TY - JOUR
T1 - Factors associated with cervical intraepithelial neoplasia (CIN2/CIN3), early stage and advanced stage of cervical cancer diagnosis in the Brazilian Amazonian region
AU - Pontes, Valéria B.
AU - Martins, Luís Felipe L.
AU - Szklo, Moysés
AU - Moreira, Miguel Ângelo M.
AU - Chaves, Cláudia Bessa P.
AU - De Almeida, Liz Maria
N1 - Funding Information:
Acknowledgments We thank Population Research team and Genetic Division team of Instituto Nacional de Câncer José Alencar Gomes da Silva; Health Professional team of Hospital Ophir Loyola (OLH); The Pará State Health Secretariat/Brazilian National Council for Scientific and Technological Development (Brazilian National Institutes of Science and Technology de Controle de Câncer); and The Pan American Health Organization.
Publisher Copyright:
Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - To understand the impact of demographic, behavioral and contextual factors on cervical cancer, we examined the profile of women classified according to cervical cancer staging [precursor lesions cervical intraephitelial neoplasia (CIN2/CIN3), early- and advanced-stage cancer]. Patients were identified in the main oncological reference hospital in Pará State, Brazil, from 2013 through 2015. Adjusted prevalence ratios and their respective 95% confidence intervals were estimated using Poisson regression with robust variance. The study included 172 cases of CIN2/CIN3 lesions, 158 of early stage and 552 of advanced stage of cervical cancer. The proportion of gynecological complaints as a reason for clinic visit was 2.3 times higher among patients at an early stage compared with patients with CIN2/CIN3 lesions. Compared with early-stage cancer groups, the prevalence of advanced-stage cancer was higher among older patients, those without paid activity (adjusted prevalence ratio = 1.15; confidence interval 95%: 1.03-1.29), those who never had a Pap test (adjusted prevalence ratio = 1.23; confidence interval 95%: 1.08-1.40), those who were seen at the hospital clinic due to gynecological complaints (adjusted prevalence ratio = 1.48; confidence interval 95%: 1.19-1.85) and those who underwent biopsy in the private care system (adjusted prevalence ratio = 1.12; confidence interval 95%: 1.02-1.22). These differences seem to reflect problems in the health system, low socioeconomic level and poor awareness of the importance of Pap tests among those with a diagnosis of advanced-stage cervical cancer.
AB - To understand the impact of demographic, behavioral and contextual factors on cervical cancer, we examined the profile of women classified according to cervical cancer staging [precursor lesions cervical intraephitelial neoplasia (CIN2/CIN3), early- and advanced-stage cancer]. Patients were identified in the main oncological reference hospital in Pará State, Brazil, from 2013 through 2015. Adjusted prevalence ratios and their respective 95% confidence intervals were estimated using Poisson regression with robust variance. The study included 172 cases of CIN2/CIN3 lesions, 158 of early stage and 552 of advanced stage of cervical cancer. The proportion of gynecological complaints as a reason for clinic visit was 2.3 times higher among patients at an early stage compared with patients with CIN2/CIN3 lesions. Compared with early-stage cancer groups, the prevalence of advanced-stage cancer was higher among older patients, those without paid activity (adjusted prevalence ratio = 1.15; confidence interval 95%: 1.03-1.29), those who never had a Pap test (adjusted prevalence ratio = 1.23; confidence interval 95%: 1.08-1.40), those who were seen at the hospital clinic due to gynecological complaints (adjusted prevalence ratio = 1.48; confidence interval 95%: 1.19-1.85) and those who underwent biopsy in the private care system (adjusted prevalence ratio = 1.12; confidence interval 95%: 1.02-1.22). These differences seem to reflect problems in the health system, low socioeconomic level and poor awareness of the importance of Pap tests among those with a diagnosis of advanced-stage cervical cancer.
KW - Brazil
KW - risk factors
KW - staging
KW - uterine cervical neoplasms
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U2 - 10.1097/CEJ.0000000000000546
DO - 10.1097/CEJ.0000000000000546
M3 - Article
C2 - 31577564
AN - SCOPUS:85086524815
SN - 0959-8278
VL - 29
SP - 342
EP - 345
JO - European Journal of Cancer Prevention
JF - European Journal of Cancer Prevention
IS - 4
ER -