Incidence rates and temporal trends of cervical cancer relating to opportunistic screening in two developed metropolitan regions of Brazil: a population-based cohort study.

Autor:	Teixeira JC; MD, PhD. Physician and Assistant Professor, Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil., Maestri CA; MD, MSc. Physician and Doctoral Student, Lower Genital Tract Disease Service, Hospital Erasto Gaertner, Curitiba (PR), Brazil., Machado HDC; MSc. Statistician, Department of Statistics, Centro de Atenção Integral à Saúde da Mulher (CAISM), Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil., Zeferino LC; MD, PhD. Physician and Professor, Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil., Carvalho NS; MD, PhD. Physician and Professor, Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Federal do Paraná (UFPR), Curitiba (PR), Brazil.
Jazyk:	angličtina
Zdroj:	Sao Paulo medical journal = Revista paulista de medicina [Sao Paulo Med J] 2019 Oct 31; Vol. 137 (4), pp. 322-328. Date of Electronic Publication: 2019 Oct 31 (Print Publication: 2019).
DOI:	10.1590/1516-3180.2018.0306220719
Abstrakt:	Background: Brazilian opportunistic screening programs for cervical cancer have limited impact. In the regions of two cities (Campinas and Curitiba) with high human development indices, consistent information from 96-97% of all cervical cancer cases managed within the public healthcare system is available. Objective: To estimate the incidence rate (IR) and temporal trends in these regions, covering 2001-2012. Design and Setting: A population-based cohort study was conducted under the assumption that all cervical cancer cases were managed in cancer referral center hospitals. Methods: 3,364 records (1,646 from Campinas; 1,718 from Curitiba) were analyzed to provide estimates of IR, age-standardized IR (ASR) and cervical cancer trends (shown per 100,000 women/year). Longitudinal patterns were analyzed using linear regression and shown as annual percentage change (APC); P < 0.05 for significance. Results: Annual IR and ASR estimates for cervical cancer ranged from 3.8 to 8.0 over 2001-2012, decreasing over more recent years, and were similar for the two regions. The age-specific IR was about 50% lower among women aged 45 years or older (IR-2001/IR-2012: Campinas = 14.8/8.0; Curitiba = 18.7/8.3; P < 0.001). There was an increasing APC trend in Campinas among women aged 15-24 years, and a decreasing IR trend for squamous-cell histology in both regions (P < 0.05). Conclusion: Cervical cancer incidence estimates showed slowly decreasing trends in both regions, most evidently for women aged 45 years or older and for squamous-cell histology. These findings reflect the opportunistic nature of the population screening program, despite the comparatively high economic development level in the two regions.
Databáze:	MEDLINE
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