Prevalência de lesões precursoras de câncer de colo uterino e fatores associados em mulheres atendidas em Hospital Universitário, Vitória-ES
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Data
2012-04-04
Autores
Boldrini, Neide Aparecida Tosato
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Universidade Federal do Espírito Santo
Resumo
Introduction: The squamous cell cervical cancer develops from precancerous lesions well defined which can progress to invasive disease if not earlier diagnosed and treated. Objectives: To determine the prevalence and factors associated with high-grade lesions and cervical cancer among women treated at University Hospital in Vitoria, ES. Methods: A cross-section conducted in women 18-59 years who were referred for outpatient cervical pathology in 2011. Women were invited to participate and were interviewed for collecting demographics, epidemiological and clinical data. After the interview, they were submitted to gynecological examination to collect specimens for cervical cytology, Chlamydia trachomatis and HPV Hybrid Capture tests, and HPV DNA detection by PCR and colposcopic examination. The patients with cervical lesions at cytology and colposcopy were confirmed by histopathology. Results: A total of 291 women participated in the study. The median age was 38 years (DIQ: 30 - 48 years), 74 (25.4%) had completed four years of schooling; 178 (61.2%) were married and 83 (28.5%) had monthly family income up to three minimum wages. When considering histopathological results, the prevalence of high-grade lesions/cervical cancer was 18.2% (95% CI: 13.8% -22.6%), being 48 (16.5%) cases of high-grade lesions (CIN II, CIN IIIca in situ) and 5 (1.7%) cases of invasive carcinoma. One hundred and eight women (37.1%) were smokers; 11 (3.8%) reported using illicit drugs;38 (13.1%) reported their first sexual intercourse before age 15;221 (75 9%) had more than one partner in life; 20 (6.9%) had more than one partner in the last 12 months;220 (75.6%) reported not using condoms;90 (30.2%) reported anal sex practice;46 (15.8%) reported previous STD. In the final logistic regression model, age between 30-49 years [OR = 4.4 (95%:1.01-19.04), history of smoking [OR = 2.43 (95% CI 1.14 to 5 , 18)], practice of anal intercourse [OR = 2.35 (95% CI 1.10 to 5.03)] and have a positive hybrid capture test for high risk HPV positive [OR = 11.23 (95% 4 0.79 to 26, 36)] remained independently associated with high-grade lesion/cervical cancer. Conclusions: The results show high prevalence of precursor lesions of cervical cancer and high prevalence of high risk HPV. The most prevalent HPV was HPV 16 followed by HPV 31. Associated risk factors for HSIL/carcinoma were age between 30-49 years, history of smoking, practice of anal sex and have a positive hybrid capture test for high risk HPV positive. The study emphasizes the importance of prevention and care strategies for the control of cervical cancer.
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Papillomavirus , Cancer- Risk factors , Molecular biology , Câncer , Papilomavírus , Câncer - Fatores de risco , Colposcopia , Biologia molecular
Citação
BOLDRINI, Neide Aparecida Tosato. Prevalência de lesões precursoras de câncer de colo uterino e fatores associados em mulheres atendidas em Hospital Universitário, Vitória-ES. 2012. 87 f. Dissertação (Mestrado em Doenças Infecciosas) - Programa de Pós-Graduação em Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, 2012.