Trends in cervical cancer and its precursor forms to evaluate screening policies in a mid-sized Northeastern Brazilian city.
Cervical cancer is a health issue that disproportionately affects developing countries, where the Papanicolaou test (Pap smear) remains an important screening tool. Brazilian government recommendations have focused screening on the female population aged from 25 to 64 years old. In this study, we ex...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0233354 |
| _version_ | 1819016785227153408 |
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| author | Marcela Sampaio Lima Érika de Abreu Costa Brito Hianga Fayssa Fernandes Siqueira Marceli de Oliveira Santos Angela Maria da Silva Marco Antonio Prado Nunes Hugo Leite de Farias Brito Marcia Maria Macedo Lima Rosana Cipolotti Carlos Anselmo Lima |
| author_facet | Marcela Sampaio Lima Érika de Abreu Costa Brito Hianga Fayssa Fernandes Siqueira Marceli de Oliveira Santos Angela Maria da Silva Marco Antonio Prado Nunes Hugo Leite de Farias Brito Marcia Maria Macedo Lima Rosana Cipolotti Carlos Anselmo Lima |
| author_sort | Marcela Sampaio Lima |
| collection | DOAJ |
| description | Cervical cancer is a health issue that disproportionately affects developing countries, where the Papanicolaou test (Pap smear) remains an important screening tool. Brazilian government recommendations have focused screening on the female population aged from 25 to 64 years old. In this study, we examined the incidence and mortality rates of invasive cervical cancer lesions and the incidence rates of in situ precancerous cervical lesions, aiming to calculate their respective statistics over time in a mid-sized Brazilian city, Aracaju. The 1996-2015 database from the Aracaju Cancer Registry and Mortality Information System was used to calculate age standardized rates for all invasive cervical tumors (International code of diseases, ICD-10: C53) and preinvasive cervical lesions (ICD-10: D06) in the following patient age ranges; ≤ 24, 25-34, 35-44, 45-54, 55-64 and ≥ 65 years old. We identified 1,030 cancer cases, 1,871 in situ lesions and 334 deaths. Using the Joinpoint Regression Program, we calculated the annual percentage incidence changes and our analyses show that cervical cancer incidence decreased up to 2008, increased up to 2012 and decreased again thereafter, a significant trend in all age groups from 25 years. The incidence of precursor lesions increased from 1996 to 2005 and has since decreased, a result significant in all age groups until 64 years. Cervical cancer mortality has decreased by 3.8% annually and trend analysis indicates that Pap smears have been effective in decreasing cancer incidence and mortality. However, recent trends shown here show a decreasing incidence of in situ lesions and may indicate either a real decrease or incomplete catchment. Thus, we suggest health policies should be re-considered and include sufficient screening and HPV vaccination strategies to avoid cervical cancer resurgence in the population. |
| first_indexed | 2024-12-21T02:53:09Z |
| format | Article |
| id | doaj.art-88b77a8a827140f2a25373ace2395360 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T02:53:09Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-88b77a8a827140f2a25373ace23953602022-12-21T19:18:24ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01155e023335410.1371/journal.pone.0233354Trends in cervical cancer and its precursor forms to evaluate screening policies in a mid-sized Northeastern Brazilian city.Marcela Sampaio LimaÉrika de Abreu Costa BritoHianga Fayssa Fernandes SiqueiraMarceli de Oliveira SantosAngela Maria da SilvaMarco Antonio Prado NunesHugo Leite de Farias BritoMarcia Maria Macedo LimaRosana CipolottiCarlos Anselmo LimaCervical cancer is a health issue that disproportionately affects developing countries, where the Papanicolaou test (Pap smear) remains an important screening tool. Brazilian government recommendations have focused screening on the female population aged from 25 to 64 years old. In this study, we examined the incidence and mortality rates of invasive cervical cancer lesions and the incidence rates of in situ precancerous cervical lesions, aiming to calculate their respective statistics over time in a mid-sized Brazilian city, Aracaju. The 1996-2015 database from the Aracaju Cancer Registry and Mortality Information System was used to calculate age standardized rates for all invasive cervical tumors (International code of diseases, ICD-10: C53) and preinvasive cervical lesions (ICD-10: D06) in the following patient age ranges; ≤ 24, 25-34, 35-44, 45-54, 55-64 and ≥ 65 years old. We identified 1,030 cancer cases, 1,871 in situ lesions and 334 deaths. Using the Joinpoint Regression Program, we calculated the annual percentage incidence changes and our analyses show that cervical cancer incidence decreased up to 2008, increased up to 2012 and decreased again thereafter, a significant trend in all age groups from 25 years. The incidence of precursor lesions increased from 1996 to 2005 and has since decreased, a result significant in all age groups until 64 years. Cervical cancer mortality has decreased by 3.8% annually and trend analysis indicates that Pap smears have been effective in decreasing cancer incidence and mortality. However, recent trends shown here show a decreasing incidence of in situ lesions and may indicate either a real decrease or incomplete catchment. Thus, we suggest health policies should be re-considered and include sufficient screening and HPV vaccination strategies to avoid cervical cancer resurgence in the population.https://doi.org/10.1371/journal.pone.0233354 |
| spellingShingle | Marcela Sampaio Lima Érika de Abreu Costa Brito Hianga Fayssa Fernandes Siqueira Marceli de Oliveira Santos Angela Maria da Silva Marco Antonio Prado Nunes Hugo Leite de Farias Brito Marcia Maria Macedo Lima Rosana Cipolotti Carlos Anselmo Lima Trends in cervical cancer and its precursor forms to evaluate screening policies in a mid-sized Northeastern Brazilian city. PLoS ONE |
| title | Trends in cervical cancer and its precursor forms to evaluate screening policies in a mid-sized Northeastern Brazilian city. |
| title_full | Trends in cervical cancer and its precursor forms to evaluate screening policies in a mid-sized Northeastern Brazilian city. |
| title_fullStr | Trends in cervical cancer and its precursor forms to evaluate screening policies in a mid-sized Northeastern Brazilian city. |
| title_full_unstemmed | Trends in cervical cancer and its precursor forms to evaluate screening policies in a mid-sized Northeastern Brazilian city. |
| title_short | Trends in cervical cancer and its precursor forms to evaluate screening policies in a mid-sized Northeastern Brazilian city. |
| title_sort | trends in cervical cancer and its precursor forms to evaluate screening policies in a mid sized northeastern brazilian city |
| url | https://doi.org/10.1371/journal.pone.0233354 |
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