Coverage of pap smear and mortality from cervical cancer in Brazil from 2006 to 2014

Abstract

Introduction: Despite the widespread programs of prevention and screening of cervix cancer in Brazil, the country still remains in the third position of the most malignant neoplasm and the third cause of female death due to cancer. The Human papillomavirus vaccine is a recent addition to the National Immunization Program. Due to its short time of implementation, it is still insufficient to evaluate the reduction of this disease. Screening and treatment of precancerous lesions through oncotic colpocytology have significantly reduced the incidence and mortality of cervix cancer. However, so that it occurs, a high population coverage is required, which is not the case of Brazil. Objective: To analyze the number of Pap smear obtained from January 2006 to December 2014 in the Brazilian female population by the public health system, comparing it to the number of cervix neoplasia deaths during the same period. Methods: A cross-sectional study evaluating the number of Pap smear and mortality due to cervix cancer in the female population aged 25 to 64 years. The number of Pap smear carried out was obtained through the Cervix Cancer Information System, and the population statistics was provided by the Brazilian Institute of Geography and Statistics (IBGE). The number of deaths was obtained through the Mortality Information System developed by the Health Ministry. Results: The coverage by Pap smear in Brazil was shown to be declining during the analyzed period. The Brazilian region with the lowest average coverage was the Northern (14.58%), and it is also the region with the highest number of deaths from cervix cancer (average of 12.58 deaths per 100,000 women). The region with the highest average coverage was the Southeast (17.14%), which presented the lowest rates of death from this neoplasm (average of 5.28 deaths per 100,000 women). The highest number of deaths from cervix cancer during the period from 2006 to 2014 occurred in the 50 to 54 age group. Conclusion: Brazilian Pap smear coverage remains very low and the mortality rates are high and constant over the last years.