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Original Article
Underestimated Cervical Cancer among Women over 65 Years Old: Is It Time to Revise the Screening Target Age Group?
- Renata Alfena Zago
, - Deolino João Camilo-Júnior ,
- Solange Correa Garcia Pires D’Ávilla,
- José Cândido Caldeira Xavier-Júnior
01-11-2023
Summary
Original ArticleUnderestimated Cervical Cancer among Women over 65 Years Old: Is It Time to Revise the Screening Target Age Group?
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(12):790-795
01-11-2023- Renata Alfena Zago ,
- Deolino João Camilo-Júnior ,
- Solange Correa Garcia Pires D’Ávilla,
- José Cândido Caldeira Xavier-Júnior
Views181See moreAbstract
Objective
To compare cytological and histological results from women > 64 years old who followed the Brazilian national cervical cancer screening guidelines with those who did not.
Methods
The present observational retrospective study analyzed 207 abnormal cervical smear results from women > 64 years old in a mid-sized city in Brazil over 14 years. All results were reported according to the Bethesda System. The women were divided into those who followed the screening guidelines and those who did not.
Results
Atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesion cytology results were found in 128 (62.2%) cases. Of these, 112 (87.5%) had repeated cytology with positive results. The other 79 (38.1%) with abnormal results should have been referred to colposcopy and biopsy. Out of 41 (51.9%) biopsied women, 23 (29.1%) had a confirmed diagnosis of neoplasia or precursor lesion. In contrast, among the 78 (37.7%) biopsied patients, 40 (51.3%) followed the guideline recommendations, with 9 (22.5%) positive biopsies. Of the 38 (48.7%) women who did not follow the guidelines, there were 24 (63.1%) positive results. Women who did not follow the guidelines demonstrated higher chances of cancer and precursor lesions (odds ratio [OR]: 5.904; 95% confidence interval [CI]: 2.188–15.932; p = 0.0002).
Conclusion
Women > 64 years old who did not follow the national screening protocol showed significant differences in the frequency of abnormal results and severity of diagnosis compared with those who followed the protocol.
Views181
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleUnderestimated Cervical Cancer among Women over 65 Years Old: Is It Time to Revise the Screening Target Age Group?
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(12):790-795
01-11-2023- Renata Alfena Zago ,
- Deolino João Camilo-Júnior ,
- Solange Correa Garcia Pires D’Ávilla,
- José Cândido Caldeira Xavier-Júnior
Views181See moreAbstract
Objective
To compare cytological and histological results from women > 64 years old who followed the Brazilian national cervical cancer screening guidelines with those who did not.
Methods
The present observational retrospective study analyzed 207 abnormal cervical smear results from women > 64 years old in a mid-sized city in Brazil over 14 years. All results were reported according to the Bethesda System. The women were divided into those who followed the screening guidelines and those who did not.
Results
Atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesion cytology results were found in 128 (62.2%) cases. Of these, 112 (87.5%) had repeated cytology with positive results. The other 79 (38.1%) with abnormal results should have been referred to colposcopy and biopsy. Out of 41 (51.9%) biopsied women, 23 (29.1%) had a confirmed diagnosis of neoplasia or precursor lesion. In contrast, among the 78 (37.7%) biopsied patients, 40 (51.3%) followed the guideline recommendations, with 9 (22.5%) positive biopsies. Of the 38 (48.7%) women who did not follow the guidelines, there were 24 (63.1%) positive results. Women who did not follow the guidelines demonstrated higher chances of cancer and precursor lesions (odds ratio [OR]: 5.904; 95% confidence interval [CI]: 2.188–15.932; p = 0.0002).
Conclusion
Women > 64 years old who did not follow the national screening protocol showed significant differences in the frequency of abnormal results and severity of diagnosis compared with those who followed the protocol.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Renata Alfena Zago
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Review Article
Effect of Lubricant Use on Cervicovaginal Cytology – What’s the Evidence?
- Diana Magalhães dos Santos ,
- Maria Beatriz Freire Oliveira Coelho de Matos ,
- Ana Raquel Borges Sousa ,
- Francisco Correia de Almeida Fertusinhos ,
- Rosa Maria Couceiro Pendás
12-05-2023
Summary
Review ArticleEffect of Lubricant Use on Cervicovaginal Cytology – What’s the Evidence?
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(11):724-728
12-05-2023- Diana Magalhães dos Santos ,
- Maria Beatriz Freire Oliveira Coelho de Matos ,
- Ana Raquel Borges Sousa ,
- Francisco Correia de Almeida Fertusinhos ,
- Rosa Maria Couceiro Pendás
Views120See moreAbstract
Objective
To determine if the use of lubricating gel on the speculum during the cervicovaginal cytology examination interferes with the results obtained, as well as whether it reduces reported discomfort in patients.
Data sources
A systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, with a search in the Pubmed/Medline, Scielo, Cochrane Library, Embase databases of articles published between January 2011 and May 2022. The keywords used were cytology, speculum, lubricant, result, and pain.
Selection of studies
The initial search resulted in 306 articles, of which were excluded three because they were duplicates, 257 after reading the title and abstract and 41 after reading the full text. Thus, five articles were selected for the study: four randomized clinical trials and one metanalysis.
Data collection
The selection of articles was performed by two investigators. The 5 selected articles were read in full and submitted to a comparative analysis.
Data synthesis
Screening through cervicovaginal cytology allows for early diagnosis and reduction of associated mortality, but the procedure can be associated with pain. A small amount of aqueous lubricating gel in the speculum can be used to reduce the discomfort associated with performing cervicovaginal cytology.
Conclusion
The use of lubricating gel in the speculum does not seem to be associated with a change in the cytology result and reduces the discomfort associated with its insertion into the vagina.
Views120This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleEffect of Lubricant Use on Cervicovaginal Cytology – What’s the Evidence?
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(11):724-728
12-05-2023- Diana Magalhães dos Santos ,
- Maria Beatriz Freire Oliveira Coelho de Matos ,
- Ana Raquel Borges Sousa ,
- Francisco Correia de Almeida Fertusinhos ,
- Rosa Maria Couceiro Pendás
Views120See moreAbstract
Objective
To determine if the use of lubricating gel on the speculum during the cervicovaginal cytology examination interferes with the results obtained, as well as whether it reduces reported discomfort in patients.
Data sources
A systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, with a search in the Pubmed/Medline, Scielo, Cochrane Library, Embase databases of articles published between January 2011 and May 2022. The keywords used were cytology, speculum, lubricant, result, and pain.
Selection of studies
The initial search resulted in 306 articles, of which were excluded three because they were duplicates, 257 after reading the title and abstract and 41 after reading the full text. Thus, five articles were selected for the study: four randomized clinical trials and one metanalysis.
Data collection
The selection of articles was performed by two investigators. The 5 selected articles were read in full and submitted to a comparative analysis.
Data synthesis
Screening through cervicovaginal cytology allows for early diagnosis and reduction of associated mortality, but the procedure can be associated with pain. A small amount of aqueous lubricating gel in the speculum can be used to reduce the discomfort associated with performing cervicovaginal cytology.
Conclusion
The use of lubricating gel in the speculum does not seem to be associated with a change in the cytology result and reduces the discomfort associated with its insertion into the vagina.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
- Diana Magalhães dos Santos
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Original Article
A New Brazilian Device for Cervical Cancer Screening: Acceptability and Accuracy of Self-sampling
- Martina Lichtenfels ,
- Noely Paula Cristina Lorenzi ,
- Maricy Tacla ,
- Kaori Yokochi ,
- Flávia Frustockl, [ ... ],
- Caroline Brunetto Farias
08-07-2023
Summary
Original ArticleA New Brazilian Device for Cervical Cancer Screening: Acceptability and Accuracy of Self-sampling
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(5):235-241
08-07-2023- Martina Lichtenfels ,
- Noely Paula Cristina Lorenzi ,
- Maricy Tacla ,
- Kaori Yokochi ,
- Flávia Frustockl,
- Camila Alves Silva ,
- André Luiz da Silva ,
- Lara Termini ,
- Caroline Brunetto Farias
Views152Abstract
Objective
To evaluate the accuracy and patient acceptability toward self-sampling using a new device - SelfCervix® - for detecting HPV-DNA.
Methods
A total of 73 women aged 25–65 who underwent regular cervical cancer screening from March to October 2016 were included. Women performed self-sampling followed by a physician-sampling, and the samples were analyzed for HPV-DNA. After that, patients were surveyed about their acceptability of self-sampling.
Results
HPV-DNA detection rate of self-sampling presented high accuracy and was similar to physician-collection. Sixty-four (87.7%) patients answered the acceptability survey. Most patients (89%) considered the self-sampling comfortable, and 82.5% preferred self-sampling to physician-sampling. The reasons cited were time-saving and convenience. Fifty-one (79.7%) reported that they would recommend self-sampling.
Conclusion
Self-sampling using the new Brazilian device SelfCervix® is not inferior in HPV-DNA detection rate compared with physician-collection, and patients are supportive of the method. Therefore, it might be an option to reach under-screened populations in Brazil.
Key-words Cytologydiagnostic screening programsearly detection of cancerHuman papillomavirusUterine cervical neoplasmsSee moreViews152This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleA New Brazilian Device for Cervical Cancer Screening: Acceptability and Accuracy of Self-sampling
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(5):235-241
08-07-2023- Martina Lichtenfels ,
- Noely Paula Cristina Lorenzi ,
- Maricy Tacla ,
- Kaori Yokochi ,
- Flávia Frustockl,
- Camila Alves Silva ,
- André Luiz da Silva ,
- Lara Termini ,
- Caroline Brunetto Farias
Views152Abstract
Objective
To evaluate the accuracy and patient acceptability toward self-sampling using a new device - SelfCervix® - for detecting HPV-DNA.
Methods
A total of 73 women aged 25–65 who underwent regular cervical cancer screening from March to October 2016 were included. Women performed self-sampling followed by a physician-sampling, and the samples were analyzed for HPV-DNA. After that, patients were surveyed about their acceptability of self-sampling.
Results
HPV-DNA detection rate of self-sampling presented high accuracy and was similar to physician-collection. Sixty-four (87.7%) patients answered the acceptability survey. Most patients (89%) considered the self-sampling comfortable, and 82.5% preferred self-sampling to physician-sampling. The reasons cited were time-saving and convenience. Fifty-one (79.7%) reported that they would recommend self-sampling.
Conclusion
Self-sampling using the new Brazilian device SelfCervix® is not inferior in HPV-DNA detection rate compared with physician-collection, and patients are supportive of the method. Therefore, it might be an option to reach under-screened populations in Brazil.
Key-words Cytologydiagnostic screening programsearly detection of cancerHuman papillomavirusUterine cervical neoplasmsSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Martina Lichtenfels
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Original Article
Anal High-risk HPV and Liquid-based Cytology of Immunocompetent Brazilian Women with Genital High-risk HPV
- Karla Maria Rêgo Leopoldo Melo ,
- José Eleutério Junior ,
- Raquel Autran Coelho Peixoto ,
- Karinne Cisne Fernandes Rebouças ,
- Renata Mirian Nunes Eleutério
02-09-2022
Summary
Original ArticleAnal High-risk HPV and Liquid-based Cytology of Immunocompetent Brazilian Women with Genital High-risk HPV
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):280-286
02-09-2022- Karla Maria Rêgo Leopoldo Melo ,
- José Eleutério Junior ,
- Raquel Autran Coelho Peixoto ,
- Karinne Cisne Fernandes Rebouças ,
- Renata Mirian Nunes Eleutério
Views107See moreAbstract
Objective
The purpose of this study was to compare the frequency of the occurrence of high-risk human papillomavirus (HPV) and abnormal anal cytology in immunocompetent women with and without HPV-induced genital lesions.
Methods
This analytical cross-sectional, observational study was conducted between July 2017 and December 2018 in a specialized outpatient clinic of a tertiary hospital in Fortaleza, CE. Fifty-seven immunocompetent women with and without genital intraepithelial lesions were assessed; they were divided into two groups: group 1 was comprised of women with HPV-associated genital lesions (n=26), and group 2 was comprised of those without HPV-associated genital lesions (n=31). Samples for liquidbased cytology and high-risk DNA-HPV polymerase chain reaction real-time tests were collected from the cervix and anus. All cases were evaluated using high-resolution anoscopy; biopsies were performed when required. The Fisher exact and chi-squared tests were applied for consolidated data in the contingency table, and the Student ttest and Mann-Whitney U-test for independent variables.
Results
Anal high-risk HPV infections were more frequent in group 1 (odds ratio [OR], 4.95; 95% confidence interval [CI], 1.34-18.3; p=0.012), along with concomitant highrisk HPV infections in the uterine cervix and the anus (OR 18.8; 95% CI, 2.20-160; p<0.001). The incidence of high-risk cervical HPV infection was associated with highrisk anal HPV infection (OR, 4.95; 95% CI, 1.34-18.3; p=0.012). There was no statistical difference concerning abnormal anal cytology or anoscopy between the groups, and no anal intraepithelial lesion was found in either group.
Conclusion
Immunocompetent women with HPV-associated genital lesions and high-risk cervical HPV were more likely to have high-risk anal HPV.
Views107This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleAnal High-risk HPV and Liquid-based Cytology of Immunocompetent Brazilian Women with Genital High-risk HPV
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):280-286
02-09-2022- Karla Maria Rêgo Leopoldo Melo ,
- José Eleutério Junior ,
- Raquel Autran Coelho Peixoto ,
- Karinne Cisne Fernandes Rebouças ,
- Renata Mirian Nunes Eleutério
Views107See moreAbstract
Objective
The purpose of this study was to compare the frequency of the occurrence of high-risk human papillomavirus (HPV) and abnormal anal cytology in immunocompetent women with and without HPV-induced genital lesions.
Methods
This analytical cross-sectional, observational study was conducted between July 2017 and December 2018 in a specialized outpatient clinic of a tertiary hospital in Fortaleza, CE. Fifty-seven immunocompetent women with and without genital intraepithelial lesions were assessed; they were divided into two groups: group 1 was comprised of women with HPV-associated genital lesions (n=26), and group 2 was comprised of those without HPV-associated genital lesions (n=31). Samples for liquidbased cytology and high-risk DNA-HPV polymerase chain reaction real-time tests were collected from the cervix and anus. All cases were evaluated using high-resolution anoscopy; biopsies were performed when required. The Fisher exact and chi-squared tests were applied for consolidated data in the contingency table, and the Student ttest and Mann-Whitney U-test for independent variables.
Results
Anal high-risk HPV infections were more frequent in group 1 (odds ratio [OR], 4.95; 95% confidence interval [CI], 1.34-18.3; p=0.012), along with concomitant highrisk HPV infections in the uterine cervix and the anus (OR 18.8; 95% CI, 2.20-160; p<0.001). The incidence of high-risk cervical HPV infection was associated with highrisk anal HPV infection (OR, 4.95; 95% CI, 1.34-18.3; p=0.012). There was no statistical difference concerning abnormal anal cytology or anoscopy between the groups, and no anal intraepithelial lesion was found in either group.
Conclusion
Immunocompetent women with HPV-associated genital lesions and high-risk cervical HPV were more likely to have high-risk anal HPV.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Karla Maria Rêgo Leopoldo Melo
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Original Article
Preventing Uterine Cervix Cancer: The Clinical Meaning of Atypical Glandular Cells
- Gutemberg Almeida ,
- Jorge Eduardo Sainz ,
- Renata Fonseca ,
- Neil Chaves ,
- Katia Silveira Silva , [ ... ],
- Yara Furtado
02-09-2022
Summary
Original ArticlePreventing Uterine Cervix Cancer: The Clinical Meaning of Atypical Glandular Cells
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):483-488
02-09-2022- Gutemberg Almeida ,
- Jorge Eduardo Sainz ,
- Renata Fonseca ,
- Neil Chaves ,
- Katia Silveira Silva ,
- Julio Nunes ,
- Yara Furtado
Views210Abstract
Objective
To determine the prevalence of the atypical glandular cells (AGCs) cytology and to analyze its clinical significance in different age ranges.
Methods
Retrospective observational study using computerized data from the Brazilian National Cancer Institute, including women screened between January 2002 and December 2008. The women included were those with an AGC result who were properly followed-up with colposcopy and a second cytology.
Results
A total of 132,147 cytopathological exams were performed during the study period. Five-hundred and thirty-three (0.4%) women with AGC cytology were identified and, of these, 69.41% (370/533) were properly referred for colposcopy and a new cytology. Most of the women (79.2%) with a 1st or 2nd AGC cytology were between the ages of 25 and 54 years. The 2nd cytology demonstrated 67.6% (250/370) of normality, 24.5% (91/370) of squamous atypia, and 6.2% (23/370) of AGC, 0.8% (3/370) adenocarcinoma in situ and 0.8% (3/370) adenocarcinoma invasor. On biopsy of the women with a second AGC cytology, 43.4% (10/23) had normal histology, 43.4% (10/23) had squamous lesions, 8.7% (2/23) had invasive adenocarcinoma, and 1.2% (1/23) had an inconclusive report. All of the women with high-grade squamous intraepithelial lesion (HSIL) or invasive adenocarcinoma (respectively 5 and 2 patients), after a 2nd AGC cytology were 25 years old or older.
Conclusion
The prevalence of the AGC cytology was low in the studied population. Most of the AGC cytology cases occurred in adult women between the ages of 25 and 54. Although most of the patients had normal histology after follow-up, several of them presented with squamous intraepithelial lesions or invasive adenocarcinoma.
Key-words AGCatypical glandular cellsBethesda systemcervical cancer screeningCytologyglandular cervical neoplasiaSee moreViews210This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticlePreventing Uterine Cervix Cancer: The Clinical Meaning of Atypical Glandular Cells
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):483-488
02-09-2022- Gutemberg Almeida ,
- Jorge Eduardo Sainz ,
- Renata Fonseca ,
- Neil Chaves ,
- Katia Silveira Silva ,
- Julio Nunes ,
- Yara Furtado
Views210Abstract
Objective
To determine the prevalence of the atypical glandular cells (AGCs) cytology and to analyze its clinical significance in different age ranges.
Methods
Retrospective observational study using computerized data from the Brazilian National Cancer Institute, including women screened between January 2002 and December 2008. The women included were those with an AGC result who were properly followed-up with colposcopy and a second cytology.
Results
A total of 132,147 cytopathological exams were performed during the study period. Five-hundred and thirty-three (0.4%) women with AGC cytology were identified and, of these, 69.41% (370/533) were properly referred for colposcopy and a new cytology. Most of the women (79.2%) with a 1st or 2nd AGC cytology were between the ages of 25 and 54 years. The 2nd cytology demonstrated 67.6% (250/370) of normality, 24.5% (91/370) of squamous atypia, and 6.2% (23/370) of AGC, 0.8% (3/370) adenocarcinoma in situ and 0.8% (3/370) adenocarcinoma invasor. On biopsy of the women with a second AGC cytology, 43.4% (10/23) had normal histology, 43.4% (10/23) had squamous lesions, 8.7% (2/23) had invasive adenocarcinoma, and 1.2% (1/23) had an inconclusive report. All of the women with high-grade squamous intraepithelial lesion (HSIL) or invasive adenocarcinoma (respectively 5 and 2 patients), after a 2nd AGC cytology were 25 years old or older.
Conclusion
The prevalence of the AGC cytology was low in the studied population. Most of the AGC cytology cases occurred in adult women between the ages of 25 and 54. Although most of the patients had normal histology after follow-up, several of them presented with squamous intraepithelial lesions or invasive adenocarcinoma.
Key-words AGCatypical glandular cellsBethesda systemcervical cancer screeningCytologyglandular cervical neoplasiaSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Gutemberg Almeida
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Review Article
Guidelines for HPV-DNA Testing for Cervical Cancer Screening in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(6):360-368
06-01-2018
Summary
Review ArticleGuidelines for HPV-DNA Testing for Cervical Cancer Screening in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(6):360-368
06-01-2018Views249See moreAbstract
Evidence-based clinical guidelines ensure best practice protocols are available in health care. There is a widespread use of human papillomavirus deoxyribonucleic acid (HPVDNA) tests in Brazil, regardless of the lack of official guidelines. On behalf of the Brazilian Association for the Lower Genital Tract Pathology and Colposcopy (ABPTGIC, in the Portuguese acronym), a team of reviewers searched for published evidence and developed a set of recommendations for the use of HPV-DNA tests in cervical cancer screening in Brazil. The product of this process was debated and consensus was sought by the participants. One concern of the authors was the inclusion of these tests in the assessment of women with cytologic atypia and women treated for cervical intraepithelial neoplasia (CIN). Testing for HPV is recommended in an organized screening scenario to identify women with precursor lesions or asymptomatic cervical cancer older than 30 years of age, and it can be performed every 5 years. It also has value after the cytology showing atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSILs) as a triage test for colposcopy, in the investigation of other cytological alterations when no abnormal findings are observed at colposcopy, seeking to exclude disease, or, further, after treatment of high-grade cervical intraepithelial neoplasia, to rule out residual disease.
PlumX Metrics
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- Citation Indexes: 26
- Policy Citations: 1
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Views249PlumX Metrics- Citations
- Citation Indexes: 26
- Policy Citations: 1
- Usage
- Full Text Views: 3338
- Abstract Views: 1756
- Captures
- Readers: 104
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleGuidelines for HPV-DNA Testing for Cervical Cancer Screening in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(6):360-368
06-01-2018Views249See moreAbstract
Evidence-based clinical guidelines ensure best practice protocols are available in health care. There is a widespread use of human papillomavirus deoxyribonucleic acid (HPVDNA) tests in Brazil, regardless of the lack of official guidelines. On behalf of the Brazilian Association for the Lower Genital Tract Pathology and Colposcopy (ABPTGIC, in the Portuguese acronym), a team of reviewers searched for published evidence and developed a set of recommendations for the use of HPV-DNA tests in cervical cancer screening in Brazil. The product of this process was debated and consensus was sought by the participants. One concern of the authors was the inclusion of these tests in the assessment of women with cytologic atypia and women treated for cervical intraepithelial neoplasia (CIN). Testing for HPV is recommended in an organized screening scenario to identify women with precursor lesions or asymptomatic cervical cancer older than 30 years of age, and it can be performed every 5 years. It also has value after the cytology showing atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSILs) as a triage test for colposcopy, in the investigation of other cytological alterations when no abnormal findings are observed at colposcopy, seeking to exclude disease, or, further, after treatment of high-grade cervical intraepithelial neoplasia, to rule out residual disease.
PlumX Metrics- Citations
- Citation Indexes: 26
- Policy Citations: 1
- Usage
- Full Text Views: 3338
- Abstract Views: 1756
- Captures
- Readers: 104
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
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Original Article
Early Age at First Sexual Intercourse is Associated with Higher Prevalence of High-grade Squamous Intraepithelial Lesions (HSIL)
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(2):80-85
02-01-2017
Summary
Original ArticleEarly Age at First Sexual Intercourse is Associated with Higher Prevalence of High-grade Squamous Intraepithelial Lesions (HSIL)
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(2):80-85
02-01-2017Views126See moreAbstract
Objective
To evaluate the association of age at first sexual intercourse with the results of the cervicovaginal cytology.
Study Design
Observational analytical study about the prevalence of altered cervicovaginal cytology results in women aged between 18 and 34 years from a densely populated area in Brazil, during 10 years. The patients were stratified into 2 categories according to their age at first sexual intercourse (13-16 years and 17-24 years).
Results
From the total of 2,505,154 exams, 898,921 tests were in accordance with the inclusion criteria. Considering women with 4 years or less from the first sexual intercourse as a reference, those with 5 to 9 years and 10 years or more showed a higher prevalence of high-grade squamous intraepithelial lesions (HSILs). Women with an earlier onset of sexual intercourse (13-16 years) showed higher prevalence ratios for atypical squamous cells (ASC), low-grade squamous intraepithelial lesion (LSIL) and HSIL. The prevalence ratio for HSIL adjusted by age at diagnosis and by age at first sexual intercourse was higher only for women with an earlier onset of sexual intercourse.
Conclusions
The age of first sexual intercourse could be a variable that might qualify the selection among young women who are really at a higher risk for HSIL.
Views126This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleEarly Age at First Sexual Intercourse is Associated with Higher Prevalence of High-grade Squamous Intraepithelial Lesions (HSIL)
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(2):80-85
02-01-2017Views126See moreAbstract
Objective
To evaluate the association of age at first sexual intercourse with the results of the cervicovaginal cytology.
Study Design
Observational analytical study about the prevalence of altered cervicovaginal cytology results in women aged between 18 and 34 years from a densely populated area in Brazil, during 10 years. The patients were stratified into 2 categories according to their age at first sexual intercourse (13-16 years and 17-24 years).
Results
From the total of 2,505,154 exams, 898,921 tests were in accordance with the inclusion criteria. Considering women with 4 years or less from the first sexual intercourse as a reference, those with 5 to 9 years and 10 years or more showed a higher prevalence of high-grade squamous intraepithelial lesions (HSILs). Women with an earlier onset of sexual intercourse (13-16 years) showed higher prevalence ratios for atypical squamous cells (ASC), low-grade squamous intraepithelial lesion (LSIL) and HSIL. The prevalence ratio for HSIL adjusted by age at diagnosis and by age at first sexual intercourse was higher only for women with an earlier onset of sexual intercourse.
Conclusions
The age of first sexual intercourse could be a variable that might qualify the selection among young women who are really at a higher risk for HSIL.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigo de Revisão
Cytological diagnosis of atypical squamous cells: a critical evaluation of diagnostic guidelines
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(11):573-582
01-12-2008
Summary
Artigo de RevisãoCytological diagnosis of atypical squamous cells: a critical evaluation of diagnostic guidelines
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(11):573-582
01-12-2008DOI 10.1590/S0100-72032008001100008
Views74PURPOSE: to identify valid guidelines for the approach of women with cytopathological diagnosis of undetermined significance atypias in squamous cells (ASC), discussing its applicability to the Brazilian scenario. METHODS: an electronic search of publications at PubMed, National Guidelines Clearinghouse and Scholar Google was carried out, as well as a manual search of references from the texts found. The guidelines identified, and specifically related to the theme, were evaluated according to its validity and the recommendations were criticized and summarized. RESULTS: guidelines for the United Kingdom, France, Australia, the USA and New Zealand have been considered as valid. These documents recommend repeating the cytology in six or twelve months, in ASCs of undetermined significance (ASC-US) before referring to colposcopy, and immediate referral to colposcopy in ASCs, when it is not possible to disregard high degree lesions (ASC-H). We have also found valid colposcopy recommendations for women with ASC-US in special situations (immune deficient women requiring specialist assistance) and the use of oncogenic HPV test, which, when present in women over 20, should motivate referral to colposcopy. CONCLUSIONS: the clinical guidelines recommended for the Programa Nacional de Controle do Cancer do Colo do Útero in Brazil can be improved with the referral to colposcopy in special situations (immune deficient women requiring specialist assistance), the use of test for the detection of oncogenic HPV in women over 20 (when present, refer to colposcopy), the investigation of vaginal lesions, the use of estrogens before the colposcopy in post-menopausal women, and disregard biopsia in case of slighter alterations.
Key-words Cervical intraepitelial neoplasiaColposcopyCytologyPratice guidelineUterine cervix neoplasmsSee moreViews74This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigo de RevisãoCytological diagnosis of atypical squamous cells: a critical evaluation of diagnostic guidelines
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(11):573-582
01-12-2008DOI 10.1590/S0100-72032008001100008
Views74PURPOSE: to identify valid guidelines for the approach of women with cytopathological diagnosis of undetermined significance atypias in squamous cells (ASC), discussing its applicability to the Brazilian scenario. METHODS: an electronic search of publications at PubMed, National Guidelines Clearinghouse and Scholar Google was carried out, as well as a manual search of references from the texts found. The guidelines identified, and specifically related to the theme, were evaluated according to its validity and the recommendations were criticized and summarized. RESULTS: guidelines for the United Kingdom, France, Australia, the USA and New Zealand have been considered as valid. These documents recommend repeating the cytology in six or twelve months, in ASCs of undetermined significance (ASC-US) before referring to colposcopy, and immediate referral to colposcopy in ASCs, when it is not possible to disregard high degree lesions (ASC-H). We have also found valid colposcopy recommendations for women with ASC-US in special situations (immune deficient women requiring specialist assistance) and the use of oncogenic HPV test, which, when present in women over 20, should motivate referral to colposcopy. CONCLUSIONS: the clinical guidelines recommended for the Programa Nacional de Controle do Cancer do Colo do Útero in Brazil can be improved with the referral to colposcopy in special situations (immune deficient women requiring specialist assistance), the use of test for the detection of oncogenic HPV in women over 20 (when present, refer to colposcopy), the investigation of vaginal lesions, the use of estrogens before the colposcopy in post-menopausal women, and disregard biopsia in case of slighter alterations.
Key-words Cervical intraepitelial neoplasiaColposcopyCytologyPratice guidelineUterine cervix neoplasmsSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cytology Archives - Page 2 of 2 - Revista Brasileira de Ginecologia e Obstetrícia
