[Women with atypical, precursor lesions and invasive cervical cancer: behaviors according to the recommendations of the Ministry of Health].
OBJECTIVE
To verify whether women with atypias of undetermined significance and precursor lesions or invasive cervical outcomes were referred to Medium Complexity Units (MCU) following the guidelines recommended by the Brazilian Ministry of Health.


METHODS
Retrospective study based on the cytopathological outcomes of users of the Unified Health System, seen at Basic Health Assistance Units (BHAU) and referred to MCUs in the municipality of Goiânia, state of Goiás, from 2005 to 2006. We assessed 832 records according to the recommendations of the Brazilian Ministry of Health, as established by the Brazilian Nomenclature for Cervical Cytopathologic Outcomes and Recommended Clinical Practice. To check the distribution of variables such as reasons for referral, results of colposcopy and histopathology and clinical procedures we calculated absolute and relative frequencies, mean, minimum and maximum values.


RESULTS
We understood 72.7% of the referrals were not in accordance with the recommendations of the Ministry of Health. There were 605 women with test results classified as atypical squamous cells of undetermined significance, possibly non-neoplasms, and squamous intraepithelial lesion of low level which were sent to MCU, and of these 71.8% were submitted to colposcopy, and 64.7% had histopathological examination which results were classified as 31.0% with non-neoplasms and 44.6% as NIC I. Out of 211 women with results classified as more severe squamous lesions, 86.3% were submitted to colposcopy and 68.7% of these had histopathological examinations.


CONCLUSIONS
The results of this study revealed high rates of inappropriate referrals to MCU, which required a high percentage of unnecessary procedures. The recommendations of the Ministry of Health were followed by BHAU and the majority of women received counseling/treatment as recommended.
Unidade de Monitoramento Externo da Qualidade dos Exames Citopatológicos Cervicais, Faculdade de Farmácia, Universidade Federal de Goiás - UFG - Goiânia (GO), Brasil.
Zair Benedita Pinheiro de
ZB
Albuquerque
Edna Joana Cláudio
EJ
Manrique
Suelene Brito do Nascimento
SB
Tavares
Adenícia Custódio
AC
Silva e Souza
Janaína Valadares
JV
Guimarães
Rita Goreti
RG
Amaral
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D002648:Child; D005260:Female; D006076:Government; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology / Q000628:therapy; D012017:Referral and Consultation / Q000592:standards*; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000628:therapy; D055815:Young Adult