QUALITY AND PERFORMANCE OF PAP SMEARS IN THE CERVICAL CANCER SCREENING PROGRAM IN A CITY OF SOUTHERN BRAZIL

OBJECTIVE. To estimate prevalence and analyze quality and performance of colpocytology carried out under the Cervical Cancer Screening Program in Maringa, Parana, Brazil. METHODS. A retrospective study of the SIS-Colo database of the Brazilian Ministry of Health. Variables such as age, colpocytology result and origin were analyzed. Ages were divided into brackets; origin was distributed in five Regional Health Divisions of the city of Maringa; colpocytology was categorized according to the Bethesda System. Colpocytology, coverage was calculated by dividing the number of exams in the population between 25 and 59 years of age by the number of women in that same age group. RESULTS. The 17,664 colpocytology exams collected in 2005 by the public health system were distributed among women between 12 and 82 years of age, with 12,961 (73.4%) examinations in women between the ages of 25 and 59, considered at high risk for cancer A total of 17,458 (98.84%) cytological examinations were negative for malignancy, and atypical results (ASCUS/AGUS, LSIL, HSIL and invasive cancer) totaled 206 (1.16%). The study found a prevalence of 0.85% (151) for ASCUS/AGUS, 1.14% (203/17.664) for atypical cells, and a 2.75 ASCUS/atypical cells ratio (151/55). CONCLUSION. The lower than expected prevalence of colpocytological and ASCUS alterations, the high ASCUS/atypical cells ratio and the insufficient population coverage by colpocytology jeopardized the performance of the cervical cancer prevention program. The low-income population requires special attention, and those more privileged should be advised about the frequency of examination and the age bracket with higher risks. [Rev Assoc Med Bras 2009; 55(5): 569-74]