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Cervical cancer screening in Portugal

Cervical cancer screening in Portugal. Daniel Pereira da Silva Portuguese Society of Ginecology. The three most important characteristics of a screening program. 1. Organization. 2. Organization. 3. Organization. Europe has strong emphasis on equity in health care.

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Cervical cancer screening in Portugal

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  1. Cervical cancerscreeningin Portugal Daniel Pereira da Silva Portuguese Society of Ginecology

  2. The three most important characteristics of a screening program 1. Organization 2.Organization 3.Organization • Europe has strong emphasis on equity in health care. • Europe has history of successful cancer prevention by organised programs. • UE repeatedly emphasises the importance of organisation in screening.

  3. CxCa Screening Guidelines Organized Screening since 2011 In Portugal there is Organized AND Opportunistic Screenning, depending on the location Organized Screening since 1989 Organized Screening since 2008 Bondaries of ARS (Regional Health Administration)

  4. Northern ARS Target population: 25 – 64 years old 1.166.848 women J M Moutinho – jose.moutinho@netcabo.pt

  5. ScreeningCxCaNorthernRegion LiquidBasedCytology every 5 years (25-64 years) Personalinvitation for screeningCxCa normal Central Lab of cytopathology abnormal unsatisfactory Comunication of theresults: woman, physicianandcoordinator LSIL/HSIL/ASC-H AGC / AIS / Ca ASC-US negative positive Repeat cytology after 1 year HPV Test Colposcopy J M Moutinho – jose.moutinho@netcabo.pt

  6. ScreeningCxCaNorthernRegion J M Moutinho – jose.moutinho@netcabo.pt

  7. ScreeningCxCa Alentejo Region Target population: 30 – 64 years old 109 776 women Conceição Margalha /Luís Gonçalves/ Tereza Lopes www.arsalentejo.min-saude.pt

  8. ScreeningCxCa Alentejo Region Total ofcitology : 65 995 Abnormalcitology : 669 (1,35%) 30 HSIL / AIS 17 Carcinomas (51% HPV16 +) HPV (+) - 587 (85.3%) HPV (-) – 88 (12.8%) Inadequatecitology 170 (0,26%) Prevalentgenotype: 16, 31, 66, 53, 51, 33, 58, 56, 52 and 18 Participation: 49.509 women- 45.1% (88.2%/32.9%) Conceição Margalha /Luís Gonçalves/ Tereza Lopes www.arsalentejo.min-saude.pt

  9. ScreeningCxCa Central Region Targetpopulation: 25-64 Yearsold 639 000 / 510 400 women D P Da Silva (dpdasilva@sapo.pt) and A Morais (amorais@arscentro.min-saude.pt)

  10. Cervical Cancer Screening Programme Central Region of Portugal – 1990-2010 Coordination board – Quality control Data base Geographic target Population target Metodology Strutural analisis Central region 109 Health care units 25-64 Years old 639 000 / 510 400 women 1 slide/women Screening interval 3-3 years call/recall Staf Equipment D P Da Silva (dpdasilva@sapo.pt) and A Morais (amorais@arscentro.min-saude.pt)

  11. Pap Smear • One slide / one women D P Da Silva (dpdasilva@sapo.pt) and A Morais (amorais@arscentro.min-saude.pt)

  12. Cervical CancerScreeningProgramme Central Regionof Portugal – since 1990 Coordination Board central data base - ARS Smears - health care Cytopatology laboratories Inadequate Abnormal Normal Health careColposcopy 3 years Normal Abnormal Treatment D P Da Silva (dpdasilva@sapo.pt) and A Morais (amorais@arscentro.min-saude.pt)

  13. Guidelineofabnornalcitology Repeat 1 year Citology ASC-US LSIL, ASC-H, ACG, HSIL, AIS, carcinoma Repeat 6 months normal abnormal Colposcopy D P Da Silva (dpdasilva@sapo.pt) and A Morais (amorais@arscentro.min-saude.pt)

  14. Cervical Cancer Screening Programme Central Region of Portugal – 1990-2009 D P Da Silva (dpdasilva@sapo.pt) and A Morais (amorais@arscentro.min-saude.pt)

  15. Age-standardised rates ofIncidencefrom Cervical Cancerinthe Regions North, Central and South of Portugal D P Da Silva (dpdasilva@sapo.pt) and A Morais (amorais@arscentro.min-saude.pt)

  16. Age-standardised rates of Mortality from Cervical Cancer in the Portugal and Central Region of Portugal D P Da Silva (dpdasilva@sapo.pt) and A Morais (amorais@arscentro.min-saude.pt)

  17. 2,1 8,1 (2006) R.Centro / Fonte : EPIDEMIOLOGICAL GUIDELINES FOR QUALITY ASSURANCE IN CERVICAL CANCER SCREENING (IARC) e ROR

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