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1.
Femina ; 50(1): 35-50, 20220131. ilus
Article in Portuguese | LILACS | ID: biblio-1358220

ABSTRACT

As neoplasias intraepiteliais cervicais correspondem a alterações identificadas por rastreamento citológico cervical e estudo histológico, pós-biópsia incisional guiada por colposcopia ou procedimento diagnóstico excisional. Podem ser tratadas com abordagens conservadoras e procedimentos excisionais. A vacinação anti-HPV e o tratamento excisional oportuno constituem, respectivamente, prevenção primária e secundária contra o câncer do colo uterino.(AU)


Cervical intraephitelial neoplasms correspond to changes identified by cervical citological screening and histological study, post-incisional biopsy guided by colposcopy or excisional diagnostic procedure. They can be treated with conservative approaches and excision procedures. Anti-HPV vaccination and timely excional treatment are primary and secondary prevention against cervical cancer, respectively.(AU)


Subject(s)
Humans , Female , Cervix Uteri/cytology , Cervical Intraepithelial Neoplasia/surgery , Cervical Intraepithelial Neoplasia/diagnosis , Squamous Intraepithelial Lesions/surgery , Squamous Intraepithelial Lesions/diagnosis , Squamous Intraepithelial Lesions/diagnostic imaging , Cervical Intraepithelial Neoplasia/diagnostic imaging , Colposcopy , Conization/instrumentation , Papillomavirus Infections/pathology , High-Intensity Focused Ultrasound Ablation , Hysterectomy
2.
Cad. Saúde Pública (Online) ; 38(1): e00304820, 2022. tab, graf
Article in English | LILACS | ID: biblio-1355972

ABSTRACT

Cervical cancer screening is a multistage process, therefore access to both the primary test and subsequent diagnostic procedures is essential. Considering women undergoing screening on the public health system in the State of São Paulo, Brazil, we aimed to estimate the proportion of women accessing colposcopy within six months of an abnormal smear result. We retrieved records from two administrative databases, the Information System on Uterine Cervical Cancer (SISCOLO) that contains smear results and the Outpatient Information System of the Brazilian Unified National Health System (SIA/SUS) that records colposcopies. A reference cohort consisted of women, aged 25 years or older, with an abnormal smear result between May 1, 2014, and June 30, 2014. We excluded prevalent cases. We linked the reference cohort and records in the SIA/SUS extending to December 31, 2014. After excluding prevalent cases, 1,761 women with abnormal cytology results were left. A total of 700 (39.8%) women were linked to a colposcopy record within the follow-up period; this dropped to 671 (38.1%) women when follow-up was censored at six months. We could notice a slightly higher attendance in women living in the metropolitan region of São Paulo compared with residents of the rest of the state. We found no association between colposcopy attendance and age or cytology class. These results emphasize that access to colposcopy in the public health system in São Paulo is limited. This compromises the quality of screening, and the issue needs to be prioritized in service planning.


A triagem do câncer de colo uterino é um processo que envolve múltiplas etapas. É essencial o acesso ao teste primário e aos procedimentos diagnósticos subsequentes. Com foco nas mulheres que fazem triagem no sistema de saúde pública no Estado de São Paulo, Brasil, buscamos estimar a proporção daquelas que acessam a colposcopia dentro de seis meses após um resultado anormal no teste de Papanicolau. Recuperamos os registros de duas bases de dados administrativos: o Sistema de Informação do Controle do Câncer do Colo do Útero (SISCOLO), que contém os resultados de Papanicolau, e o Sistema de Informação Ambulatorial do Sistema Único de Saúde (SIA/SUS), com os registros das colposcopias. Uma coorte de referência foi constituída de mulheres com idade de 25 anos ou mais com Papanicolau anormal entre 1º de maio de 2014 e 30 de junho de 2014. Excluímos casos prevalentes. Relacionamos a coorte de referência aos registros no SIA/SUS, estendendo até 31 de dezembro de 2014. Após a exclusão dos casos prevalentes, restaram 1.761 mulheres com citologia anormal. Setecentas delas (39,8%) foram relacionadas a um registro de colposcopia dentro do período de seguimento; esse número diminuiu para 671 (38,1%) quando o seguimento foi censurado aos seis meses. Foi observada uma cobertura ligeiramente maior entre mulheres residentes na Grande São Paulo, em comparação com mulheres residentes do interior do estado. Não houve associação entre realização de colposcopia e idade ou classe citológica. Os resultados destacam o acesso restrito à colposcopia no sistema público de saúde no Estado de São Paulo. O cenário compromete a qualidade da triagem, e a questão deve ser priorizada no planejamento dos serviços.


Las pruebas de detección del cáncer cervical forman parte de un proceso multietapa. El acceso a tanto el test primario, como a los subsiguientes procedimientos de diagnóstico, es esencial. Considerando a las mujeres que se realizan las pruebas de detección en el sistema público de la salud en el Estado de São Paulo, Brasil, el objetivo del estudio fue estimar la proporción de mujeres que acceden a una colposcopía dentro de los seis meses, tras el resultado anormal en una citología. Recuperamos los registros de dos bases de datos administrativas: el Sistema de Información del Cáncer de Cuello de Útero (SISCOLO), que contiene resultados citológicos, y el Sistema de Información Ambulatoria del Sistema Único de Salud (SIA/SUS), que registra colposcopías. La cohorte de referencia consistía en mujeres, con 25 años de edad o mayores, quienes recibieron un resultado anormal en su citología entre el 1º mayo de 2014 y el 30 de junio 2014. Excluimos los casos prevalentes. Vinculamos la cohorte de referencia y los registros en la SIA/SUS, extendiéndolos hasta el 31 de diciembre 2014. Tras excluir los casos prevalentes, quedaron 1.761 mujeres con resultados citológicos anormales; 700 (39.8%), vinculados a un registro de colposcopía dentro del periodo de seguimient. Esta cifra cayó a 671 (38.1%) cuando el seguimiento fue censurado a los seis meses. Se observó una participación ligeramente superior en mujeres que viven en la región metropolitana de la gran São Paulo, comparada con los residentes del resto del estado. No hubo asociación entre la participación en la colposcopía y edad o tipo de citología. Estos resultados resaltan que el acceso a la colposcopía en el sistema público de São Paulo es limitado. Esto compromete la calidad de las pruebas de detección por lo que se necesita darles prioridad en la planificación de los servicios sanitarios.


Subject(s)
Humans , Female , Pregnancy , Adult , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control , Colposcopy , Vaginal Smears , Brazil/epidemiology , Mass Screening/methods , Early Detection of Cancer
3.
Femina ; 49(7): 425-432, 20210731. ilus
Article in Portuguese | LILACS | ID: biblio-1290592

ABSTRACT

As células glandulares atípicas representam 0,2% a 2,1% dos resultados dos testes de Papanicolaou. Mesmo com essa baixa prevalência, tem um significado importante no diagnóstico do câncer cervical e endometrial, tendo em vista que tais células e subcategorias, associadas à idade da paciente, podem prenunciar um número expressivo de doença intraepitelial, doença invasiva do endocérvix, endométrio e até neoplasias anexiais. E não se pode esquecer do importante número de resultados histológicos benignos, identificados no seguimento dessas pacientes, muitas vezes assintomáticas.(AU)


Atypical glandular cells represent 0,2% to 2,1% of Pap test results even with this low prevalence has an important significance in the diagnosis of cervical and endometrial cancer, considering that such cells and subcategories associated with the patient's age can predict a significant number of intraepithelial disease, invasive disease of the endometrium, endocervix and even adnexial neoplasms; no forgetting the important number of benign histological results, identified in the follow up of these patients, often asymptomatic.(AU)


Subject(s)
Humans , Female , Uterine Cervical Neoplasms/pathology , Cervix Uteri/surgery , Carcinoma, Endometrioid/pathology , Conization , Adenocarcinoma in Situ/surgery , Adenocarcinoma in Situ/pathology , Colposcopy , Cytodiagnosis/methods
4.
Rev. bras. med. fam. comunidade ; 16(43): 2992, 20210126. tab, graf
Article in Portuguese | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1292044

ABSTRACT

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.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Uterine Cervical Neoplasms/diagnosis , Comprehensive Health Care , Uterine Cervical Neoplasms/epidemiology , Cross-Sectional Studies , Retrospective Studies , Risk Factors , Colposcopy
5.
Rev. Méd. Paraná ; 79(1): 52-54, 2021.
Article in Portuguese | LILACS | ID: biblio-1282428

ABSTRACT

O câncer de colo de útero é uma doença invasiva causada pelo vírus oncogênico do HPV. Sendo o terceiro câncer maligno mais comum na mulher. O tratamento das lesões de câncer colo uterino é realizado a partir de métodos ablativos ou excisionais. Este estudo teve como objetivo avaliar o sucesso e a frequência de margens livres nas peças cirúrgicas obtidas por meio de cirurgia de alta frequência (CAF), utilizando uma alça diatérmica triangular modificada. Foi um estudo transversal, retrospectivo e descritivo. Os dados foram obtidos através de prontuários de pacientes submetidas a CAF com documentação do exame anatomopatológico, entre 07/10/15 até 31/08/2020. A coleta foi realizada em 34 pacientes que realizaram esse tratamento. Os resultados mostraram que 29 pacientes tiveram margens tanto ectocervical como endocervical livre. Conclui-se que a técnica utilizando a alça diatérmica triangular modificada mostrou-se eficaz no tratamento de lesões no colo do útero por HPV


Cervical cancer is an invasive disease caused by the oncogenic virus HPV. It's the third most common malign cancer in women. The treatment of the cervical cancer lesions is performed by ablative or excisional techniques. This study's objective was to evaluate the success and frequency of resection margins on surgical resections obtained by large loop excision of the transformation zone (LEEP), using a modified triangular diathermy loop. It was a cross-sectional, retrospective and descriptive study. The data was obtained through the records of patients who had undergone LEEP with the documentation of the anatomopathological examination between October 7th 2015 and August 31st 2020. The collection was performed in 34 patients who had undergone this treatment. The results showed that 29 patients had both ectocervical and endocervical resection margins. The conclusion was that the technique using a modified triangular diathermy loop presented itself as effective in the cervical cancer lesions treatment


Subject(s)
Humans , Female , Papillomaviridae , Uterine Cervical Neoplasms/surgery , Cervix Uteri , Colposcopy
6.
Hist. ciênc. saúde-Manguinhos ; 27(4): 1077-1095, Oct.-Dec. 2020.
Article in Portuguese | LILACS | ID: biblio-1142984

ABSTRACT

Resumo O artigo discute a organização do Hospital de Ginecologia em Belo Horizonte, fundado pelo ginecologista Clóvis Salgado, em 1939, atentando para sua atuação no controle do câncer do colo do útero. Criado como espaço para ensino prático da Faculdade de Medicina, foi pioneiro na introdução da colposcopia em Minas Gerais e na montagem de uma estrutura própria de atendimento e diagnóstico. Na análise, investiga-se como a promoção e tentativa de afirmação das tecnologias de diagnóstico foram pontos importantes na estruturação da instituição e de seu corpo profissional. O hospital afirmou-se na organização de ações de controle da doença, por meio da difusão da técnica, do diálogo com instituições nacionais congêneres e do intercâmbio com a ciência alemã.


Abstract This article discusses the structuring of the Hospital of Gynecology in Belo Horizonte, Minas Gerais, which was founded by the gynecologist Clóvis Salgado in 1939 as part of efforts to control cervical cancer. Created as a space for practical teaching in the School of Medicine, the hospital was a pioneer in introducing colposcopy in the state and establishing a structure specifically for care and diagnosis. This analysis investigates how promoting and attempting to assert diagnostic technologies were important in organizing this institution and its professional staff. The hospital firmly established itself in terms of activities to control cervical cancer by disseminating colposcopy as a technique, establishing dialogs with similar national institutions, and participating in exchanges with German science.


Subject(s)
Humans , Female , History, 20th Century , Uterine Cervical Neoplasms/history , Colposcopy/history , Gynecology/history , Hospitals, Special/history , Brazil , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control , Medical Records , Early Detection of Cancer/history , Gynecology/education
7.
Univ. salud ; 22(3): 231-237, set.-dic. 2020. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1139844

ABSTRACT

Resumen Introducción: Actualmente, el cáncer de cérvix sigue siendo una enfermedad importante por su incidencia y mortalidad. Aunque se conoce su etiología generada por la infección del virus del Papiloma Humano (PVH) y sus métodos de tamizaje como la citología convencional y el test de ADN-PVH, aún es necesario reconocer diversas características que se relacionan con la aparición de este tipo de cáncer. Objetivo: Describir las características citológicas previas al diagnóstico de cáncer cervical en mujeres de una institución de salud de la ciudad de Medellín. Materiales y métodos: Estudio descriptivo. Se tomaron los registros clínicos correspondientes a mujeres con diagnóstico confirmado de cáncer de cérvix entre 2012 y 2017 y se revisaron los resultados de citología previos al diagnóstico. Se realizó análisis univariado para describir las variables de estudio. Resultados: La muestra de mujeres con cáncer fue de 714, la mediana de edad fue 51 años (rango intercuartílico: 42-60), la alteración citológica más frecuente fue lesión intraepitelial de alto grado (33,8%), el principal cáncer diagnosticado fue carcinoma escamocelular (70,6%). Conclusiones: Los resultados de citología alteradas son un indicador para riesgo de cáncer de cérvix, de ahí la importancia de continuar con el protocolo de tamizaje establecido.


Abstract Introduction: Currently, cervical cancer continues to be an important disease because of its high incidence and mortality. Even though its etiology (Human Papilloma Virus infection) and screening methods (conventional cytology and HPV-DNA test) are well known, understanding the various characteristics associated with the appearance of cervical cancer is fundamental. Objective: To describe the cytological characteristics that precede the diagnosis of cervical cancer in women diagnosed in a health care institution from the city of Medellín. Materials and methods: A descriptive study. The clinical records corresponding to women with a confirmed diagnosis of cervical cancer between 2012 and 2017 were used. Also, the citology results obtained before the diagnosis were reviewed. An univariate analysis was carried out in oder to describe the study variables. Results: The sample size of women with cervical cancer was 714, the age median was 51 years old (interquartile range: 42-60), the most frequent cytological alteration was high-grade intraepithelial lesion (33.8%), and the main diagnosed cancer type was squamous cell carcinoma (70.6%). Conclusions: Results showing an altered cytology are indicators of cervical cancer risk. Therefore, it is important to continue with the stablished screening protocol.


Subject(s)
Cervix Uteri , Cell Biology , Uterine Cervical Neoplasms , Colposcopy , Squamous Intraepithelial Lesions of the Cervix
8.
Rev. bras. ginecol. obstet ; 42(3): 140-145, Mar. 2020. tab
Article in English | LILACS | ID: biblio-1098862

ABSTRACT

Abstract Objective To describe the referral for colposcopy in a Hospital in Brazil and the relative frequency of patients who benefited from it, considering the correct indications for the examination and its final diagnoses. Methods A retrospective study was performed in the colposcopy service database of the Hospital Universitário de Taubaté, Taubaté, state of São Paulo, Brazil. The frequency validated in the analysis of the medical records of women referred for clinical indication or cytological alteration, attended from March 2015 to March 2017. The population selected and analyzed included 256 results that were correlated to the cytological, clinical data and the result of the colposcopy. Results Of the women referred, 45% presented out of the age of screening according to the guidelines of cervical cancer screening, 8.6% being adolescents and young adults < 25 years old, and 36.4% of the patients being ≥ 65 years old. A total of 50% of the patients had no indication of colposcopy, that is, normal cytologies, benign changes, ectopia, cervicitis, atypical squamous cells of indeterminate significance (ASC-US) and low-grade intraepithelial lesion (LSIL) without persistence and normal clinical appearance. A total of 39.84% who underwent colposcopy had high-grade lesion or cancer results, thus benefiting from the adequate referral. Conclusion Most (60.16%) of the patients referred to the colposcopy service did not benefit from the referral for results without changes, such as negative colposcopies, histologies with no cervical intraepithelial neoplasm (CIN) or only CIN 1, or were out of the age for screening. These findings therefore demonstrate a significant number of unnecessary and inadequate referrals.


Resumo Objetivo Descrever os encaminhamentos para colposcopia em um hospital no Brasil e a frequência relativa dos pacientes que foram beneficiados, considerando as indicações corretas para o exame e seus diagnósticos finais. Métodos Foi realizado um estudo retrospectivo no banco de dados do serviço de colposcopia do Hospital Universitário de Taubaté, Taubaté, SP, Brasil. A frequência validou em análise de prontuários de mulheres encaminhadas por indicação clínica ou alteração citológica, atendidas no período de março de 2015 a março de 2017. A população selecionada e analisada incluiu 256 resultados que estavam correlacionadas aos dados citológicos, clínicos e com o resultado da colposcopia. Resultados Das mulheres encaminhadas, 45% apresentaram-se fora da idade de rastreamento conforme as diretrizes de rastreio de câncer de colo uterino, sendo que 8,6% eram adolescentes e adultas jovens < 25 anos de idade e 36,4% das pacientes tinham idade ≥ 65 anos. Um total de 50% das pacientes não possuía indicação de colposcopia, ou seja, citologias normais, de alterações benignas, ectopia, cervicite, células escamosas atípicas de significado indeterminado (ASC-US) e lesão intraepitelial escamosa de baixo grau (LSIL) sem persistência e aspecto clínico normal. Um total de 39,84% das pacientes que realizaram a colposcopia tiveram resultados de lesão de alto grau ou câncer e, dessa forma, se beneficiaram com o encaminhamento adequado. Conclusão A maioria (60,16%) das pacientes encaminhadas para o serviço de colposcopia não se beneficiou com o encaminhamento, por resultados sem alterações como colposcopias negativas, histologias com ausência de neoplasia intraepitelial cervical (NIC) ou apenas NIC 1, ou estavam fora da idade de rastreamento. Esses achados demonstram, portanto, significativo número de encaminhamentos desnecessários e inadequados.


Subject(s)
Humans , Female , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Referral and Consultation/statistics & numerical data , Uterine Cervical Neoplasms/pathology , Cervical Intraepithelial Neoplasia/pathology , Colposcopy/statistics & numerical data , Brazil , Women's Health Services , Medical Records , Retrospective Studies , Age Factors , Hospitals , Middle Aged
9.
Infectio ; 24(1): 20-26, ene.-mar. 2020. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1090539

ABSTRACT

Resumen Objetivos del trabajo: Se determinaron los porcentajes de las lesiones precancerosas de cuello uterino en un grupo de mujeres diagnosticadas positivas por la prueba ADN-VPH. Materiales y métodos: El presente estudio es un análisis exploratorio descriptivo transversal de una base de datos con resultados de las pruebas de ADN-VPH (genotipo y tipo de infección), citología y colposcopia, realizadas en 58 mujeres de 30 años o más, para el periodo de octubre del 2018 a febrero del 2019. Resultados: De las 58 mujeres positivas para la prueba ADN-VPH, el 57% (n=33) fueron positivas para la prueba citológica cervical. De este grupo de mujeres fueron diagnosticadas negativas para LEI el 21% (n=7); para LEI-BG el 33% (n=11); y para LEI-AG el 45% (n=15) mediante la prueba de colposcopia. El VPH-16 mostró la mayor frecuencia relativa de detección en las LEI-AG con un 46,7% (n=7). Igualmente, los genotipos que cubre la vacuna Gardasil_4 fueron identificados en mayor porcentaje en las LEI-AG en comparación con los otros tipos histopatológicos diagnosticados, siendo esta asociación estadísticamente significativa, valor de p = 0,033. Conclusiones: La implementación de la nueva guía de práctica clínica para la detección y manejo de lesiones precancerosas de cuello uterino muestra resultados satisfactorios, siendo concordante la detección de ADN-VPH, con la identificación de anormalidades citológicas e histopatológicas, permitiendo la identificación precoz de mujeres en riesgo de desarrollar cáncer cervical.


Abstract Objectives of the study: To determine the percentages of precancerous lesions in the cervix in a group of women with positive diagnostic to the DNA-HPV test. Materials and methods: The present study is a cross-sectional exploratory analysis of a database with information on the results of DNA-HPV tests (genotype and type of infection), cytology and colposcopy, carried out on 58 women aged 30 or older, for the period from October 2018 to February 2019. Results: Of the 58 women positive for the DNA-HPV test, 57% (n=33) were positive for the cervical cytology test. Of this group of women, 21% (n=7) were diagnosed LEI-negative; for LEI-BG 33% (n=11); and for LEI-AG, 45% (n=15) using the colposcopy test. HPV-16 has a higher detection frequency in the LEI-AG with 46.7% (n=7). Likewise, the genotypes that cover the Gardasil_4 vaccine were members in a greater percentage in the LEI-AG in comparison with other diagnosed histopathological types, this association being statistically significant, value of p = 0.033. Conclusions: The implementation of the new clinical practice guideline for the detection and management of precancerous lesions of the cervix shows satisfactory results, the DNA-HPV detection being consistent, with the identification of cytological and histopathological abnormalities, allowing the early identification of women at risk to develop cervical cancer.


Subject(s)
Humans , Female , Adult , Precancerous Conditions , Uterine Cervical Neoplasms , Practice Guideline , Cervix Uteri , Colombia , Colposcopy , Cell Biology
10.
Säo Paulo med. j ; 138(1): 47-53, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1099384

ABSTRACT

ABSTRACT BACKGROUND: Cervical cancer screening in Brazil is done using Pap smears. Women who are most likely to have a preinvasive lesion or cervical cancer are immediately referred for colposcopy. OBJECTIVE: The aim of this study was to evaluate the diagnostic performance of endocervical cytological tests in diagnosing preinvasive cervical lesions in women with initial high-grade squamous intraepithelial lesions (HSIL), or atypical squamous cells in which high-grade lesions could not be ruled out (ASC-H), or atypical glandular cells (AGC), and whose colposcopy did not show any abnormalities, with no fully visible transformation zone (types 2 and 3). DESIGN AND SETTING: Retrospective observational study conducted in Rio de Janeiro, Brazil. METHODS: Data from women who came to the cervical pathology outpatient clinic between January 2012 and April 2017 were analyzed. The results from endocervical cytological tests were compared with the final diagnosis, which was obtained through examination of a surgical specimen or, among women who did not undergo an excisional procedure, after cytological and colposcopic follow-up for two years. RESULTS: We included 78 women. The sensitivity of endocervical cytological tests was 72.7%; specificity 98.5%; positive and negative predictive values 88.9% and 95.6%, respectively; and positive and negative likelihood ratios 48.7 and 0.28. CONCLUSION: Endocervical cytological tests are simple, inexpensive and noninvasive, and form a reliable method for determining management among patients with HSIL, ASC-H and AGC cytological findings and negative colposcopic findings without visualization of the squamocolumnar junction.


Subject(s)
Humans , Female , Pregnancy , Uterine Cervical Neoplasms , Cervical Intraepithelial Neoplasia , Vaginal Smears , Brazil , Retrospective Studies , Colposcopy , Early Detection of Cancer
11.
Rev. méd. (La Paz) ; 26(1): 24-31, 2020. ilus
Article in Spanish | LILACS | ID: biblio-1127073

ABSTRACT

INTRODUCCION El cáncer cervicouterino es una enfermedad prevenible y curable, de etiología multifactorial y trasmitida sexualmente por el virus del papiloma humano. Este cáncer se desarrolla generalmente en la zona de transformación de la unión escamo-columnar del cuello uterino. La citología cervicovaginal es un método de detección precoz que tiene como objeto de estudio la detección de células anormales. MÉTODO EL presente trabajo es un estudio descriptivo, analítico, retrospectivo y correlacional. Se evaluaron 370 historias clínicas completas de pacientes con resultados de citología, colposcopia e histología. RESULTADO En la gestión 2015 se registraron con diagnostico citológico de LIE-BG un 63% y un 17.2% con LIE-AG, ASCUS fue 6.7% y ASCH 12.8%. Según el diagnóstico colposcópico el 54% dio LIE-BG y un 42.5% LIE-AG. El reporte histológico un 62.2% fue NIC I. 26.5% NIC II y el 9.7% NIC III. CONCLUSIONES En cuanto a los tres métodos diagnósticos existe correlación en porcentajes elevados y significativos en lesiones pre malignas de cérvix


INTRODUCTION Cervical cancer is a preventable, curable and multifactorial disease, it is sexually transmitted through the human papillomavirus. This cancer is usually developed in the transformation zone of squamocolumnar junction in the cervix. Cervicovaginal cytology is a method of early detection which focuses on the study of abnormal cells. METHOD A descriptive, analytical, retrospective and correlational study was conducted. It was evaluated 370 complete clinical histories of patients with cytology, colposcopy and histology results. RESULT Cytological diagnosis of LIE-BG was observed at 63 % and LIE-AG at 17.2 %, moreover ASCUS was 6.7 % and ASCH 12.8 %. Concerning colposcopy diagnosis, 54% displayed LIE-BG and 42.5% displayed LIE-AG. The histological report reflected NIC I 62.2 %, NIC II 26.5 % and NIC III 9.7 %. CONCLUSIONS Regarding these three diagnostic methods, the correlation is high and provides significant percentages for premalignant lesions of the cervix


Subject(s)
Colposcopy
12.
Article in English | WPRIM | ID: wpr-811219

ABSTRACT

OBJECTIVE: To investigate pathologic discrepancies between colposcopy-directed biopsy (CDB) of the cervix and loop electrosurgical excision procedure (LEEP) in women with cytologic high-grade squamous intraepithelial lesions (HSILs).METHODS: We retrospectively identified 297 patients who underwent both CDB and LEEP for HSILs in cervical cytology between 2015 and 2018, and compared their pathologic results. Considering the LEEP to be the gold standard, we evaluated the diagnostic performance of CDB for identifying cervical intraepithelial neoplasia (CIN) grades 2 and 3, adenocarcinoma in situ, and cancer (HSIL+). We also performed age subgroup analyses.RESULTS: Among the study population, 90.9% (270/297) had pathologic HSIL+ using the LEEP. The diagnostic performance of CDB for identifying HSIL+ was as follows: sensitivity, 87.8%; specificity, 59.3%; balanced accuracy, 73.6%; positive predictive value, 95.6%; and negative predictive value, 32.7%. Thirty-three false negative cases of CDB included CIN2,3 (n=29) and cervical cancer (n=4). The pathologic HSIL+ rate in patients with HSIL− by CDB was 67.3% (33/49). CDB exhibited a significant difference in the diagnosis of HSIL+ compared to LEEP in all patients (p<0.001). In age subgroup analyses, age groups <35 years and 35–50 years showed good agreement with the entire data set (p=0.496 and p=0.406, respectively), while age group ≥50 years did not (p=0.036).CONCLUSION: A significant pathologic discrepancy was observed between CDB and LEEP results in women with cytologic HSILs. The diagnostic inaccuracy of CDB increased in those ≥50 years of age.


Subject(s)
Adenocarcinoma in Situ , Biopsy , Cervical Intraepithelial Neoplasia , Cervix Uteri , Colposcopy , Conization , Dataset , Diagnosis , Early Detection of Cancer , Female , Humans , Papanicolaou Test , Retrospective Studies , Sensitivity and Specificity , Squamous Intraepithelial Lesions of the Cervix , Uterine Cervical Neoplasms
13.
Rev. cuba. obstet. ginecol ; 45(3): e478, jul.-set. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1093653

ABSTRACT

Introducción: El cáncer cérvico uterino es la segunda neoplasia más común en mujeres en el mundo. Una buena correlación entre las pruebas de tamizaje, diagnóstico y tratamiento de las lesiones cervicales optimiza su manejo, evita procedimientos innecesarios y maximiza recursos disponibles. Objetivo: Identificar la relación entre los métodos diagnósticos de las patologías del cuello uterino. Métodos: Se realizó un estudio observacional, descriptivo, transversal y prospectivo en el Hospital Provincial Camilo Cienfuegos de Sancti Spíritus, desde septiembre de 2015 a septiembre de 2017. Se tomó una población de 1172 pacientes de la consulta de patología de cuello uterino según los criterios de la investigación. Los métodos científicos fueron: de nivel teórico, empírico-experimental y matemático-estadístico. Se asumieron las variables: edad, factores de riesgo asociados, sintomatología, citología, colposcopia y biopsia. Resultados: El grupo de edad que con mayor frecuencia se presentó estuvo comprendido entre 26 y 35 años de edad. Los principales factores de riesgo asociados fueron: edad de inicio de las relaciones sexuales antes de los 18 años, virus del papiloma humano, paridad de más de dos hijos y antecedentes familiares de alguna patología de cuello. La sintomatología destacada fue el sangramiento poscoital e intermenstrual. Los resultados de los métodos diagnósticos fueron: virus del papiloma humano y displasia leve, tanto en la citología como en la biopsia, y lesiones de bajo grado en la colposcopia. Conclusiones: La asociación entre los métodos diagnósticos estudiados mostró una buena correlación citocolposcópica y colpohistológica, con diagnóstico de confirmación principalmente ante lesiones de alto grado(AU)


Introduction: Cervical cancer is the second most common neoplasm in women in the world. Good correlation between screening tests, diagnosis and treatment of cervical lesions optimizes management, avoiding unnecessary procedures and maximizing available resources. Objective: To identify the relationship between the diagnostic methods of cervical pathologies. Methods: An observational, descriptive, cross-sectional and prospective study was conducted at Camilo Cienfuegos Provincial Hospital in Sancti Spíritus, from September 2015 to September 2017. A population of 1172 patients was taken from the cervical pathology clinic according to the research criteria. The scientific methods were theoretical, empirical-experimental and mathematical-statistical. The assumed variables were age, associated risk factors, symptomatology, cytology, colposcopy and biopsy. Results: The age group that most frequently appeared was ages between 26 and 35 years. The main associated risk factors were age of first sexual intercourse before 18 years old, human papillomavirus, parity of more than two children and family history of some cervix pathology. The outstanding symptomatology was postcoital and intermenstrual bleeding. The results of the diagnostic methods were human papillomavirus and mild dysplasia, both in cytology and biopsy, and low-grade colposcopy lesions. Conclusions: The association between the diagnostic methods studied showed good cytocolposcopic and colpohistological correlation, with confirmation diagnosis mainly in cases of high-grade lesions(AU)


Subject(s)
Humans , Female , Adolescent , Adult , Uterine Cervical Diseases/pathology , Cervical Intraepithelial Neoplasia/diagnosis , Colposcopy/methods , Epidemiology, Descriptive , Cross-Sectional Studies , Prospective Studies
14.
Rev. colomb. obstet. ginecol ; 70(2): 94-102, 20190723. tab
Article in Spanish | LILACS | ID: biblio-1042832

ABSTRACT

RESUMEN Objetivo: evaluar la concordancia interobservador por nivel de entrenamiento al aplicar la escala Swede utilizando imágenes digitales de colposcopias. Materiales y métodos: estudio de concordancia ensamblado en un estudio de corte transversal. Se incluyeron pacientes remitidas para colposcopia por resultado de citología anormal, en un centro de referencia de patología cervical de Bogotá, Colombia. Muestreo por conveniencia. Variables medidas: edad, grado de escolaridad, estado civil, factores de riesgo para cáncer de cérvix (paridad, edad de inicio de la vida sexual, número de contactos sexuales); método de planificación, reporte de la citología y resultado de la colposcopia de acuerdo con los criterios de la escala Swede. Se utilizó estadística descriptiva, la concordancia se calculó usando el estadístico kappa (k) ponderado. Resultados: el análisis se realizó con un set de 3 imágenes colposcópicas digitales de 251 pacientes. Para el puntaje total de la escala, dos ginecólogos expertos mostraron una concordancia baja (k= 0,38; IC 95 %: 0,26-0,44), una pareja de dos ginecólogos con diferente nivel de entrenamiento mostró una concordancia baja (k = 0,27; IC 95 %: 0,20-0,38) y el otro par mostró una concordancia moderada (k= 0,45; IC 95 %: 0,34-0,53). Para los criterios individuales de la escala Swede la mejor concordancia se dio para "reacción acetoblanca" y "tamaño de la lesión" (k= 0,43; IC 95 %: 0,33-0,53). Conclusiones: la concordancia interobservador utilizando la escala Swede en imágenes colposcópicas digitales varió de baja a moderada según el nivel de entrenamiento de los ginecólogos.


Objective: To assess inter-observer concordance by training level when applying the Swede score to digital colposcopy images. Materials and methods: Concordance study assembled in a cross-sectional study. The population consisted of patients referred for colposcopy to a cervical pathology reference center in Bogotá, Colombia, due to abnormal cytology. Convenience sampling was used. Measured variables were age, level of education, marital status, risk factors for cervical cancer such as parity, age of sexual activity initiation and number of sexual contacts, contraceptive method, cytology report and colposcopy result according to the criteria of the Swede score. Concordance was calculated using the weighted kappa (k) index. Results: The analysis was based on a set of 3 digital colposcopic images of 251patients. For the total score on the scale, low agreement (k = 0.38; 95% CI: 0.26-0.44) was found between two expert gynecologists; low agreement (k = 0.27; IC 95 %: 0.20-0.38) was also shown for a pair of gynecologists with different training levels, while moderate agreement (k = 0.45; 95% CI: 0.34-0.53) was found for the third pair. For individual criteria on the Swede scale, the best agreement was found for "acetowhite reaction" and "lesion size" (k = 0.43; 95% CI: 0.33-0.53). Conclusions: Inter-observer concordance using the Swede score for digital colposcopic images ranged from low to moderate according to the level of training of the gynecologists.


Subject(s)
Female , Colposcopy , Uterine Cervical Diseases , Uterine Cervical Neoplasms
15.
Cambios rev. méd ; 18(1): 76-84, 28/06/2019. ilus; tabs; grafs
Article in Spanish | LILACS | ID: biblio-1015165

ABSTRACT

INTRODUCCIÓN. El cáncer cérvico-uterino tiene una fase precursora de larga duración, pues debe pasar por varios estados previos al cáncer invasivo, denominados lesiones intraepiteliales, de bajo y de alto grado, que pueden transformarse en lesiones malignas. La importancia de un diagnóstico oportuno y certero de las lesiones intraepiteliales escamosas de alto grado radica en que, si son tratadas de manera oportuna, son ciento por ciento curables. OBJETIVO. Proporcionar información actualizada sobre el diagnóstico y tratamiento de las lesiones precursoras de cáncer de cérvix y ayudar a los profesionales en la toma de decisiones médicas. MATERIALES Y MÉTODOS. Estudio de revisión de 45 artículos científicos la gran mayoría de la última década y, unos pocos, con datos históricos vigentes sobre lesiones intraepiteliales escamosas de alto grado del cuello uterino. La búsqueda se realizó en MedLine, PLoS y Scielo utilizando los términos tamizaje, neoplasias uterinas, lesiones intraepiteliales escamosas de cuello uterino y tratamiento. RESULTADOS. Los artículos científicos fueron seleccionados por niveles de evidencia 1 y 2, con recomendaciones A y B. Las recomendaciones de inicio de tamizaje han cambiado y el manejo toma en cuenta el riesgo acumulado por tipo de lesión. El tratamiento, en la mayoría de casos, es la escisión y resulta definitivo. CONCLUSIÓN. El diagnóstico sigue siendo cito-colpo-histológico y el tratamiento depende de la edad de la paciente, pudiendo las posibilidades ir de la observación hasta la escisión quirúrgica y, en casos específicos, la histerectomía.


INTRODUCTION. Cervical-uterine cancer has a long-term precursor phase, as it must go through several states prior to invasive cancer, called intraepithelial lesions, low and high grade, which can become malignant lesions. The importance of a timely and accurate diagnosis of high-grade squamous intraepithelial lesions is that, if treated in a timely manner, they are one hundred percent curable. OBJECTIVE. Provide updated information on the diagnosis and treatment of precursor lesions of cervical cancer and assist professionals in medical decision making. MATERIALS AND METHODS. Review study of 45 scientific articles the vast majority of the last decade and, a few, with current historical data on high-grade squamous intraepithelial lesions of the cervix. The search was conducted in MedLine, PLoS and Scielo using the terms screening, uterine neoplasms, squamous intraepithelial lesions of the cervix and treatment. RESULTS. The scientific articles were selected by levels of evidence 1 and 2, with recommendations A and B. The recommendations for starting screening have changed and management takes into account the accumulated risk by type of injury. The treatment, in most cases, is excision and is definitive. CONCLUSION. The diagnosis is still cyto-histological and the treatment depends on the age of the patient, and the possibilities may range from observation to surgical excision and, in specific cases, hysterectomy.


Subject(s)
Humans , Female , Uterine Neoplasms , Uterine Cervical Neoplasms/diagnosis , Cervix Uteri/abnormalities , Mass Screening , Colposcopy , Squamous Intraepithelial Lesions of the Cervix , Papillomaviridae , Therapeutics , Papillomavirus Infections
16.
Rev. méd. panacea ; 8(1): 31-45, ene.-abr. 2019. ilus, tab, graf, mapas
Article in Spanish | LIPECS, LILACS, LIPECS | ID: biblio-1016569

ABSTRACT

Objetivo: Determinar la relación que existe entre citología, biopsia y colposcopia en cáncer cérvico uterino. Materiales y métodos: : Es un estudio, descriptivo, transversal y retrospectivo..Se realizó una revisión bibliográfica de los artículos publicados en los últimos 5 años, y de otros originales teniendo en cuenta su nivel de evidencia médica I - II. Se utilizaron los buscadores de la biblioteca Cochrane, Dynamed, Evidence-Based Medicine Updates, New England Journal of Medicine, J Clinical Oncology, Medscape, PubMed, PubMed Central y artículos de la Agencia Internacional del Cáncer de Francia. Se revisaron los siguientes aspectos: Definiciones, epidemiología, etiología, factores de riesgo, citología, colposcopia, histopatología, clasificaciones, estadios clínicos, tratamientos, prevención, promoción de salud y problemas sociales. Resultados: En Europa, se encontró una concordancia insignificante entre citología - colposcopia (k=0,16; IC 95% 0,09-0,22); una concordancia moderada entre colposcopia - biopsia (k=0,57; IC 95% 0,47-0,68); y una concordancia insignificante entre citología - biopsia (k=0,21; IC 95% 0,08-0,34). ; En América Latina; se observó: la citología S: 80% y E: 56.6%; la colposcopia mostró S: 72,7% y E: 71,4%. La colposcopia mostró mayor correlación diagnóstica que la citología cervical en lesiones pre malignas de cáncer cervico uterino. La relación colpo-histológica mostró un 87,5% de coincidencias en las LIE bajo grado y en las LIE de alto grado un 71,4%. Perú 2017, citología mostró una S: 69% y E: 40%; colposcopía S: 86% y E: 44%. La relación citología - colposcopia S: 96% y E: 19%. Existe una asociación estadísticamente significativa de los resultados de la anatomía patológica con los hallazgos colposcópicos y del PAP (P<0.05) .La citología - colposcopia para lesiones precursoras y malignas de cáncer de cuello uterino moderada concordancia (Kappa: 0.4549); débil concordancia entre la citología - histología (Kappa: 0.3889) y buena concordancia entre la colposcopía - histología (Kappa: 0.6191). Trabajos Regionales Los hallazgos anátomo-patológicos fueron: 25,9% carcinomas invasivos y el 74,1% lesiones intraepiteliales de alto de malignidad. Conclusiones: La citología y la colposcopía han demostrado tener una utilidad clínica para la detección precoz de displasia moderada, displasia severa, carcinoma in situ y carcinoma escamoso invasor. Aunque no se obtuvo una adecuada correlación colpo-citológica, la correlación cito-histológica fue muy elevada tanto en las lesiones intraepiteliales de bajo grado como en las de alto grado. (AU)


Objective: To determine the relationship between cytology, biopsy and colposcopy in cervical cancer. Materials and methods: It is a descriptive, transversal and retrospective study. A bibliographic review of the articles published in the last 5 years, and of other originals taking into account their level of medical evidence I - II was made. We used search engines from the Cochrane library, Dynamed, Evidence-Based Medicine Updates, New England Journal of Medicine, J Clinical Oncology, Medscape, PubMed, PubMed Central and articles from the International Cancer Agency of France. The following aspects were reviewed: Definitions, epidemiology, etiology, risk factors, cytology, colposcopy, histopathology, classifications, clinical stages, treatments, prevention, health promotion and social problems Discussion: In Europe, insignificant concordance was found between cytology - colposcopy (k = 0.16, 95% CI 0.09-0.22); a moderate agreement between colposcopy - biopsy (k = 0.57, 95% CI 0.47-0.68); and an insignificant concordance between cytology - biopsy (k = 0.21, 95% CI 0.08-0.34). ; In Latin America; it was observed: cytology S: 80% and E: 56.6%; colposcopy showed S: 72.7% and E: 71.4%. Colposcopy showed a greater diagnostic correlation than cervical cytology in pre malignant lesions of uterine cervical cancer. The colpo-histological relationship showed 87.5% of coincidences in the low-grade IELs and 71.4% in the high-grade IELs. Peru 2017, cytology showed an S: 69% and E: 40%; Colposcopy S: 86% and E: 44%. The relationship cytology - colposcopy S: 96% and E: 19%. There is a statistically significant association of the results of the pathological anatomy with the colposcopic and PAP findings (P <0.05). Cytology - colposcopy for precursor and malignant lesions of moderate cervical cancer concordance (Kappa: 0.4549); weak concordance between cytology - histology (Kappa: 0.3889) and good agreement between colposcopy - histology (Kappa: 0.6191). Regional Workings The anatomopathological findings were: 25.9% invasive carcinomas and 74.1% intraepithelial lesions of high of malignancy. Conclusions:Cytology and colposcopy have been shown to be clinically useful for the early detection of moderate dysplasia, severe dysplasia, carcinoma in situ, and invasive squamous cell carcinoma. Although an adequate colpo-cytological correlation was not obtained, the cyto-histological correlation was very high in both low-grade and high-grade intraepithelial lesions. (AU)


Subject(s)
Humans , Female , Biopsy , Uterine Cervical Neoplasms , Colposcopy , Cell Biology , Epidemiology, Descriptive , Cross-Sectional Studies , Retrospective Studies
17.
Femina ; 47(4): 245-252, 20190430. ilus
Article in Portuguese | LILACS | ID: biblio-1046515

ABSTRACT

O adenocarcinoma cervical é uma patologia grave cuja incidência tem aumentado, principalmente em pacientes jovens. Um diagnóstico oportuno, na assistência primária e secundária à saúde, com métodos convencionais, melhora sobremaneira o prognóstico da paciente, a um custo tolerável para países em desenvolvimento.(AU)


The cervical adenocarcinoma is a serious pathology whose incident has increased mainly in young patients. One opportunistic diagnosis, in primary and secondary health care, with conventional methods, greatly improves the prognosis of the patients, at a cost tolerable to developing countries.(AU)


Subject(s)
Humans , Female , Primary Health Care , Secondary Care , Adenocarcinoma/classification , Uterine Cervical Neoplasms/diagnosis , Colposcopy , Adenocarcinoma in Situ/diagnosis , Clinical Diagnosis , Risk Factors , Diagnostic Techniques and Procedures , Atypical Squamous Cells of the Cervix/pathology
18.
Revista Digital de Postgrado ; 8(3): e179, 2019. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1094822

ABSTRACT

Determinar la prevalencia de las lesiones intraepiteliales cervicales de bajo y alto grado en pacientes de edad fértil en la consulta de ginecología del centro Materno pediatrico Zulia, en el período comprendido febrero 2016 -febrero 2018 Maracaibo, Estado Zulia. Métodos: Se realizó un estudio descriptivo retrospectivo en el que se incluyeron mujeres entre los 15 y 44 años, que acudieron a la consulta de Ginecología obstetricia del centro materno pediátrico Zulia para el periodo comprendido febrero 2016 ­ febrero 2018. Se evaluó la normalidad de las variables cuantitativas, empleándose la mediana o el promedio con sus varianzas según su distribución, y frecuencias y proporciones para las variables categóricas. Resultados: Se incluyeron 150 pacientes. La mediana de la edad fue 29 años con rango (R: 15-43 años), la mediana del número de partos 1 (R: 0-3). Uso de métodos anticonceptivos, la mayoría utilizaba ACO. El 60% de las citologías se reportaron como negativas, 20 % lesión de bajo grado (LSIL), 10% células escamosas atípicas de significado indeterminado (ASC-US), 2% lesiones de alto grado (HSIL), 2,3% células escamosas atípicas de significado indeterminado de alto grado ASC-H, 3,3% células glandulares atípicas de significado incierto (ASGUS) y 2% carcinoma invasor. Conclusión: La prevalencia de las anormalidades citológicas fue alta en todos los grupos analizados, sin embargo, existe un mayor número de LSIL hacia la tercera década de la vida y en aquellas que iniciaron su vida sexual después de los 40 años. De igual manera se encontró una relación inversa entre el número de partos, planificación familiar hormonal y aparición de lesiones pre neoplásicas(AU)


To determine the prevalence of cervical intraepithelial lesions of low and high grade in patients of fertile age in the gynecology clinic of the Zulia maternity center, in the period February 2016-February 2018 Maracaibo, Zulia State. Methods: A retrospective descriptive study was carried out that included women between 15 and 44 years old, who attended the obstetrics gynecology clinic of the Zulia pediatric maternity center for the period February 2016-February 2018. The normality of the quantitative variables, using the median or average with their variances according to their distribution, and frequencies and proportions for the categorical variables. Results: 150 patients were included. the median age was 29 years with range (R: 15-43 years), the median number of births 1 (R: 0-3). Using contraceptive methods, most used ACO. 60% of cytologies were reportedas negative, 20% low grade lesion (LSIL), 10% atypical squamous cells of undetermined significance (ASC-US), 2% high grade lesions (HSIL), 2.3% cells Atypical squamous of indeterminate significance of high grade ASC-H, 3.3% atypical glandular cells of uncertain significance (ASGUS) and 2% invasive carcinoma. Conclusion: The prevalence of cytological abnormalities was high in all the groups analyzed, however, there is a greater number of LSIL in the third decade of life and in those who began their sexual life their 40 years. Likewise, an inverse relationship was found between the number of births, hormonal family planning and the appearance of pre-neoplastic lesions(AU)


Subject(s)
Humans , Female , Adolescent , Adult , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/epidemiology , Cervical Intraepithelial Neoplasia/diagnosis , Papillomavirus Infections/diagnosis , Biopsy/instrumentation , Biopsy/statistics & numerical data , Retrospective Studies , Colposcopy/instrumentation , Papanicolaou Test/statistics & numerical data , Squamous Intraepithelial Lesions of the Cervix/pathology
19.
Cad. Saúde Pública (Online) ; 35(6): e00183118, 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1011689

ABSTRACT

Estimaram-se parâmetros para planejamento e programação da oferta de procedimentos para rastreamento, investigação diagnóstica e tratamento de lesões precursoras do câncer do colo do útero e, com base nessas estimativas, avaliou-se a adequação da produção nacional dos procedimentos realizados pelo Sistema Único de Saúde (SUS) em 2017. As estimativas foram calculadas utilizando como referencial as condutas preconizadas nas diretrizes nacionais para o rastreamento. Os dados referentes aos exames de rastreamento foram obtidos no Sistema de Informação do Câncer do Colo do Útero, e os dados de seguimento, em prontuários médicos de uma unidade de referência em patologia cervical. A produção nacional dos procedimentos foi obtida a partir de dados dos Sistemas de Informações Ambulatoriais e Hospitalares do SUS. Para cada cem mil mulheres na faixa etária alvo do rastreamento (25-64 anos), estimou-se a necessidade anual de 44.134 exames citopatológicos, 1.886 colposcopias, 275 biópsias, 236 excisões tipo 1 e 2 ambulatoriais, 236 excisões tipo 2 e 3 hospitalares e 39 encaminhamentos para alta complexidade para realização de cirurgia, quimioterapia e/ou radioterapia. Aplicando-se os parâmetros estimados ao número de mulheres rastreadas no Brasil em 2017, identificou-se déficit de todos os procedimentos para o seguimento adequado das mulheres com alterações, variando de 7% nas colposcopias a 74% nas excisões tipo 3. Os resultados apontam necessidade de ampliar e qualificar a oferta de procedimentos da linha de cuidado do câncer do colo do útero. Os parâmetros estimados poderão subsidiar gestores na programação e implementação de programas de rastreamento organizado.


The study estimated parameters for planning and programming the supply of procedures for screening, diagnostic workup, and treatment of precursor lesions of uterine cervical cancer. These estimates were used as the basis for assessing the adequacy of Brazil's production of procedures performed by the Brazilian Unified National Health System (SUS) in 2017. Estimates were calculated using as the reference the recommended management in the national screening guidelines. Data on screening tests were obtained from the Information System on Uterine Cervical Cancer and the follow-up data from patient charts in a referral center for cervical pathology. Brazil's production of procedures was obtained from data in the Outpatient and Hospital Information Systems of the SUS. For every one hundred thousand women in the target age bracket for screening (25 to 64 years) there was an estimated annual need for 44,134 cytopathology tests, 1,886 colposcopies, 275 biopsies, 236 type 1 and 2 outpatient exicision procedures, 236 type 2 and 3 hospital exicision procedures, and 39 high-complexity referrals for surgery, chemotherapy, and/or radiotherapy. Applying the estimated parameters to the number of women screened in Brazil in 2017, a deficit was identified in all the procedures for adequate follow-up of the women with altered test results, varying from 7% in colposcopies to 74% in type 3 excisions. The results point to the need to expand and upgrade the supply of line of care procedures for cervical cancer. The estimated parameters can support policymakers in programming and implementing organized screening programs.


Se estimaron parámetros para la planificación y programación de la oferta de procedimientos, con el fin de detectar, realizar investigación diagnóstica y tratar lesiones precursoras del cáncer de cuello uterino. En base a las mismas, se evaluó la adecuación del protocolo nacional de procedimientos realizados por el Sistema Único de Salud (SUS) en 2017. Las estimaciones se calcularon utilizando como marco de referencia los procedimientos recomendados en las directrices nacionales para la detección de este tipo de cáncer. Los datos referentes a los exámenes de detección se obtuvieron en el Sistema de Información del Cáncer de Cuello de Útero, y los datos de seguimiento en registros médicos de una unidad de referencia en patología cervical. La producción nacional de los procedimientos se obtuvo a partir de datos de los sistemas de información ambulatoria y hospitalaria del SUS. De cada cien mil mujeres, en la franja de edad objetivo de la detección (25 a 64 años), se estimó una necesidad anual de 44.134 exámenes citopatológicos, 1.886 colposcopias, 275 biopsias, 236 escisiones tipo 1 y 2 ambulatorias, 236 escisiones tipo 2 y 3 hospitalarias y 39 derivaciones hacia centros hospitalarios de alta complejidad para la realización de cirugías, quimioterapia y/o radioterapia. Aplicando los parámetros estimados al número de mujeres a quienes se les realizó el examen en Brasil durante 2017, se identificó un déficit de todos los procedimientos para un seguimiento adecuado de las mujeres con alteraciones, variando de un 7% en las colposcopias, a un 74% en las escisiones tipo 3. Los resultados apuntan la necesidad de ampliar y dotar la oferta de procedimientos en la línea de cuidados del cáncer de cuello uterino. Los parámetros estimados podrán ayudar a los gestores en la programación e implementación de programas organizados de detección.


Subject(s)
Humans , Female , Adult , Middle Aged , Uterine Cervical Neoplasms/diagnosis , Mass Screening/methods , Biopsy , Brazil , Uterine Cervical Neoplasms/prevention & control , Women's Health , Colposcopy , Early Detection of Cancer/methods , National Health Programs
20.
Postgrad. Med. J. Ghana ; 8(2): 117-122, 2019.
Article in English | AIM, AIM | ID: biblio-1268726

ABSTRACT

Background: Cervical cancer is the commonest cancer in sub-Saharan African with majority of the women presenting with an advanced disease stage. This is largely due to the unavailability of an established cervical cancer screening programme in most countries. This also includes the use of colposcopy which is still not available to many gynaecologists practicing in Nigeria. Aim: To review reports of colposcopy carried out at the University of Abuja Teaching Hospital, Abuja, Nigeria and to determine the degree of concurrence between colposcopic impression and histologic diagnosis. Methods: A retrospective analysis of the colposcopic findings of 84 patients was done. Subsequent correlation with histopathology report was carried out in 53 patients who had colposcopically directed biopsies between March 2012 and February 2014. Results: The commonest impression made on colposcopy was high grade CIN in 40(47.6%) patients. The concurrence rate between colposcopic findings and histology diagnosis was 64.2% (34/53) {K =0.302, 95%CI= -0.010-0.436}. The concurrence rate was higher for high grade CIN 29/40(72.5%) than for low grade CIN 5/12 (41.7 %). There was an overestimation of colposcopic diagnosis in 13(24.5%) patients and an underestimation in 6(11.3%) patients. The sensitivity of colposcopy for detecting high grade lesions or more was 32/36(88.9%) while the specificity was 8/17(47.1%). False positive rate for high grade lesions was 9/17(52.9%) and false negative rates for low grade lesions was 4/36(11.1%). Positive predictive value (PPV) of high grade colposcopic diagnosis or more was 32/41(78.04%) while the negative predictive value (NPV) was 8/12(66.73%). Conclusion: The strength of agreement between colposcopic diagnosis and cervical pathology was fair and colposcopy performs better in the detection of high grade lesions


Subject(s)
Africa South of the Sahara , Cervix Uteri , Colposcopy , Early Detection of Cancer , Predictive Value of Tests , Uterine Cervical Neoplasms/diagnosis
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