborda sobre características referente aos exames citopatológicos do colo do útero em Altamira, coletado no Sistema de Informação do Câncer, dentro do período de 2014 a 2020. Observou-se também a qualidade da interpretação dos principais resultados encontrados, sobre a técnica de coleta e qualidade de exames. O objetivo é analisar o perfil epidemiológico dos exames citopatológicos do colo do útero do município. MÉTODO: A metodologia realizada foi estudo quantitativo, de corte transversal, epidemiológico, descritiva e analítico. RESULTADOS: Verificou- se um crescimento anual na taxa de cobertura do exame do preventivo no período de 2014 a 2019, que está ligado à implementação do Plano de Desenvolvimento Regional Sustentável do Xingu, e que esse crescimento mostra uma diferença estatística significativa entre a taxa de cobertura de Altamira, Pará, Brasil. Observou-se presença de falhas no preenchimento da ficha de notificação é referente ao campo da escolaridade das pacientes que não apresentam registro. Quanto a faixa etária mais frequente que realizam o exame do preventivo está entre 25 a 34 anos e as lesões intraepiteliais do colo uterino mais frequentes são: a de baixo grau que corresponde à população jovem (<34 anos) e de alto grau entre 25 a 44 anos.

OBJECTIVE: This paper deals with characteristics related to cytopathological examinations of the cervix in Altamira, collected in the Cancer Information System, within the period from 2014 to 2020. It was also observed the quality of interpretation of the main results found, on the technique collection and quality of exams. The objective is to analyze the epidemiological profile of cytopathological tests of the cervix in the city. METHOD: The methodology used was a quantitative, cross- sectional, epidemiological study, descriptive and analytical approach. RESULTS: As a result, there was an annual growth in the coverage rate of the preventive exam in the period from 2014 to 2019, which is linked to the implementation of the Xingu Sustainable Regional Development Plan, and that this growth shows a significant statistical difference between the coverage rate of Altamira, Pará, Brazil. It was observed the presence of failures in completing the notification form referring to the field of education of patients who do not have a record. As for the most frequent age group that undergoes the preventive examination, it is between 25 and 34 years old and the most frequent intraepithelial lesions of the uterine cervix are: low-grade, which corresponds to the young population (<34 years) and high-grade, between 25 and 34 years old. 44 years.

OBJETIVO: En este trabajo se abordan las características relacionadas con los exámenes citopatológicos de cérvix en Altamira, recogidos en el Sistema de Información del Cáncer, en el periodo comprendido entre 2014 y 2020. También se observó la calidad de interpretación de los principales resultados encontrados, sobre la técnica de recolección y calidad de los exámenes. El objetivo es analizar el perfil epidemiológico de los exámenes citopatológicos de cuello uterino en la ciudad. MÉTODO: La metodología utilizada fue un estudio cuantitativo, transversal, epidemiológico, de abordaje descriptivo y analítico. RESULTADOS: Como resultado, se observó un crecimiento anual de la tasa de cobertura del examen preventivo en el período de 2014 a 2019, que está vinculado a la implementación del Plan de Desarrollo Regional Sostenible Xingu, y que este crecimiento muestra una diferencia estadística significativa entre la tasa de cobertura de Altamira, Pará, Brasil. Se observó la presencia de fallas en el llenado del formulario de notificación referente al campo de la educación de los pacientes que no tienen un registro. En cuanto al grupo de edad más frecuente que se somete al examen preventivo, es entre 25 y 34 años y las lesiones intraepiteliales del cuello uterino más frecuentes son: de bajo grado, que corresponde a la población joven (<34 años) y de alto grado, entre 25 y 44 años.

Improved population coverage of the human papillomavirus vaccine after implementation of a school-based vaccination programme: the Singapore experience

INTRODUCTION@#Cervical cancer has a high disease burden in Singapore, and it is strongly associated with human papillomavirus (HPV) infections. Despite constant efforts to encourage vaccination, local HPV vaccine uptake remains low. Universal mass vaccination is a proven cost-effective method to reduce the cervical cancer disease burden. This paper reviews the newly implemented school-based HPV vaccination programme in Singapore and the factors that led to its success.@*METHODS@#Fully subsidised HPV vaccinations were offered to all Secondary 1 female students on an opt-in basis, starting as a rollout dose in 2019. One-time catchup vaccination was also offered to female students in Secondary 2-5. Eligible recipients were identified using enrolment data provided by Ministry of Education schools. A total of 19,144 students across 139 schools were offered the rollout dose, and 20,854 students across 140 schools were offered the catchup doses.@*RESULTS@#High vaccine uptake rates of 80.6%-87.3% were noted with the introduction of the school-based programme, translating to high vaccine coverage of 90.3%-93.4%. Only a small proportion of students (1.5%-1.9% per cohort) opted out. The rate of reported side effects, which were commonly known effects, was low at one in 1000. Among the students who reported side effects, those who received the second vaccine dose did so uneventfully.@*CONCLUSION@#High HPV vaccine coverage was achieved after implementation of the school-based immunisation programme. Timely assessment of knowledge lapses and targeted intervention, strong partnerships with stakeholders, constant on-site adaptation and positive social influence contributed to its success. This model can be applied to future school health programmes.

Prevalencia y genotipicación de virus papiloma humano vaginal y cervical en trabajadoras sexuales de un centro de salud sexual en la zona Norte de Santiago, Chile / Prevalence and genotypes of cervical and vaginal HPV in female sex workers attending a Sexual Control Centre, North Area of Santiago, Chile

INTRODUCCIÓN: En Chile, el cáncer de cuello uterino (CCU) es la segunda causa de muerte por neoplasias malignas en la mujer. El principal agente causal es el virus papiloma humano (VPH). Comparando con la población general, los o las trabajadoras(es) sexuales (TS) tienen alto riesgo de adquirir VPH. OBJETIVO: Analizar la prevalencia y genotipos del VPH cervical y vaginal en TS que se atienden en un Centro de Salud Sexual de Santiago, Chile. Pacientes y MÉTODO: Se realizó un estudio transversal en 97 mujeres TS, de 19 a 70 años de edad. Se obtuvieron dos muestras por paciente, una de exocérvix y otra de paredes vaginales. El ADN de VPH fue identificado por reacción de polimerasa en cadena (RPC) y su genotipo fue investigado para 32 tipos de VPH. RESULTADOS: La prevalencia de VPH global fue de 45%, observándose portación cervical en 41,2% y vaginal en 36,1%, con una coinfección de 32%. El 63% de las muestras tenía genotipos de alto riesgo. Los VPH de alto riesgo más frecuentes fueron el VPH 66 (12%), VPH 58 (9,3%), seguidos por VPH 16, VPH 59 y VPH 82 con igual frecuencia (8% c/u). Treinta y dos mujeres (43%) fueron infectadas con genotipos múltiples. CONCLUSIÓN: El VPH es una infección frecuente entre las TS. Este es el primer estudio en Chile sobre prevalencia y genotipos de VPH en TS.

BACKGROUND: In Chile, cervical cancer is the second leading cause of death from malignancy in women. The main causal agent of cervical cancer is the human papillomavirus (HPV). Compared with the general population, sex workers (SW) are at increased risk of acquiring HPV. AIM: To analyze the prevalence and genotypes of cervical and vaginal HPV in female SW attending a Sexual Control Centre. METHODS: A cross-sectional study was carried out on 97 women (19-70 years old). Two samples were taken per patient, one from exocervix and the other from vaginal walls. HPV DNA. was identified by polymerase chain reaction (PCR) and genotyping using specific probes for 32 types of HPV. RESULTS: The overall frequency of HPV was 45%, 41.2% in cervical carrier and 36.1% in vaginal carrier, 32% were co-infected, 63% of HPV were high-risk genotypes. The most frequent high-risk HPV was HPV 66 (12%), HPV 58 (9.3%), followed by HPV 16, HPV 59 and HPV 82 with the same frequency (8% each one). Thirty two (43%) of females were infected with multiple genotypes. CONCLUSION: HPV is frequent infection among SW. This is the first study in Chile on the prevalence and genotypes of HPV in sex workers.

Rastreamento do câncer do colo do útero com teste de DNA-HPV: atualizações na recomendação / Cervical cancer screening with DNA-HPV testing: updates on the recommendation

Esta é uma atualização da recomendação de especialistas publicada em 2018 para o uso do teste de detecção do DNA-HPV de alto risco no rastreamento do câncer do colo do útero no Brasil, de acordo com as mudanças observadas nas diretrizes internacionais e atualizações do conhecimento. As recomendações mais relevantes e recentes foram revisadas. Questões referentes à prática clínica foram formuladas, e as respostas consideraram a perspectiva do sistema de saúde brasileiro, tanto público quanto privado. Essa revisão abrange estratégias baseadas em risco sobre idade para início e término de rastreamento, o uso da citologia e colposcopia para apoiar as condutas, tratamento, estratégias de seguimento, e rastreamento em grupos específicos, incluindo mulheres vacinadas. O objetivo é melhorar as estratégias de prevenção do câncer do colo do útero e reduzir o supertratamento e o uso incorreto dos testes de HPV.(AU)

Influencing factors and risk prediction model for cervical cancer recurrence / 中南大学学报(医学版)

OBJECTIVES@#Cervical cancer is the most common malignant tumor in the female reproductive system worldwide. The recurrence rate for the treated cervical cancer patients is high, which seriously threatens women's lives and health. At present, the risk prediction study of cervical cancer has not been reported. Based on the influencing factors of cervical cancer recurrence, we aim to establish a risk prediction model of cervical cancer recurrence to provide a scientific basis for the prevention and treatment of cervical cancer recurrence.@*METHODS@#A total of 4 358 cervical cancer patients admitted to the Hunan Cancer Hospital from January 1992 to December 2005 were selected as research subjects, and the recurrence of cervical cancer patients after treatment was followed up. Univariate analysis was used to analyze the possible influencing factors. Variables that were significant in univariate analysis or those that were not significant in univariate analysis but may be considered significant were included in multivariate Cox regression analysis to establish a cervical cancer recurrence risk prediction model. Line graphs was used to show the model and it was evaluated by using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis.@*RESULTS@#Univariate analysis showed that the recurrence rates of cervical cancer patients with different age, age of menarche, parity, miscarriage, clinical stage, and treatment method were significantly different (all P<0.05). Multivariate Cox regression analysis showed that RR=-0.489×(age≥55 years old)+0.481×(age at menarche >15 years old)+0.459×(number of miscarriages≥3)+0.416×(clinical stage II)+0.613×(clinical stage III/IV)+0.366×(the treatment method was surgery + chemotherapy) + 0.015×(the treatment method was chemotherapy alone). The area under the ROC curve (AUC) of the Cox risk prediction model for cervical cancer recurrence constructed was 0.736 (95% CI 0.684 to 0.789), the best prediction threshold was 0.857, the sensitivity was 0.576, and the specificity was 0.810. The accuracy of the Cox risk model constructed by this model was good. From the clinical decision curve, the net benefit value was high and the validity was good.@*CONCLUSIONS@#Patient age, age at menarche, miscarriages, clinical stages, and treatment methods are independent factors affecting cervical cancer recurrence. The Cox proportional hazards prediction model for cervical cancer recurrence constructed in this study can be better used for predicting the risk of cervical cancer recurrence.

Analysis on cancer incidence and mortality attributed to human papillomavirus infection in China, 2016 / 中华流行病学杂志

Objective: We aim to evaluate the morbidity and mortality of cancer attributable to human papillomavirus (HPV) infection in China in 2016. Methods: Based on the cancer incidence and mortality rates, national population data, and population attributable fraction (PAF) in China, we calculated the number of incidence and death cases attributed to HPV infection in different areas, age groups, and gender in China in 2016. The standardized incidence and mortality rates for cancer attributed to HPV infection were calculated by using Segi's population. Results: In 2016, a total of 124 772 new cancer cases (6.32 per 100 000) were attributed to HPV infection in China, including 117 118 cases in women and 7 654 cases in men. Of these cancers, cervical cancer was the most common one, followed by anal cancer, oropharyngeal cancer, penile cancer, vaginal cancer, laryngeal cancer, oral cancer, and vulvar cancer. A total of 41 282 (2.03 per 100 000) deaths were attributed to HPV infection, of which 37 417 occurred in women and 3 865 in men. Most deaths were caused by cervical cancer, followed by anal cancer, oropharyngeal cancer, penile cancer, laryngeal cancer, vaginal cancer, oral cancer, and vulvar cancer. The incidence and mortality rates of cervical cancer increased rapidly with age, peaked in age group 50-54 years, then decreased obviously. The morbidity and mortality rates of non-cervical cancer increased with age. The cancer case and death numbers in rural areas (57 089 cases and 19 485 deaths) were lower than those in urban areas (67 683 cases and 21 797 deaths). However, the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of cervical cancer were higher in rural areas than in urban areas. There were no significant differences in ASIR and ASMR of non-cervical cancers between urban areas and rural areas. Conclusions: The incidence of cancers attributed to HPV infection in China was lower than the global average, but the number of incidences accounted largely, furthermore there is an increasing trend of morbidity and mortality. The preventions and controls of cervical cancer and male anal cancer are essential to contain the increases in cancer cases and deaths attributed to HPV infection.

Tendência temporal de mortalidade por neoplasia maligna de mama e de colo de útero em Passo Fundo, Rio Grande do Sul: uma análise segundo faixa etária e escolaridade, 1999-2019 / Tendencias temporales de la mortalidad por cáncer maligno de mama y de cuello uterino en Passo Fundo, Rio Grande do Sul: un análisis por grupo de edad y escolaridad, 1999-2019 / Mortality trends of breast and cervical cancer in Passo Fundo, Rio Grande do Sul: an analysis by age and schooling, 1999-2019

Objetivo: analisar a tendência temporal de mortalidade por neoplasia maligna de mama e de colo de útero em Passo Fundo, Rio Grande do Sul, Brasil, de 1999 a 2019. Métodos: estudo de série temporal a partir de dados do Sistema de Informações sobre Mortalidade; as taxas padronizadas de mortalidade foram calculados segundo idade e escolaridade e a tendência, avaliada por regressão de Prais-Winsten. Resultados: observou-se estabilidade nos coeficientes gerais de mortalidade por câncer de colo de útero (ß = -0,03; IC95% -0,08;0,02) e por câncer de mama (ß = -0,006; IC95% -0,02;0,01) no período avaliado; para ambos os tipos de câncer, identificou-se tendência ascendente dos coeficientes em mulheres com até 7 anos de estudo; entretanto, tendência estacionária foi observada na maior parte dos estratos etários analisados. Conclusão: mulheres em idades mais avançadas e com baixa escolaridade foram aquelas com pior prognóstico da doença.

Objetivo: analizar la tendencia temporal de la mortalidad por neoplasia maligna de mama y cuello uterino, de 1999 a 2019, en Passo Fundo, Rio Grande do Sul, Brasil. Métodos: estudio de series temporales a partir de datos del Sistema de Información de Mortalidad; las tasas estandarizadas se calcularon según la edad y la educación; y la tendencia, evaluada por regresión de Prais-Winsten. Resultados: hubo estabilidad en los coeficientes de mortalidad por cáncer de cuello uterino (ß = -0,03; IC95% -0,08;0,02) y por el cáncer de mama maligno (ß = -0,006; IC95% -0,02;0,01) a lo largo de la serie temporal; en ambos tipos de neoplasias se identificó una tendencia ascendente en mujeres con baja escolaridad; se observó una tendencia estacionaria en la mayoría de los estratos de edad analizados. Conclusión: las mujeres de mayor edad y con hasta 7 años de escolaridad fueran las de peor pronóstico.

Objective: to analyze the temporal trend of mortality due to malignant neoplasms of the breast and cervix from 1999 to 2019 in Passo Fundo, Rio Grande do Sul, Brazil. Methods: this was a time-series study based on data from the Mortality Information System; standardized rates were calculated according to age and schooling, and the temporal trend was assessed using Prais-Winsten regression. Results: the overall mortality coefficients for cervical cancer (ß= -0.03; 95%CI -0.08;0.02) and for breast cancer (ß = -0.006; 95%CI -0.02;0.01) were stable over the time series; in both types of neoplasms, a rising trend was identified in women with up to 7 years of schooling; on the other hand, a stationary trend was found in the majority of the age strata analyzed. Conclusion: older women and those with low levels of schooling had the worst prognosis.

Perfil do rastreamento do câncer do colo do útero em Campo Grande, Mato Grosso do Sul: um estudo avaliativo do período 2006-2018 / Perfil de seguimiento del cáncer de cuello uterino en Campo Grande, Mato Grosso do Sul, Brasil: un estudio evaluativo del periodo 2006-2018 / Profile of cervical cancer screening in Campo Grande, Mato Grosso do Sul, Brazil: an evaluative study, 2006-2018

Objetivo: Avaliar a cobertura e a qualidade do rastreamento do Programa de Controle do Câncer do Colo do Útero (PCCCU) em Campo Grande, Mato Grosso do Sul, Brasil, 2006-2018. Métodos: Estudo descritivo da tendência da série histórica de exames citopatológicos para rastreamento do CCU em mulheres residentes em Campo Grande. Foram descritas características demográficas das mulheres avaliadas e a qualidade dos exames realizados nos cinco últimos anos do período. Analisou-se a tendência temporal por modelos de regressão polinomiais. Resultados: Foram registradas 578.417 citologias, das quais 1,8% apresentaram alterações citológicas pré-malignas/malignas. Na faixa etária-alvo do programa, verificou-se redução de 48,4% no número de exames realizados. A positividade dos exames variou entre 2,2% e 3,3% e aumentou o percentual de amostras insatisfatórias. Conclusão: O programa de rastreamento de CCU apresenta fragilidades que necessitam ser superadas, como baixa cobertura da população-alvo, crescimento do número de amostras insatisfatórias e baixo índice de positividade.

Objetivo: Evaluar la cobertura y calidad del tamizaje del programa de control de cáncer cervicouterino en Campo Grande, MS, Brasil, entre 2006-2018. Métodos: Estudio descriptivo de la serie histórica de exámenes citopatológicos en mujeres de Campo Grande. Se realizó un análisis descriptivo de las características demográficas de las mujeres y la calidad de los exámenes realizados en los últimos cinco años del período. La tendencia temporal se analizó mediante modelos de regresión polinómica. Resultados: Se registraron 578.417 citologías, de las cuales el 1,8% mostró alteraciones citológicas. En la población objetivo del programa, hubo reducción del 48,4% en el número de pruebas realizadas. La positividad de las pruebas varió entre 2,2% y 3,3% y aumentó el porcentaje de muestras no satisfactorias. Conclusión: El programa de cribado tiene debilidades que es necesario superar, como baja cobertura de la población objetivo, crecimiento del número de muestras insatisfactorias y baja tasa de positividad.

Objective: To assess the coverage and quality of screening by the Cervical Cancer Control Program in Campo Grande, Mato Grosso do Sul, Brazil, between 2006 and 2018. Methods: This was a descriptive study of the cytology screening time series among women living in Campo Grande. A descriptive analysis of the demographic characteristics of these women and the quality of the tests performed in the last five years of the period was carried out. Temporal trends were analyzed using polynomial regression models. Results: 578,417 cytology tests were recorded, of which 1.8% showed pre-malignant/malignant cytological changes. There was a 48.4% reduction in the number of tests performed in the Program's target age group. Test positivity varied between 2.2% and 3.3% and the percentage of unsatisfactory samples increased. Conclusion: The cervical cancer screening program has weaknesses that need to be overcome, such as low coverage of the target population, growth in the number of unsatisfactory samples and a low positivity rate.

Câncer de colo de útero e componentes de saneamento nos municípios do estado do Mato Grosso do Sul: seria uma questão de má qualidade da água? / Cervical cancer and sanitation components in the municipalities of the state of Mato Grosso do Sul: would it be a question of poor water quality?

Resumo Este artigo investiga relações entre a incidência de câncer de colo de útero (ICC) e os componentes e indicadores de qualidade da água nos municípios do Mato Grosso do Sul, entre 2014 e 2017, por correlação estatística (Determinante de Pearson) e espacial (agrupamentos por k-médias). Houve maior resposta estatística de ICC em relação à tarifa média dos serviços de abastecimento praticado (-36,28%) e de água (-34,15%); à quantidade de suas interrupções sistemáticas (28,3%) e paralizações (22,28%); ao consumo médio per capita de água (20,74%) e à quantidade de serviços executados (-17,98%), todas as respostas sob p-valor ≤ 0,001. Em Costa Rica, cidade sob maior ICC média, os agrupamentos espaciais identificaram maior efeito daquelas interrupções (z-valor = 8,741) e das paralizações (z = 7,6097); enquanto em Rochedo, também sob alta ICC, houve maior efeito à incidência de análises com resultados fora do padrão para coliformes totais (z = 8,6803) e turbidez (z = 5,7427), sob correlação estatística de 12,05% (p-valor = 0,032) e 15,18% (p-valor = 0,007), respectivamente. Dados do SISAGUA revelaram a presença de coliformes e de altos níveis de turbidez, por exemplo, em Antônio João e Tacuru, cidades sob altas ICC médias. Recomenda-se maiores investigações sobre as relações aqui apresentadas entre ICC e água.

Abstratct This article investigates relationships between the incidence of cervical cancer (CCI) and the water components and quality indicators, in the municipalities of Mato Grosso do Sul, between 2014 and 2017, by statistical (Pearson's Determinant) and spatial (k-means Clustering) correlation. There was a greater statistical response of CCI in relation to the average tariff of the practiced supply (−36.28%) and water (−34.15%) services; the number of their systematic interruptions (28.3%) and outages (22.28%); the average per capita consumption of water (20.74%); and the number of services performed (−17.98%), all answers under p-value ≤ 0.001. In Costa Rica, city with the highest average CCI, the spatial clustering identified a greater effect of those interruptions (z-value = 8.741) and outages (z = 7.6097); whereas, in Rochedo, also under high CCI, the analyses showed greater effect with non-standard results for total coliforms (z = 8.6803) and turbidity (z = 5.7427), under a statistical correlation of 12.05% (p-value = 0.032) and 15.18% (p-value = 0.007), respectively. Data from SISAGUA revealed the presence of coliforms and high levels of turbidity, for example, in Antônio João and Tacuru, cities with high average ICC. We recommend further investigation into the relationships presented here between CCI and water.

Análisis epidemiológico del cáncer de cérvix in situ e invasor, periodo 2015-2019 / Epidemilogical analysis of cérvix cancer in situ and invasor, period 2015-2019

El cáncer de cérvix sigue siendo un problema de salud pública a nivel mundial en las mujeres que se presenta mayormente en los países en desarrollo y en niveles de estrato socio económico bajo. Objetivo. Realizar un análisis epidemiológico del cáncer de cérvix in situ e invasor, atendidos en el hospital de SOLCA Guayaquil. Metodología. Estudio observacional, de diseño de investigación tipo corte transversal, descriptivo. Lugar: hospital SOLCA en Guayaquil, período 2015 a 2019. Los sujetos fueron las pacientes con cáncer de cérvix in situ e invasor. Aplicando estadísticas descriptivas como porcentaje y comparación entre variables. Resultados. Cáncer invasor tuvo un incremento entre 2015 al 2019 del 4% e in situ del 4,7%; corroborado al aplicar el modelo de tendencia polinomial. El invasor tuvo topográficamente de mayor frecuencia al Tumor maligno de cuello de útero sin otra especificación (79,59%), mientras en el cáncer in situ al Carcinoma in situ de otras partes especificadas del cuello del útero (53,13%); el invasor se observó en edades de 45 a 54 años e in situ de 30 a 39 años; morfológicamente el invasor tuvo al Carcinoma de células escamosas SAI (38,36%) e in situ al Carcinoma in situ de células escamosas SAI (83,07%). Conclusiones. El cáncer de cérvix presentado en este quinquenio se ha incrementado, siendo el cáncer invasor más frecuente en edades entre 45-54 años y el cáncer in situ en edades más tempranas, considerando que está patología se puede detectar oportunamente, se recomienda fortalecer las campañas de tamizaje para su prevención y control.

Cervical cancer continues being a public health problem worldwide in women, which occurs mainly in developing countries and at low socio-economic levels. Target. Carry out an epidemiological analysis of in situ and invasive cervical cancer treated at the SOLCA Guayaquil hospital. Methodology. Observational, descriptive, cross-sectional research design study. Place: SOLCA hospital in Guayaquil, period 2015 to 2019. The subjects were patients with in situ and invasive cervical cancer. Applying descriptive statistics as a percentage and comparison between variables. Results. Invasive cancer had an increase between 2015 and 2019 of 4% and in situ of 4,7%; corroborated by applying the polynomial trend model. The invader had a topographically higher frequency of malignant neoplasm of the cervix without other specification (79,59%), while in cancer in situ it had Carcinoma in situ of other specified parts of the cervix (53,13%); the invader was observed in ages 45 to 54 years and in situ from 30 to 39 years; Morphologically, the invader had squamous cell carcinoma NOS (38,36%) and in situ squamous cell carcinoma in situ NOS (83,07%). Conclusions. Cervical cancer presented in this five-year period has increased, being the most frequent invasive cancer in ages between 45-54 years and in situ cancer in younger ages, considering that this pathology can be detected in a timely manner, it is recommended to strengthen the campaigns of screening for its prevention and control.

Mortalidad del cáncer de cuello uterino en mujeres de 20 a 50 años en el Ecuador / Mortality of cervical cancer in women aged 20 to 50 in Ecuador

INTRODUCCIÓN El cáncer de cuello uterino es una enfermedad que afecta a las mujeres a partir de los 20 años de edad, y en algunas ocasiones se desarrolla a partir de una edad temprana como a los 18 años. Muchas veces puede llegar a la muerte. La falta de información ha provocado un incremento en el índice de mortalidad de esta enfermedad. OBJETIVO Esta investigación fue determinar el índice de mortalidad de cáncer de cuello uterino que existe en mujeres de 20 a 50 años de edad en Hospitales Públicos de la ciudad de Guayaquil -Ecuador. MATERIAL Y MÉTODOS: La presente investigación fue descriptiva, cuantitativa y de prevalencia. Se obtuvo una muestra de 224 pacientes. Realizando una encuesta virtual con 12 preguntas divididas en 3 categorías en la cual se calcula los porcentajes de: Conocimiento, Prevención, Síntomas. RESULTADOS: Las respuestas de las pacientes encuestadas varían en su porcentaje, el 50.4% tienen poco o nada de información acerca de esta enfermedad mientras que el 10% conoce mucho sobre el tema. CONCLUSIÓN: El cáncer de cuello uterino afecta a un sinnúmero de mujeres entre 20 a 50 años de edad, uno de los motivos para que la mujer padezca de esta enfermedad es el virus del papiloma humano. De acuerdo a los resultados, se pudo evidenciar que gran parte de la población encuestada tienen desconocimientos del tema tratado, así mismo sus prevenciones y sus síntomas, y toman esto como anomalías pasajeras.

INTRODUCTION: Cervical cancer is a disease that affects women from the age of 20, and sometimes develops from an early age such as 18 years. Many times it can lead to death. The lack of information has caused an increase in the mortality rate from this disease. OBJECTIVE: This research was to determine the mortality rate from cervical cancer that exists in women between 20 and 50 years of age in Public Hospitals in the city of Guayaquil -Ecuador. MATERIAL AND METHODS: The present investigation was descriptive, quantitative and of prevalence. A sample of 224 patients was obtained. Carrying out a virtual survey with 12 questions divided into 3 categories in which the percentages of: Knowledge, Prevention, Symptoms are calculated. RESULTS: The responses of the surveyed patients vary in their percentage, 50.4% have little or no information about this disease while 10% know a lot about the subject. CONCLUSION: Cervical cancer affects countless women between 20 and 50 years of age, one of the reasons for women to suffer from this disease is the human papillomavirus. According to the results, it was possible to show that a large part of the surveyed population has ignorance of the subject treated, likewise its preventions and its symptoms, and they take this as temporary anomalies.

Análisis del uso de las técnicas de tamizaje para la detección de cáncer cervicouterino en Chile / Analysis of the use of screening techniques for the detection of cervical cancer in Chile

El Cáncer Cervicouterino es una de las principales problemáticas en salud de las mujeres a nivel mundial. Las técnicas de tamizaje para la detección de Cáncer Cervicouterino han ido desarrollándose a través de la historia reciente tanto intencionada como casualmente, incorporando con cada nuevo descubrimiento a las nuevas tecnologías. Actualmente existen diversos procedimientos vigentes que van desde pruebas sencillas de inspección visual, pasando por las tradicionales muestras citológicas, hasta la utilización de tecnología molecular, y los usos que se les dan a estos métodos de cribado potencian la detección temprana del Cáncer Cervicouterino, razón por lo cual se realiza una revisión respecto de las técnicas de tamizajes disponibles y su aplicación en Chile.

Cervical Cancer is one of the main problems in women's health worldwide. Screening techniques for the detection of Cervical Cancer have been developed throughout recent history both intentionally and incidentally, incorporating new technologies with each new discovery. Currently there are various procedures in force that range from simple visual inspection tests, through traditional cytological samples, to the use of molecular technology, and the uses that are given to these screening methods enhance the early detection of Cervical Cancer, which is why which is carried out a review regarding the available screening techniques and their application in Chile.

Boletim epidemiológico: painel oncologia ­ Goiás: tempo do diagnóstico até o início do tratamento oncológico, 2013 a 2020 / Epidemiological bulletin: Oncology Panel ­ Goiás: time from diagnosis to initiation of cancer treatment, 2013 to 2020

Câncer é um conjunto de mais de 100 doenças, incluindo tumores malignos de diferentes locais, que possuem característica comum falha dos mecanismos que regulam o crescimento normal das células, proliferação e morte celular. O prognóstico do tumor pode ser de leve a grave, com invasão de tecidos vizinhos e, eventualmente, espalhando-se para outras áreas do corpo. O Painel-oncologia foi criado em maio de 2019 a fim de monitorar o cumprimento da referida lei e da Portaria MS nº 876/2013, que dispõe sobre a sua aplicação. Não é uma plataforma para inserção de dados, mas para apresentar informações obtidas dos Sistemas de Informações do SUS, apresentando os casos por estado federativo, por tipo de câncer, por ano, como também por intervalo de tempo entre o diagnóstico de neoplasia maligna e o a data do primeiro tratamento realizado no SUS 5,6. Este relatório tem o objetivo de apresentar dados do Painel-oncologia para os cânceres mais incidentes no Estado de Goiás nos anos de 2013 a 2020 e verificar se o período estabelecido pela legislação está sendo cumprido

Cancer is a set of more than 100 diseases, including malignant tumors of different sites, which have a common characteristic of failure of mechanisms that regulate normal cell growth, proliferation and cell death. Tumor prognosis can be mild to severe, with invasion of neighboring tissues and eventually spreading to other areas of the body. The Oncology Panel was created in May 2019 to monitor compliance with the aforementioned law and Ordinance MS nº 876/2013, which provides for its application. It is not a platform for data entry, but to present information obtained from the SUS Information Systems, presenting cases by federal state, by type of cancer, by year, as well as by time interval between the diagnosis of malignant neoplasm and the date. of the first treatment performed in the SUS 5,6. This report aims to present data from the Oncology Panel for cancers more incidents in the State of Goiás in the years 2013 to 2020 and to verify if the period established by the legislation is being fulfilled

Rastreio e associações ao câncer cervical / Screening and associations to cervical cancer / Seguimiento y asociaciones al cáncer de cuello uterino

Introdução: De acordo com o Instituto Nacional do Câncer (INCA) a estimativa de novos casos de câncer do colo do útero (CCU) para o Estado do Espírito Santo, no triênio 2020-2022, é de 11,65 por 100.000 habitantes. Objetivos: Traçar o perfil clínico-epidemiológico das usuárias do serviço de atenção integral à saúde da mulher da policlínica da Universidade Vila Velha (UVV), a partir dos determinantes da consulta ginecológica, e correlacionar aos achados citológicos e histológicos. Métodos: Estudo de corte transversal, observacional e retrospectivo envolvendo 590 prontuários de pacientes, atendidas entre fevereiro de 2011 e julho de 2016 no serviço de atenção integral à saúde da mulher na policlínica/UVV. Resultados: A média de idade das mulheres incluídas nesse estudo foi de 39,5 anos (DP± 16,2). Os fatores de risco como estado civil e tempo de relacionamento conjugal, multiparidade, e uso de contraceptivos hormonais orais foram associados a maior chance de CCU. Associação estatística da variável idade não evidenciou risco de CCU. Conclusões: Os resultados vão de acordo com os preconizados pelo INCA e Ministério da Saúde. Isso reforça a importância da rastreabilidade na atenção primária e os fatores que interferem na mesma.

Introduction: According to the National Cancer Institute (INCA), the estimate of new cases of cervical cancer (CC) for the State of Espírito Santo, in the 2020-2022 period, is 11.65 per 100,000 inhabitants. Objectives: To trace the clinical-epidemiological profile of users of the comprehensive women's health care service at the University Vila Velha (UVV), based on the determinants of gynecological consultation, and to correlate with cytological and histological findings. Methods: Cross-sectional, observational and retrospective study involving 590 medical records of patients, attended between February 2011 and July 2016 at the comprehensive care service for women's health in the polyclinic/UVV. Results: The average age of women included in this study was 39.5 years (SD±16.2). Risk factors such as marital status and length of marital relationship, multiparity, and use of oral hormonal contraceptives were associated with an increased chance of CC. Statistical association of the age variable did not show a risk of CC. Conclusion: The results are in line with those recommended by INCA and the Ministry of Health. This reinforces the importance of traceability in primary care and the interfering factors.

Introducción: Según el Instituto Nacional del Cáncer (INCA), la estimación de nuevos casos de cáncer de cuello uterino (CC) para el Estado de Espírito Santo en el período 2020-2022 es de 11,65 por 100.000 habitantes. Objetivo: Trazar el perfil clínico-epidemiológico de las usuarias del servicio de atención integral de salud a la mujer de la policlínica Universitaria Vila Velha (UVV), a partir de los determinantes de la consulta ginecológica, y correlacionarlo con hallazgos citológicos e histológicos. Métodos: Estudio transversal, observacional y retrospectivo que involucró a 590 historias clínicas de pacientes, atendidas entre febrero de 2011 y julio de 2016 en el servicio de atención integral de salud de la mujer de la policlínica/UVV. Resultados: La edad promedia de las mujeres incluidas en este estudio fue de 39,5 años (DE ± 16,2). Los factores de riesgo como el estado civil y la duración de la relación matrimonial, la multiparidad y el uso de anticonceptivos hormonales orales se asociaron con una mayor probabilidad de CC. La asociación estadística de la variable edad no mostró riesgo de CC. Conclusiones: Los resultados están en línea con los recomendados por INCA y el Ministerio de Salud, lo que refuerza la importancia de la trazabilidad en la atención primaria y los factores que interfieren en ella.

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecção pelo papilomavírus humano (HPV) / Brazilian Protocol for Sexually Transmitted Infections 2020: human papillomavirus (HPV) infection / Protocolo Brasileño para Infecciones de Transmisión Sexual 2020: infección por papilomavirus humano (PVH)

Resumo O artigo aborda a infecção pelo papilomavírus humano (human papillomavirus, HPV), tema constitutivo do Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde. Tal documento foi elaborado com base em evidências científicas e validado em discussões e consenso entre especialistas. São apresentados aspectos epidemiológicos e clínicos, bem como orientações para os gestores e profissionais de saúde no diagnóstico, tratamento e prevenção da infecção pelo HPV. Este tema representa importante problema de saúde pública, haja vista essa infecção sexualmente transmissível ser a mais prevalente no mundo, capaz de desencadear o processo oncogênico do câncer do colo uterino, além de possibilitar a ocorrência de verrugas anogenitais. Neste artigo, são apresentadas informações importantes para o conhecimento do HPV, estratégias de ação para a prevenção e controle da infecção, uma assistência de qualidade e tratamento efetivo da doença.

Abstract This article addresses human papillomavirus (HPV) infection, this being one of the topics covered by the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health. The Protocol and Guidelines have been developed based on scientific evidence and validated in discussions with specialists. This article presents epidemiological and clinical aspects, as well as guidelines for health service managers and health workers about diagnosing and treating people with papillomavirus infection. This theme is an important public health problem, since it is the most prevalent sexually transmitted infection in the world, capable of triggering the oncogenic process of cervical cancer, as well as the possibility anogenital warts occurring. Important information is presented for gaining knowledge about HPV, as well as action strategies for infection prevention and control, provision of quality care and effective treatment of the disease.

Resumen El tema del papilomavirus humano (PVH) es uno de los capítulos del Protocolo Clínico y Conductas Terapéuticas para la Atención Integral a Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil. Este documento fue desarrollado en base a evidencia científica y validado en discusiones con especialistas. Se presentan aspectos epidemiológicos y clínicos, así como guías para gestores y profesionales de la salud en el diagnóstico, tratamiento y prevención de la infección por papilomavirus. Este tema constituye uno de los principales problemas de salud pública, pues además de ser la infección transmitida sexualmente más prevalente en todo el mundo, puede tener implicaciones para el proceso oncogénico del cáncer de cuello uterino y la posibilidad de presentar verrugas anogenitales. Se presenta información sobre estrategias de acciones de prevención y control, las cuales son importantes para entender el problema, ofrecer asistencia de calidad y tratamiento efectivo.

Test VPH en estrategia de screening primario para detección de cáncer cervicouterino / HPV test in a primary screening strategy for cervical cancer detection

El presente informe es producto del trabajo colaborativo de la Comisión Nacional de Evaluación de Tecnologías de Salud (CONETEC), dependiente del Ministerio de Salud de la Nación y creada por RM N° 623/2018. La CONETEC realiza evaluaciones y emite recomendaciones a la autoridad sanitaria sobre la incorporación, forma de uso, financiamiento y políticas de cobertura de las tecnologías sanitarias desde una perspectiva global del sistema de salud argentino. En sus evaluaciones y recomendaciones, la CONETEC tiene en cuenta criterios de calidad, seguridad, efectividad, eficiencia y equidad, evaluados bajo dimensiones éticas, médicas, económicas y sociales. Sus resultados son consensuados mediante discusiones públicas y ponderados a través de un marco de valor explícito, con la participación de todos los actores involucrados en el proceso de toma de decisiones en salud. Los informes y recomendaciones de esta comisión surgen de este proceso público, transparente y colaborativo, siendo de libre consulta y acceso para toda la sociedad

Human papillomavirus distribution and cervical cancer epidemiological characteristics in rural population of Xinjiang, China / 中华医学杂志(英文版)

BACKGROUND@#Cervical cancer remains a major public health issue for the Uyghur women and other women living mainly in rural areas of Xinjiang. This study aims to investigate the distribution of human papillomavirus (HPV) infection and cervical cancer in rural areas of Xinjiang, China.@*METHODS@#Cervical cancer screening was performed on rural women aged 35 to 64 years from Xinjiang, China in 2017 through gynecological examination, vaginal discharge smear microscopy, cytology, and HPV testing. If necessary, colposcopy and biopsy were performed on women with suspicious or abnormal screening results.@*RESULTS@#Of the 216,754 women screened, 15,518 received HPV testing. The HPV-positive rate was 6.75% (1047/15,518). Compared with the age 35-44 years group, the odds ratios (ORs) of HPV positivity in the age 45-54 years and 55-64 years groups were 1.18 (95% confidence interval [CI]: 1.02-1.37) and 1.84 (95% CI: 1.53-2.21), respectively. Compared with women with primary or lower education level, the ORs for HPV infection rates of women with high school and college education or above were 1.37 (95% CI: 1.09-1.72) and 1.62 (95% CI: 1.23-2.12), respectively. Uyghur women were less likely to have HPV infection than Han women, with an OR (95% CI) of 0.78 (0.61-0.99). The most prevalent HPV types among Xinjiang women were HPV 16 (24.00%), HPV 33 (12.70%), and HPV 52 (11.80%). The detection rate of cervical intraepithelial neoplasia (CIN)2+ was 0.14% and the early diagnosis rate of cervical cancer was 85.91%. The detection rates of vaginitis and cervicitis were 19.28% and 21.32%, respectively.@*CONCLUSIONS@#The HPV infection rate in Xinjiang is low, but the detection rate of cervical cancer and precancerous lesions is higher than the national average level. Cervical cancer is a prominent public health problem in Xinjiang, especially in southern Xinjiang.