ABSTRACT
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.
Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Young Adult , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/epidemiology , Papillomavirus Infections/epidemiology , Alphapapillomavirus/genetics , Sex Workers , Papillomaviridae/genetics , DNA, Viral/analysis , DNA, Viral/genetics , Chile/epidemiology , Prevalence , Cross-Sectional Studies , GenotypeABSTRACT
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)
Subject(s)
Humans , Female , National Health Strategies , Global Health Strategies , Uterine Cervical Neoplasms/diagnosis , Human Papillomavirus DNA Tests , Practice Patterns, Physicians' , Brazil/epidemiology , Uterine Cervical Neoplasms/epidemiology , Mass Screening , Databases, Bibliographic , Early Detection of Cancer , Health Services AccessibilityABSTRACT
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.
Subject(s)
Humans , Female , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology , Early Detection of Cancer/statistics & numerical data , Brazil/epidemiology , Uterine Cervical Dysplasia/diagnosis , Time Series Studies , Women's HealthABSTRACT
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.
Subject(s)
Water Quality , Uterine Cervical Neoplasms/epidemiology , Sanitation , Public Health , Cities , Correlation of DataABSTRACT
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.
Subject(s)
China/epidemiology , Female , Humans , Incidence , Laryngeal Neoplasms , Male , Middle Aged , Mouth Neoplasms , Oropharyngeal Neoplasms/epidemiology , Papillomavirus Infections/epidemiology , Penile Neoplasms/epidemiology , Registries , Uterine Cervical Neoplasms/epidemiology , Vaginal Neoplasms , Vulvar NeoplasmsABSTRACT
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.
Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Carcinoma in Situ , Uterine Cervical Neoplasms/epidemiology , Tertiary Care Centers/statistics & numerical data , Topography , Medical Records , Cross-Sectional Studies , Survival Rate , Hospitals, Teaching/statistics & numerical dataABSTRACT
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.
Subject(s)
Humans , Female , Adult , Middle Aged , Uterine Cervical Neoplasms/mortality , Uterine Cervical Neoplasms/epidemiology , Mortality , Signs and Symptoms , Uterine Cervical Neoplasms/prevention & control , Epidemiology, Descriptive , Prevalence , Surveys and Questionnaires , Knowledge , Ecuador/epidemiology , Hospitals, Public , InpatientsABSTRACT
El CaÌncer Cervicouterino es una de las principales problemaÌticas en salud de las mujeres a nivel mundial. Las teÌcnicas de tamizaje para la deteccioÌn de CaÌncer Cervicouterino han ido desarrollaÌndose a traveÌs de la historia reciente tanto intencionada como casualmente, incorporando con cada nuevo descubrimiento a las nuevas tecnologiÌas. Actualmente existen diversos procedimientos vigentes que van desde pruebas sencillas de inspeccioÌn visual, pasando por las tradicionales muestras citoloÌgicas, hasta la utilizacioÌn de tecnologiÌa molecular, y los usos que se les dan a estos meÌtodos de cribado potencian la deteccioÌn temprana del CaÌncer Cervicouterino, razoÌn por lo cual se realiza una revisioÌn respecto de las teÌcnicas de tamizajes disponibles y su aplicacioÌn 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.
Subject(s)
Humans , Female , Uterine Cervical Neoplasms/diagnosis , Mass Screening/methods , Papillomaviridae/isolation & purification , Algorithms , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/virology , Chile/epidemiology , Gynecological Examination , Papanicolaou TestABSTRACT
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
Subject(s)
Humans , Male , Female , Neoplasm Staging/statistics & numerical data , Neoplasms/epidemiology , Prostatic Neoplasms/epidemiology , Breast Neoplasms/epidemiology , Uterine Cervical Neoplasms/epidemiology , Neoplasms/complications , Neoplasms/diagnosis , Neoplasms/therapyABSTRACT
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 , ColposcopyABSTRACT
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
Subject(s)
Papillomaviridae , Women , Uterine Cervical Neoplasms , Uterine Cervical Neoplasms/epidemiologyABSTRACT
ABSTRACT OBJECTIVES To analyze the magnitude of changes in the incidence and mortality from cervical cancer (CC) and breast cancer (BC) in Campinas, São Paulo State, between the five-year periods of 1991-1995 and 2010-2014. METHODS data on cancer were obtained from the Campinas Population-Based Cancer Registry and data on deaths from the Mortality Information System of the Computing Department of the Unified Health System. Age-standardized incidence and mortality rates were calculated by the direct method, with the respective 95% confidence intervals. The magnitude of the changes was measured by the rate ratio (rate ratio; 95%CI). RESULTS among the periods studied, there was a threefold increase in the detection rate of in situ CC (3.03; 95%CI: 2.64-3.47) and fivefold increase for in situ BC (5.23; 95%CI: 4.98-5.50). The proportion of cases of in situ BC in relation to the total number of cases of BC increased from 3.31% to 11.05%. The incidence rate of invasive CC decreased by 57% (0.43; 95%CI: 0.40-0.47), and the incidence rate of invasive BC increased by 40% (1.40; 95%CI: 1.33-1.47). The mortality rate of the CC decreased by 58% (0.42; 95%CI: 0.32-0.56), and that of BC by 15% (0.85; 95%CI: 0.82-0.89). CONCLUSION the incidence of in situ carcinomas of CC and BC increased in almost two decades. The rate of invasive carcinoma of CC decreased, and that of BC increased. Mortality from both cancers decreased. Observing these changes is useful for assessing the impact of the actions carried out in the period and for planning future actions.
RESUMO OBJETIVOS Analisar a magnitude das mudanças na incidência e mortalidade por câncer do colo do útero (CCU) e câncer de mama (CM) em Campinas (SP) entre os quinquênios 1991-1995 e 2010-2014. MÉTODOS Os dados sobre câncer foram obtidos do Registro de Câncer de Base Populacional de Campinas e os dados sobre óbitos do Sistema de Informação de Mortalidade do Departamento de Informática do Sistema Único de Saúde. Foram calculadas taxas de incidência e de mortalidade padronizadas por idade pelo método direto, com os respectivos intervalos de confiança de 95%. Mensurou-se a magnitude das mudanças por meio da razão de taxas (RT). RESULTADOS Entre os períodos estudados, houve aumento de três vezes na taxa de detecção do CCU in situ (RT = 3,03; IC95% 2,64-3,47) e de 5 vezes para o CM in situ (RT = 5,23; IC95% 4,98-5,50). A proporção de casos de CM in situ em relação ao total de casos de CM aumentou de 3,31% para 11,05%. A taxa de incidência do CCU invasivo declinou em 57% (RT = 0,43; IC95% 0,40-0,47), e a do CM invasivo aumentou em 40% (RT = 1,40; IC95% 1,33-1,47). A taxa de mortalidade do CCU caiu em 58% (RT = 0,42; IC95% 0,32-0,56), e a do CM em 15% (RT = 0,85; IC95% 0,82-0,89). CONCLUSÃO A incidência de carcinomas in situ de CCU e CM aumentou nessas quase duas décadas. A taxa de carcinoma invasivo do CCU diminuiu, e a do CM aumentou. A mortalidade pelos dois cânceres foi reduzida. Observar essas alterações é útil para avaliar o impacto das ações realizadas no período e planejar ações futuras.
Subject(s)
Humans , Female , Breast Neoplasms/epidemiology , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Dysplasia , Brazil/epidemiology , Registries , Incidence , MortalityABSTRACT
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.
Subject(s)
Female , Humans , Sexually Transmitted Diseases , Uterine Cervical Neoplasms , Papillomavirus Infections , Alphapapillomavirus , Brazil/epidemiology , Sexually Transmitted Diseases/prevention & control , Sexually Transmitted Diseases/epidemiology , Uterine Cervical Neoplasms/epidemiology , Papillomavirus Infections/prevention & control , Papillomavirus Infections/epidemiologySubject(s)
Humans , Female , Child , Adolescent , Adult , Young Adult , Uterine Cervical Neoplasms/prevention & control , Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 , Sweden , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/epidemiology , Incidence , Vaccination , Immunization Programs , Neoplasm InvasivenessABSTRACT
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.
Subject(s)
Adult , Alphapapillomavirus , China/epidemiology , Early Detection of Cancer , Female , Humans , Middle Aged , Papillomaviridae/genetics , Papillomavirus Infections/epidemiology , Rural Population , Uterine Cervical Neoplasms/epidemiologyABSTRACT
Abstract Objective: To evaluate age patterns in human papillomavirus (HPV) prevalence and visual inspection with acetic acid (VIA) positivity among women participating in cervical cancer screening in Honduras. Materials and methods: Data on the HPV status (careHPV) and subsequent VIA in HPV-positive women were retrieved from three provinces within the Public Health Sector. Results: Between 2015 and 2018, 60 883 women aged 15-85 years were screened. HPV was detected in 15%, with variation by age, peaking at 20-24 years (27.8%) decreasing to 16% at 30-49 years. Differences in point age-specific HPV prevalence were observed between provinces, but with similar age pattern. VIA was positive in 24.5% of the women aged 30-44 years. Conclusions: The age pattern of the HPV prevalence supports starting HPV testing at age 30+. The low positivity of VIA in ages close to menopause suggest underdetection of cervical lesions in this age group.
Resumen Objetivo: Evaluar la prevalencia del virus del papiloma humano (VPH) y la positividad a la inspección visual con ácido acético (IVA) de cáncer cervicouterico, según edad en mujeres tamizadas en Honduras. Material y métodos: Se extrajo información sobre la prueba de VPH (careHPV) y de IVA en tres provincias en el ámbito de la Atención Pública en Salud. Resultados: Durante 2015-2018, 60 883 mujeres de 15-85 años fueron tamizadas, 15% fueron VPH positivas con valores máximos en mujeres de 20-24 años (27.8%), con una disminución a 16% entre 30-49 años. Se observaron diferencias mínimas entre provincias, con un patrón de edad similar. La IVA fue positiva en 24.5% en mujeres de 30-44 años, con una posterior disminución. Conclusiones: La curva de prevalencia del VPH respalda el tamizar con VPH a los 30+ años. La baja positividad de la IVA en edades cercanas a la menopausia sugiere una subdetección de lesiones cervicales en este grupo.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Young Adult , Uterine Cervical Neoplasms , Papillomavirus Infections , Early Detection of Cancer , Papillomaviridae , DNA, Viral , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/virology , Mass Screening , Triage , Age Distribution , Papillomavirus Infections/diagnosis , Papillomavirus Infections/epidemiology , Honduras/epidemiologyABSTRACT
O artigo tem o objetivo de determinar a frequência de neoplasia intraepitelial cervical (NIC) e de papilomavírus humano (HPV) no Rio Grande do Sul (RS). Tratou-se de um estudo retrospectivo, em que se analisou a frequência de NIC e de HPV no RS durante o período de janeiro de 2015 a junho de 2018. Foram analisados 1.249 laudos histopatológicos de colo uterino, tendo sido possível observar na análise global que a maioria dos casos se manteve estável (183 casos), porém 107 progrediram em um nível. Dos 64 casos de NIC I em 2015, 12 apresentaram a presença de HPV; em 2016, 19 casos de NIC I, e todos com HPV; em 2017 teve uma diminuição de casos de NIC I mais HPV (12 casos). Até junho de 2018, apenas 2 casos de HPV foram registrados. Com este estudo, ficou evidente que, na população estudada, houve diminuição no número de casos de NIC (22%), o que pode estar relacionado a campanhas e incentivo aos cuidados com a saúde e prevenção.(AU)
The article aims to determine the frequency of cervical intraepithelial neoplasia (CIN) and human papillomavirus (HPV) in Rio Grande do Sul (RS). This was a retrospective study, in which the frequency of CIN and HPV in RS, from January 2015 to June 2018, was analyzed. 1,249 cases of histopathological reports of the cervix were analyzed, being It is possible to observe in the global analysis that the majority of cases remained stable (183 cases), but 107 progressed at one level. Of the 64 cases of CIN I in 2015, 12 presented the presence of HPV, in 2016, 19 cases of CIN I, and all with HPV, in 2017 there was a decrease in cases of CIN I plus HPV (12 cases). As of June 2018, only 2 cases of HPV have been reported. With this study it was evident that in the studied population there was a decrease in the number of CIN cases (22%), which may be related to campaigns and incentives to health care and prevention.(AU)
Subject(s)
Humans , Female , Uterine Cervical Neoplasms/epidemiology , Papillomavirus Infections/epidemiology , Papillomaviridae/pathogenicity , Brazil/epidemiology , Diseases Registries , Cross-Sectional Studies , Health Status IndicatorsABSTRACT
RESUMEN Objetivo: Estimar la incidencia de cáncer de cuello uterino y sobrevida de pacientes con esta enfermedad según subtipo histológico y estadios en Manizales, Colombia para el periodo 2008-2012, y comparar cambios en la sobrevida con el quinquenio anterior. Materiales y métodos: A partir de datos poblacionales, se estandarizaron las tasas de incidencia según la edad para cada subtipo histológico. Se realizó un seguimiento activo y pasivo para determinar el estado vital y la causa de muerte a 60 meses. Se ajustaron funciones de Kaplan-Meier y modelos de Cox para estimar la sobrevida global y según covariables. Resultados: Se presentaron 217 casos nuevos para una incidencia media de 17,8 por 100000 mujeres-año. Hubo mayor frecuencia de estadios III-IV en pacientes de nivel socioeconómico medio y bajo. La sobrevida a cinco años fue de 68,9%; la edad (>70 años) se asoció con menor sobrevida (p<0,001). El riesgo de fallecer fue 90% mayor en pacientes con muestra histológicas no diferenciadas o desconocidas comparado con el carcinoma escamocelular (hazard ratio [HR] 1,9; IC 95%: 1,1-3,3); 1,7 veces mayor para personas mayores de 70 años (HR 2,7; IC 95%: 1,6-4,8); y tres veces mayor para estadio III (HR 4,3; IC 95%: 1,8-10,2) y siete veces mayor para estadio IV (HR 8,7; IC 95%: 3,6-20,1) en comparación con el estadio I. Conclusión: La incidencia de cáncer del cuello uterino en Manizales es similar a la global y a la continental, y fue más baja que otras ciudades colombianas con características similares. Hubo mayor frecuencia de estadios avanzados en mujeres de bajo nivel socioeconómico. La sobrevida se asoció con la edad, el subtipo histológico y la estadificación.
ABSTRACT Objective: To estimate the cervical cancer incidence and survival rates by histological subtype and stage in Manizales, Colombia during 2008-2012; and to compare the survival rate to the one from the previous five years. Materials and methods: Using population-based data, incidence rates by age were standardized for each histological subtype. Active and passive follow-up was performed to determine vital status and cause of death at 60 months. The Kaplan-Meier method and Cox models were adjusted to estimate overall survival by each covariant. Results: A total of 217 new cases were observed; with a mean incidence of 17.8 per 100,000 woman-years. Stages III-IV were more frequently observed in patients of medium and low socioeconomic status. At 5 years, the survival rate was 68.9%; ages over 70 years were associated with lower survival rates (p<0.001). Risk of death was 90% higher in patients with undifferentiated or unknown histological samples, when compared with those with squamous cell carcinoma (HR 1.9, 95% CI: 1.1-3.3). Likewise, the risk of death was 1.7 times higher for patients aged over 70 years (HR 2.7, 95% CI 1.6-4.8); and it was also found to be 3 times higher for stage III (HR 4.3, 95% CI: 1.8-10.2) and 7 times higher for stage IV (HR 8.7, 95% CI: 3.6-20.1), when compared with stage I. Conclusion: The incidence rate of cervical cancer in Manizales was found to be similar to the global and continental rates and lower than those from other Colombian cities with similar characteristics. Advanced stages were more frequent in women of low socioeconomic status. Survival was associated with age, histological subtype and staging.