title: [Why does the prevalence of cytopathological results of cervical cancer screening can vary significantly between two regions of Brazil?].
abstract: OBJECTIVE
  To analyze the prevalence of cervical cytopathological results for the screening of cervical cancer with regard to women's age and time since the last examination in Maceió and Rio de Janeiro, Brazil, among those assisted by the Brazilian Unified Health System.
  
  
  METHODS
  Cervical cytopathological results available in the Information System of Cervical Cancer Screening for the year 2011 were analyzed, corresponding to 206,550 for Rio de Janeiro and 45,243 for Maceió.
  
  
  RESULTS
  In Rio de Janeiro, examination at one and two year intervals predominated, while in Maceió examination at one and three year intervals had a higher predominance. Women who underwent cervical smear screening in Maceió were older than those in Rio de Janeiro. The prevalence of invasive squamous cell carcinoma was similar for the two cities, but all the other results presented a higher prevalence in Rio de Janeiro: ASCUS (PR=5.32; 95%CI 4.66-6.07); ASCH (PR=4.27; 95%CI 3.15-5.78); atypical glandular cells (PR=10.02; 95%CI 5.66-17.76); low-grade squamous intraepithelial lesions (PR=6.10; 95%CI 5.27-7.07); high-grade squamous intraepithelial lesions (PR=8.90; 95%CI 6.50-12.18) and adenocarcinoma (PR=3.00; 95%CI 1.21-7.44). The rate of unsatisfactory cervical samples was two times higher in Maceió and that of rejected samples for analysis was five times higher in Maceió when compared to Rio de Janeiro.
  
  
  CONCLUSIONS
  The prevalence rates of altered cervical cytopathological results was significantly higher in Rio de Janeiro than in Maceió. There is no objective information that may justify this difference. One hypothesis is that there may be a difference in the diagnostic performance of the cervical cancer screening, which could be related to the quality of the Pap smear. Thus, these findings suggest that it would be necessary to perform this evaluation at national level, with emphasis on the performance of cervical cancer screening in order to improve the effectiveness of cervical cancer control.
authors.affiliation: Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Michelle Garcia
authors.initials: MG
authors.lastname: Discacciati
authors.affiliation: Instituto de Ciências da Saúde, Universidade Paulista, Campinas, SP, Brasil.
authors.forename: Bárbara Maria Santos
authors.initials: BM
authors.lastname: Barboza
authors.affiliation: Departamento de Obstetrícia e Ginecologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: Zeferino
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001938:Brazil; D002648:Child; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D002583:Uterine Cervical Neoplasms / Q000473:pathology*