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Critical Evaluation of Pap Test Adherence to Routine Screening in Amazonas State, Brazil.

Rosana Lima de Oliveira1, Emanuelle Cristina de Andrade Valente1, João Guilherme de Souza Gadelha1

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Summary

Pap test screening for cervical cancer in Amazonas showed decreased utilization, particularly in smaller municipalities, during the COVID-19 pandemic. This uneven screening may hinder early detection of cervical lesions.

Keywords:
Cervical cancer screeningCervical cytologyCytology in low-resource settingsPrimary screeningPublic health

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Area of Science:

  • Public Health
  • Oncology
  • Epidemiology

Background:

  • Cervical cancer screening is crucial for early detection and prevention.
  • Pap tests are a primary method for cytological screening of cervical cancer.
  • Adherence to screening guidelines varies geographically and over time.

Purpose of the Study:

  • To evaluate adherence to Pap test screening practices in Amazonas over a decade.
  • To identify trends and variations in Pap test utilization across municipalities.
  • To assess the impact of the COVID-19 pandemic on screening rates.

Main Methods:

  • Retrospective analysis of cytological screening data from 2013-2023.
  • Utilized Brazilian public health databases: SISCOLO and SISCAN (DATASUS).
  • Examined Pap test volumes and variations by municipality size and time period.

Main Results:

  • A decline in Pap tests occurred from 2019-2021 due to the COVID-19 pandemic, followed by an increase.
  • Municipalities with <10,000 annual Pap tests showed reduced screening rates pre-pandemic and a greater decrease during the pandemic.
  • Significant variation in Pap test utilization exists across Amazonas municipalities.

Conclusions:

  • Considerable disparities in Pap test utilization were observed throughout Amazonas.
  • The lack of uniform screening coverage likely impairs early detection of cervical intraepithelial lesions.
  • Geographic and temporal variations in screening necessitate targeted public health interventions.