Cervical cancer is one of the leading causes of death by neoplasia in the world. In Brazil, it is the 3rd cause of women's death by neoplasia. Since its implantation, 20 years ago, the federal program to prevent cervical cancer frequently had logistic and technical difficulties, especially in remote areas. Morbimortality studies are necessary to evaluate the evolution of the prevention program.
The present study evaluated cervical cancer hospitalizations in the state of Sergipe between 2008 and 2015. The data was extracted from a public database containing information about the unified public health system. The variables age, city of residence and type of hospitalization (clinical or surgical) were analyzed. Changes in hospitalization rates after the introduction of Papanicolaou test as a priority in primary care were considered through a temporal analysis using Joinpoint regression software. For this purpose, it was devised a linear logarithmic model that includes points and calculate the difference from a statistically significant value using a Monte-Carlo permutation test. The Average Annual Percent Change (AAPC), Annual Percent Change (APC) and temporal tendencies in hospitalization frequencies were calculated.
873 hospitalizations were analyzed, the median age was 46 years. Surgical hospitalizations correspond to 67%.The temporal analysis showed a yearly decrease in hospitalizations of about 10%, both for the population living in the capital and in other cities of the state. When the hospitalizations in the whole state were divided by age subgroups, there was a statistically significant reduction in the subgroups 40 to 59 years and 60 years or more.
A consistent reduction in cervical cancer hospitalizations was observed in the state of Sergipe in the analyzed time period. This suggests an improvement after 20 years of the cervical cancer prevention program. Better access to diagnostic methods and appropriate treatment allow for more effective interventions, with fewer hospitalizations. There is, however, a long way to go, especially with regard to expanding health care for the population across the state, also aiming at reducing mortality rates.
The authors.
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All authors have declared no conflicts of interest.