RESUMO
AIM: This study complements the national screening program for cervical cancer, implemented in Romania. MATERIAL AND METHODS: Inclusion criteria for this program of active detection of cervical cancer are women aged 25 to 64 years and exclusion criteria were other age groups and the diagnosis confirmed of cervical cancer. The testing was free and used the method of colored cervical smear Pap. RESULTS: In 2013, 23.680 women were tested, that means only 10.13% of the total female population eligible for screening. In 2014, the test group was 6337 (one smear required retesting), of which 5852 were negative results and 484 positive results. Squamous cell abnormalities were detected in 433 women (6.84% of total group who attended the screening). Cervical smears with atypical squamous lesions were present at the most women included in the screening, regardless of age group (67.43%). The screening detected 21 lesions HSIL (4.84%), 2 HSIL with suspicion of invasion (0.46%) and 5 lesions of squamous carcinoma (1.15%). CONCLUSIONS: The presence of a small number of people compared to the female population eligible to the test screening may show the need for a better spread of notions about the screening and the afferent national program, for the population in northeastern Romania, considering the ethical issues that this test assumes.
Assuntos
Carcinoma de Células Escamosas , Detecção Precoce de Câncer/ética , Programas de Rastreamento/ética , Teste de Papanicolaou/ética , Displasia do Colo do Útero , Neoplasias do Colo do Útero , Esfregaço Vaginal/ética , Adulto , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/epidemiologia , Demografia , Feminino , Humanos , Incidência , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Teste de Papanicolaou/estatística & dados numéricos , Prevalência , Romênia/epidemiologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Esfregaço Vaginal/estatística & dados numéricos , Displasia do Colo do Útero/diagnóstico , Displasia do Colo do Útero/epidemiologiaRESUMO
OBJECTIVE: to synthesize scientific evidences about methods to increase cervical, breast and colorectal cancer screening participation. METHODS: a multidisciplinary working group has been set up to define the scope of the report and to conduct the evaluation. The scope and the final evaluation have been submitted to a stakeholder committee, including the Ministry of Health, the National Screening Observatory, regional screening program coordinators, scientific societies, and Lega Italiana Lotta ai Tumori, for comments and integrations. A systematic review of the principal biomedical and social literature databases was conducted to identify experimental and observational studies, updating the existing review by Jepson and coll. (Health Technol Assess. 2000;4(14):i-vii, 1-133). RESULTS: 5900 have been identified, 900 relevant for the topic.Among those, 148 reported quantitative information on intervention efficacy, other 90 came from the previous review. Organised screening programmes, based on invitation letter or on GP involvement,were consistently effective in increasing participation compared to spontaneous screening. Interventions are classified according to their target: individual, community, test simplification, health operators, health service organization. The report presents meta-analyses on efficacy, analyses of cost-effectiveness, impact on organisation and social inequality, and ethical and legal issues, of all the intervention reported in the literature. CONCLUSIONS: there are several interventions consistently effective in any context, some of them have minimal impact on costs and health service resources.
