Historical Analysis of the Brazilian Cervical Cancer Screening Program from 2006 to 2013: A Time for Reflection

PLoS One. 2015 Sep 24;10(9):e0138945. doi: 10.1371/journal.pone.0138945. eCollection 2015.

Abstract

Background: The Cervical Cancer Database of the Brazilian National Health Service (SISCOLO) contains information regarding all cervical cytological tests and, if properly explored, can be used as a tool for monitoring and managing the cervical cancer screening program. The aim of this study was to perform a historical analysis of the cervical cancer screening program in Brazil from 2006 to 2013.

Material and methods: The data necessary to calculate quality indicators were obtained from the SISCOLO, a Brazilian health system tool. Joinpoint analysis was used to calculate the annual percentage change.

Results: We observed important trends showing decreased rates of low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and an increased rate of rejected exams from 2009 to 2013. The index of positivity was maintained at levels below those indicated by international standards; very low frequencies of unsatisfactory cases were observed over the study period, which partially contradicts the low rate of positive cases. The number of positive cytological diagnoses was below that expected, considering that developed countries with low frequencies of cervical cancer detect more lesions annually.

Conclusions: The evolution of indicators from 2006 to 2013 suggests that actions must be taken to improve the effectiveness of cervical cancer control in Brazil.

Publication types

  • Historical Article

MeSH terms

  • Adult
  • Brazil
  • Early Detection of Cancer / history*
  • Early Detection of Cancer / standards
  • Female
  • History, 21st Century
  • Humans
  • Middle Aged
  • Quality Indicators, Health Care
  • Uterine Cervical Neoplasms / diagnosis*
  • Vaginal Smears

Grants and funding

The authors have no support or funding to report.