Screening, Diagnosis and Treatment of Precursory Lesions and Invasive Cervical Cancer in the City of Franco da Rocha, São Paulo, Brazil

Abstract

The objective of this cross-sectional study was to evaluate the severity of cervical lesion among women with preneoplasic or invasive cervical biopsy, the characterisitics of these women, as well as the procedure and resources available to screen, diagnose and treat them. The files of all women with abnormal cervical histological diagnosis, who attended the Franco da Rocha Regional Hospital between 1998 and 2002, were reviewed. To evaluate the resources available in the hospital and in the primary healthcare units, an interview was carried out with one employee from each facility. The Pap test coverage was estimated using data from Datasus. Odds Ratios, with a confidence interval of 95%, were estimated for the analysis of the association between the variables and the histological diagnosis. Eighty-seven files were identified - 52% with a diagnosis of HPV / CIN 1, 28% of CIN 2 / CIN 3, and 21% of invasive cervical cancer. Presenting to the hospital because of abnormal cytology and/or biopsy results, being between 35 and 49 years old and having had five or more deliveries were factors associated with CIN 2 / CIN 3. Presenting for a specific symptom of cancer, attending the hospital spontaneously, being 50 or more years old, or 35 to 49 years of age, having had five or more deliveries, not having used contraceptive pills and not having had a previous Pap smear were factors positively associated with a diagnosis of invasive neoplasia. The Pap smear coverage was below 25% for every year studied.