title: [Epidemiology and economic impact of cervical cancer in Roraima, a Northern state of Brazil: the public health system perspective].
abstract: OBJECTIVE
  to evaluate the incidence and direct economic impact of cervical cancer (CC) in Roraima, in 2009, and to analyze the epidemiological profile of patients with this disease.
  
  
  METHODS
  the histopathologic reports issued in Roraima in 2009 were reviewed, as were hospital records of female patients under treatment for cancer. Clinical data and medical procedures related to CC were recorded. CC carriers were treated under expenses of the public Brazilian health system (SUS) in Roraima underwent an interview dealing with socio-economic topics.
  
  
  RESULTS
  we registered 90 cases of CC and high grade pre-invasive lesions. Roraima has the highest incidence of CC of Brazil (46.21 cases/100,000 women), which is 3 times higher than that of breast cancer, comparable to low-income developing countries. The epidemiological profile shows patients with economic deprivation, social disadvantage, low education, early first intercourse (mean age is 13.8 years), and high parity (medium of 5.5 gestations). Among the patients included in this report, 71.7% had never been submited to a Pap smear, and ignorance about it was the main reported reason (47.4%). As a public health problem, the management of CC generates direct annual expenditures of more than R$ 600,000, with an average cost per patient of R$ 8,711.
  
  
  CONCLUSIONS
  CC is the most common cancer among women from Roraima, and represents a serious public health problem in Roraima. Its high economic impact favors the implementation of preventive strategies from the standpoint of cost-effectiveness. The profile of patients reveals the ineffectiveness of preventive services in reaching patients with a socio-economic exclusion profile at high risk for cervical cancer.
authors.affiliation: Hospital Geral de Roraima - HGR, Boa Vista, RR, Brasil. allex.jardim@bol.com.br
authors.forename: Allex Jardim
authors.initials: AJ
authors.lastname: da Fonseca
authors.forename: Leonardo Pires
authors.initials: LP
authors.lastname: Ferreira
authors.forename: Anderson César
authors.initials: AC
authors.lastname: Dalla-Benetta
authors.forename: Cibelli Navarro
authors.initials: CN
authors.lastname: Roldan
authors.forename: Mauro Luiz Schmitz
authors.initials: ML
authors.lastname: Ferreira
mesh_terms: D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011634:Public Health; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000191:economics* / Q000453:epidemiology*