López ALC, Mejía PDL, Amaya GJ

Language: Spanish
References: 20
Page: 510-517
PDF size: 332.55 Kb.

ABSTRACT

Objective: To perform the sociodemographic characterization of patients attending cervical pathology services and to study the concordance between screening and diagnostic tests that can contribute to the correct and timely identification of patients with increased risk of progression to cancer.
Material and Method: Descriptive, cross-sectional, retrospective study based on data from the Cervical Pathology Unit of the Subred Norte de Bogotá (January 2018 to December 2022). Study parameters: sociodemographic information of patients with cytology, colposcopy or biopsy report; descriptive statistical analysis of sociodemographic variables and assessment of concordance between screening and diagnostic tests.
Results: Data from 3754 patients with a mean age of 39.4 years were included, with a high prevalence of multiparity (82%). Cytology showed ASCUS as the most common alteration (43.9%). High-grade lesions and carcinoma were confirmed by histopathology in less than 25% of cases. The percentage of HPV-DNA history during the five years was less than 9% and biopsies showed weak concordance with cytology findings (kappa = 0.36) compared to colposcopy (kappa = 0.6).
Conclusions: The need for improved screening with HPV DNA for more accurate detection of cervical lesions is underscored. These findings highlight the importance of effective public policies and health programs that can reduce the incidence and improve the management of patients with cervical cancer.

REFERENCES

1. Bray BSC F, Laversanne M, Sung H, Ferlay J, et al. Globalcancer statistics 2022: GLOBOCAN estimates of incidenceand mortality worldwide for 36 cancers in 185 countries. CACancer J Clin 2024; 74 (3): 229-63. https://doi.org/10.3322/CAAC.21834

2. Cancer.Net. Cervical Cancer: Statistics. 2023. Accessed July2, 2024. Sitio web: https://www.cancer.net/cancer-types/cervical-cancer/statistics

3. Liga Colombiana Contra el Cáncer. Cáncer de cuello uterino.2022. https://www.ligacancercolombia.org/cancer-decuello-uterino/

4. Secretaria de Salud de Bogotá. Infografía / Día Mundial dela prevención del cáncer de cuello uterino. SaluData Observatoriode Bogotá. 2022. https://saludata.saludcapital.gov.co/osb/index.php/2022/03/26/infografia-dia-mundial-dela-prevencion-del-cancer-de-cuello-uterino/

5. National Cancer Institute. Cervical Cancer Causes, Risk Factors,and Prevention. 2023. Accessed July 2, 2024. https://www.cancer.gov/types/cervical/causes-risk-prevention

6. IARC. Chapter 2: Interpretation of the results of cervicalscreening. In: IARC Handbooks of Cancer Prevention2016;10: 13-22. https://screening.iarc.fr/doc/colpochapteres02.pdf

7. Allemani C, Weir HK, Carreira H, et al. Global surveillance ofcancer survival 1995–2009: analysis of individual data for25 676 887 patients from 279 population-based registriesin 67 countries (CONCORD-2). Lancet 2015; 385 (9972):977. https://doi.org/10.1016/S0140-6736(14)62038-9

8. Singh D, Vignat J, Lorenzoni V, et al. Global estimates of incidenceand mortality of cervical cancer in 2020: a baselineanalysis of the WHO Global Cervical Cancer EliminationInitiative. Lancet Glob Health. 2023;11(2):e197-e206.doi:10.1016/S2214-109X(22)00501-0

9. Ministerio de Salud. Por la salud de las mujeres, eliminemosel cáncer de cuello uterino. 2023. Accessed July 2, 2024.https://www.minsalud.gov.co/Paginas/Por-la-salud-delas-mujeres-eliminemos-el-cancer-de-cuello-uterino.aspx

10. Burger EA, De Kok IMCM, Groene E, et al. Estimating theNatural History of Cervical Carcinogenesis Using SimulationModels: A CISNET Comparative Analysis. JNCI 2020; 112(9): 955. https://doi.org/10.1093/JNCI/DJZ227

11. Rajaram S, Gupta B. Screening for cervical cancer: Choices& dilemmas. Indian J Med Res 2021; 154 (2): 210. https://doi.org/10.4103/IJMR.IJMR_857_20

12. Winstead E. Why Are Many Women Overdue for CervicalCancer Screening? ASCO Meetings, April 25, 2022.

13. Mayorga-Bautista CD, Hidalgo-Martínez SM, Romo-RodríguezM del R, et al. Concordancia de los hallazgos citológicos,colposcópicos e histológicos en lesiones premalignasdel cuello uterino. Ginecol Obstet Mex 2023; 91 (1): 32-38.http://doi.org/10.24245/GOM.V91I1.8249

14. Koliopoulos G, Nyaga VN, Santesso N, et al. Cytologyversus HPV testing for cervical cancer screening in thegeneral population. Cochrane Database of Systematic Reviews2017; 2017 (8). https://doi.org/10.1002/14651858.CD008587.PUB2

15. Ciendua G, Ortiz N, Alvarado C, et al. Hallazgos en colposcopia.Experiencia en una unidad de referencia. Ginecol ObstetMex 2019; 87 (5): 302-310. https://doi.org/10.24245/GOM.V87I5.2873

16. Katz LMC, Souza ASR, Fittipaldi SO, de Santos GM,Amorim MMR. Agreement between cytology, colposcopyand cervical histopathology. Rev Bras Ginecol Obstet2010; 32 (8): 368-373. https://doi.org/10.1590/S0100-72032010000800002

17. Abolafia Cañete B, Monserrat Jordán JÁ, Cuevas Cruces J,Arjona Berral JE. Diagnóstico precoz del cáncer de cérvix:correlación entre citología, colposcopia y biopsia. Progobstet ginecol 2017: 314-319. https://sego.es/documentos/progresos/v60-2017/n4/02_Diagnostico_precoz_cancer_cervix.pdf

18. Mora-Enríquez JA, Amaya-Guio J, Salamanca-Mora S,Monsalve-Páez S, et al. Evaluation of inter-observer concordanceof the Swede score for digital colposcopic images.Rev Colomb Obstet Ginecol 2019; 70 (2): 94-102. https://doi.org/10.18597/RCOG.3215

19. Paolino M, Arrossi S. Analysis of the reasons for abandoningthe follow-up and treatment process in women with precancerouscervical lesions in the province of Jujuy: implicationsfor health management. Salud Colect 2012; 8 (3): 247-61. https://doi.org/10.1590/S1851-82652012000400003

20. WHO. Cervical cancer screening in developing countries:report of a WHO Consultation. 2022.