Cervical câncer screening in São Paulo

preliminary results for 3.000 women

Abstract

Introduction: In the last decades, the role of HPV has been intensely studied duc to its close association with genesis of a series of carcinomas mainly in relation to the female genital tract. Objective: to describe the initial results of lhe LAMS Study in one center from Brazil. The main objective of the LAMS study is to verify the applicability of different tools to detect pre invasive cervical lesions and câncer. Methods: This study was conductcd in Sao Paulo. Three thousand (3,000) women were recruited between February 2002 and March 2003. After signing the informed consent forni and ans- wering a questionnaire, all women were submilted to a pclvic examination including lhe samples collection. The pelvic examination included visual inspection with acetic acid 5% (VIA). Pap Test (liquid based or conventional) and Hybrid Capture II (HC II-Digene do Brasil). Women with al leasl one positive test were invited for colposcopy and biopsy, if necessary. Results: The Pap test identified 92% with a normal result, 7% with abnormai results, including ASCUS (4.2%), LSIL (1.4%) and HSIL (0.57%). Two tests were positive for invasive lesion. 13% presented abnormai VIA and 4 women presented câncer suggestive tests. Of the 3,000 women, 1,040 were lesled for Hybrid Capture II. Overall, 17.5% was positive for both methods (self sampling or doctofs collection). The VIA was abnormai in 14% of the normal Pap and in 23% of the altered Pap. The colposcopy and biopsy sho-. wed a significative statistical difference regarding Pap test and HC II results (p < 0.01). Conclusion: This initial enrollment in Sao Paulo, joined with othcr centers, will provide necessary data for designing ncw strategies for control of cervical câncer in low-resource settings.