Infecção por papilomavirus humano e fatores associados a não adesão ao exame de papanicolau em mulheres atendidas no programa médico de família, Niterói-RJ

• Autor(a) principal: Augusto, Everton Faccini
• Data de Publicação: 2012
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal Fluminense (RIUFF)
• Texto Completo: https://app.uff.br/riuff/handle/1/19725
• topic: HPV; Exame de Papanicolaou; Prevalência; Fatores de risco; MEDICINA; CIÊNCIAS MÉDICAS; Papillomavirus humano; Neoplasia uterina; HPV; Papanicolaou exam; Prevalence; Risk factors; CNPQ::CIENCIAS DA SAUDE

Cervical cancer is an important public health problem worldwide. The mean risk factor associated with this disease is the human papillomavirus (HPV) infection. The primary strategy adopted in screening programs to cervical cancer control refers to the Papanicolaou exam. The aim of this study was to determine the HPV prevalence and HPV genital types distribution in a female population attended the Family Medical Program. The factors which contributed with the non compliance of Papanicolaou test following the protocol of Health Ministry were also investigated. Through a cross-sectional study, 351 cervical smears from women attended this Program were analyzed. The HPV detection and genotyping were performed using polymerase chain reaction (PCR) and restriction fragments length polymorphism technique (RFLP). Demographic and behavior data were record from each participant throughout a structured questionnaire. SPSS program version 17 was used to achieve univariate analysis (chi-square test) and logistic regression. Among women who were included in this study, 282 (80.3%) were into the standard period established by health Ministry, and realized the Papanicolaou test in an interval of no more than three years between two screening exams. The cytological results found were: normal (96.3%), ASCUS (1.5%), LSIL (0.9%) e HSIL (0.3%). Significant variables associated with failure in the protocol program were: illiteracy and previous absence of sexual transmitted disease (STD). Women with failure in screening had approximately 13 times more chance (OR =12.83; IC =1.31 125.34; p=0.016) to present cytological changes (ASCUS, LSIL e HSIL). Among the barriers asserted to having screening exams into protocol periods, the more frequent were: embarrassment, lack of time due to job or children care, disinformation, absence of gynecological symptoms, and fear of the exam. HPV prevalence was 8.8% and 21 different HPV types were detected (10 high risk and 11 low risk). Women with non stable sexual partner were more likely to acquire the HPV infection (OR=2.67; IC=1.16-6.14; p=0.020). High risk HPV types were statistically associated with cytological alterations (OR=9.97; IC=2.07-47.85; p=0.004), corroborating their oncogenic potential. In this population, among which the screening coverage was acceptable, the Papanicolaou test was an efficient tool in controlling cervical cancer. The variability of HPV types among this women suggests that the HPV prophilatic vaccines currently available might be only a complementary tool in cancer prevention and control.