Quality of cervical cancer screening in a Brazilian sample: cross-sectional study
DOI:
https://doi.org/10.15649/cuidarte.3597Keywords:
Uterine Cervical Neoplasms, Papillomaviridae, Papanicolaou Test, Mass ScreeningAbstract
Highlights
- Achieving the global goal of eliminating cervical cancer requires adopting a patient-centered care model, assessing clinical protocols, and establishing effective mechanisms to monitor and/or correct operational errors.
- The presence of squamous-columnar junction (SCJ) cells in Pap smears is crucial for accurate screening results, as their absence compromises the detection of cytological atypia and precancerous conditions.
- Programs providing theoretical and practical training on specimen collection techniques, result interpretation, protocol updates, and achievement of screening goals should be offered regularly.
- Women within the target screening age should receive adequate health education to participate in their healthcare actively, understand the associated risks, and advocate for their rights.
Introduction: In Pap test reports, sample quality is assessed based on the presence of squamous-columnar junction (SCJ) cells and atypia. Objectives: To assess the quality of Pap test samples by analyzing the frequency of SCJ cells in Pap test results and examining their association with sociodemographic, clinical, and professional-related variables. Materials and Methods: A cross-sectional study was conducted using 1.251 reports collected from primary healthcare facilities in São Paulo, SP, Brazil. The chi-square test was used to evaluate potential associations, and the test for equality of two proportions was used to compare responses to the same variable. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to determine the strength of associations. Results: Squamous epithelial cells were the most frequently observed, appearing alone in 50.80% of the samples, while the frequency of SCJ cells was 48.60%, significantly higher among women aged 25-39 years (p < 0.001). The presence of inflammation (OR = 7.7; 95% CI: 1.00–50.00), bacilli (OR = 1.8; 95% CI: 1.40–2.20), and cytological atypia (OR = 4.6; 95% CI: 2.00–10.00) was more likely in samples containing SCJ cells. The absence of atrophy, the presence of moderate cytolysis, and red blood cells were significantly associated with the presence of SCJ cells. Discussion: The study demonstrated that SCJ cells were absent in most samples, which may compromise the quality of cervical cancer screening. Conclusion: The main indicators of sample quality in Pap test reports fell below recommended standards, particularly among women aged 40-59 years, revealing deficiencies in the quality of cervical cancer screening.
How to cite this article: Tochetto, Liane de Oliveira Serra; Brevidelli, Maria Meimei; Santos, Tainara Rodrigues; Almeida, Michelle Samora de; De Domenico, Edvane Birelo Lopes. Quality of cervical cancer screening in a Brazilian sample: cross-sectional study. Revista Cuidarte. 2025;16(2):e3597. https://doi.org/10.15649/cuidarte.3597
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