Background: Cervical cancer remains as an important problem for public health authorities in developing countries due to the high rates of incidence and mortality. This malignancy is the second most common cancer among women worldwide, accounting for more than 520,000 new cases and the deaths of approximately 270,000 women, annually. Estimates by the Brazilian National Cancer Institute (INCA) indicate an incidence of 16,340 new cases of cervical cancer for 2016 in Brazil. Objectives: To demonstrate the implementation of an organized cervical screening program in low-resource settings supported by Barretos Cancer Hospital (BCH) initiative to implement.
Methods: We developed an organizational, laboratorial and human resources training necessary to administrate the program. A computational program to report all epidemiological, clinical and laboratorial findings, and also to trace all necessary informations to periodically recruit the women for regular screening was developed by the BCH. Women from rural and remote areas were screened in mobile units.
. Results: More than 160,000 Pap tests were analyzed and 2,900 colposcopy examinations were performed in one single year. Importantly, from 2011 to 2015, 89.4% of all carcinomas were detected at clinical stage in situ carcinoma and I, and only 5% at stages III and IV. In 2014, e.g., 1,130 patients were referred for colposcopy: 98% of the patients from Barretos region attended the call; 97.1% of the patients from other regions attended in Public Health Ambulatories, and 74% attended in Mobile Units from other Brazilian States.
Conclusions: Since the organized system was implemented, 98% of women attended the recall for colposcopy. However, the main restriction of our program for prevention cervical cancer is still the lack of ideal coverage for this agenda. We did not reach yet the 70% of the women target for this proposal as recommended by the international standards.
Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., ... & Bray, F. (2015). Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International journal of cancer, 136(5), E359-E386.
INCA. Estimativa 2016: Incidência de câncer no Brasil. Available: http://www.inca.gov.br/estimativa/2016/.