Dados do Trabalho

Título

EPIDEMIOLOGICAL DESIGN OF CERVICAL CANCER OIN BRAZIL AND COVERAGE OF PREVENTION STRATEGIES, WITH THE HELP OF A GEOSPATIAL MODEL, TO SUPPORT ACTIONS FOR ITS CONTROL

Introdução

In Brazil, the National Cancer Institute (INCA) predicts an estimated risk of 16.35 cases of cervical cancer (CC) per 100 thousand women for the 2020-2022 triennium. The Brazillian Ministry of Health (MnS) created the Brazilian Guidelines for Cervical Cancer Screening, which determines cervical cytology in patients between 25 to 64 years. The MnS also has incorporated a vaccine against HPV subtypes 6, 11, 16 and 18 for girls aged between 9 to 14 years old and boys aged between 11 to 14 years old.

Objetivo

Describing CC's epidemiological profile at the national level and by federative units, relating to incidence and mortality with the coverage of screening and immunization programs to aid in the intervention through improvements in public health policies by determining priority areas.

Método

Ecological study evaluating data on incidence, mortality, HPV vaccination coverage in girls and proportion of Pap screening, provided by the MnS and INCA. Using the geospatial model, the variables were classified by states and maps were elaborated from the overlap of the variables for visualization and comparison of deficient areas, conceiving a geographic representation of the priority areas for directing interventions by health managers.

Resultado

Seven of the 27 (25.9%) Brazilian states have an incidence of more than 20 cases per 100,000. There is a greater burden of disease in the North, where all states, except Rondônia, have an incidence of more than 18.85 cases per 100,000 women per year, and where all states, without exception, have a mortality rate greater than 6.93 cases per 100,000 women per year. The analysis also shows an overlap of higher incidence and higher mortality from CC concentrated in the northern region of the country (states of Acre, Amapá, Amazonas, Pará, Roraima, Tocantins) and in a state in the northeast region (Maranhão). Brazil's geographic mapping highlighted a national disparity in HPV vaccination and Pap coverage, both with low median rates.

Conclusão

Despite the promise of the recent implementation of HPV vaccination, its full impact will take decades to occur, and this data argue that continuous efforts are needed to improve access to screening and treatment for CC. The results also suggest that vaccination rates against HPV are below the target, at the risk of repeating Pap test trajectory: an efficient but underutilized tool for CC control.

Palavras-chave

Cervical cancer; HPV vaccination; geospatial model.