Evaluation of cytopathological screening results and risk factors of women who underwent Papanicolaou test in a maternity school in Fortaleza, Ceará, Brazil

Cytopathology. 2020 Nov;31(6):586-592. doi: 10.1111/cyt.12883. Epub 2020 Sep 6.

Abstract

Introduction: Papanicolaou test (Pap smear) is the standard screening test of pre-neoplastic lesions and cervical cancer. This study aimed to investigate cervical cancer screening results and risk factors such as age, reason for the examination, the epithelia detected in the sample, microbiota and signs of sexually transmitted infection (STIs) of women in a maternity school in Fortaleza, Ceará, Brazil.

Methods: In this cross-sectional study, data were retrieved of 353 women who underwent Pap smear between April 2016 and January 2017 at the Federal University of Ceará.

Results: Of all Pap smear samples retrieved, 54.1% (191/353) had glandular epithelium and 40.2% (142/353) had metaplastic epithelium. After statistical analyses adjusted for the final model, age ≥51 years (odds ratio = 3.47) and signs of STIs (odds ratio = 4.95) remained as risk factors.

Conclusions: The diagnosis of high-grade lesions and carcinomas in patients older than 50 years indicates a deficiency in cervical screening. Women with signs and symptoms of STIs and candidiasis sought medical services more frequently than asymptomatic women, and presence of these signs and symptoms contributes to the diagnosis of cervical cancer. We highlight the importance of obtaining a correct smear sampling to allow prompt detection of all preneoplastic lesions; moreover, the implementation of human papillomavirus vaccination and an efficient routine Pap screening are necessary in low-resource settings.

Keywords: Papanicolaou smear; STIs; cervical cancer; cytopathology; endocervix; screening; women.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brazil
  • Child
  • Cytodiagnosis*
  • Early Detection of Cancer / standards
  • Female
  • Hospitals, Maternity / standards
  • Humans
  • Middle Aged
  • Papanicolaou Test
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / pathology
  • Papillomavirus Infections / virology
  • Papillomavirus Vaccines / therapeutic use
  • Precancerous Conditions / diagnosis*
  • Precancerous Conditions / epidemiology
  • Precancerous Conditions / pathology
  • Pregnancy
  • Risk Factors
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / pathology
  • Vaginal Smears
  • Young Adult

Substances

  • Papillomavirus Vaccines