title: Incidence of cervical intraepithelial lesions in a population of adolescents treated in public health services in Rio de Janeiro, Brazil.
abstract: This study aimed to estimate the incidence and types of cervical cytopathological findings in adolescents who were treated in public health services between 1993 and 2006. This is a cohort study, with the following inclusion criteria: < 20 years of age, sexually-active, without cervical lesions upon entry into the study or sexually active < 1 year. The data were collected from 403 adolescents' medical records. Incidence density of cytopathological alterations was estimated and the actuarial method was used to calculate the 5-year incidence during follow-up after sexual initiation. In the first year of sexual activity, the incidence of cervical lesions was 24.1%. The incidence decreased to 3-8% over the following 4 years. The incidence density was 4.7 cases per 100 persons per year. The first abnormal cytological diagnosis showed atypical squamous cells of undetermined significance (ASCUS) in 5.5% (22) of patients, low-grade squamous intra-epithelial lesions (LSIL) in 28% (113), and high-grade squamous intraepithelial lesions (HSIL) in 3% (12). Eight (67%) cases of HSIL occurred during the first year of sexual activity. The incidence of cytopathological findings at beginning of sexual life is high, suggesting the importance of including sexually-active adolescents in cervical cancer prevention programs.
authors.affiliation: Centro Universitário Serra dos Orgãos, Teresópolis, Brasil. denimonteiro2@yahoo.com.br
authors.forename: Denise Leite Maia
authors.initials: DL
authors.lastname: Monteiro
authors.forename: Alexandre José Baptista
authors.initials: AJ
authors.lastname: Trajano
authors.forename: Kátia Silveira da
authors.initials: KS
authors.lastname: Silva
authors.forename: Fábio Bastos
authors.initials: FB
authors.lastname: Russomano
mesh_terms: D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D017150:Public Sector; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000453:epidemiology*; D014626:Vaginal Smears; D055815:Young Adult