Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Profile of the effectiveness of detection of
atypia by the cervical cancer screening in the
municipalities of Rio de Janei...
Introduction
• Among all malignant tumors, cervical cancer is
the one that can be most effectively
controlled by screening...
Brazilian Screening Program
• Coverage of Pap smear test (87%) - public and private
healthcare systems (IBGE, 2008).
• Sev...
Objective
To establish the effectiveness profile
of the municipalities of the State of
Rio de Janeiro/ Brazil related to t...
Materials and Methods - Data
Production of 65 535 Pap smear
tests during year 2007 was obtained
from SISCOLO for 90 munici...
Materials and Methods - Variables
• Atypia: positive exam for
cancer precursor lesions.
• Reference laboratory: exams
carr...
Materials and Methods - Statistical Analysis
To characterize the profile of the
municipalities, the cluster analysis
techn...
Results – Identified Groups
The cluster analysis identified four groups
Group No. Municipalities Population %
G1 20 51
G2 ...
Results - Dispersion of groups for the variables
that best discriminate the groups
Results - Dispersion of groups for the variables
that best discriminate the groups
Results - Dispersion of groups for the variables
that best discriminate the groups
Results - Dispersion of groups for the variables
that best discriminate the groups
Results - Dispersion of groups for the variables
that best discriminate the groups
Results - Dispersion of groups for the variables
that best discriminate the groups
Results - Dispersion of groups for the variables
that best discriminate the groups
Results - Human Development Index for groups
Dispersion of groups Human Development Index
Results - Human Development Index for groups
Dispersion of groups Human Development Index
Discussion and Conclusion
• The profile of the detection of atypia revealed 3 different
levels of detections among the gro...
Thanks!
Sulafa YM Ahmed
e-mail: sulafa@peb.ufrj.br
Acknowledgement:Acknowledgement:
TWAS-CNPq Postgraduate Fellowship Prog...
Upcoming SlideShare
Loading in …5
×

HTAi 2015 - Profile of the effectiveness of detection of atypia by the cervical cancer screening in the municipalities of Rio de Janeiro

461 views

Published on

Apresentação realizada em Oslo - Noruega, 2015.

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

HTAi 2015 - Profile of the effectiveness of detection of atypia by the cervical cancer screening in the municipalities of Rio de Janeiro

  1. 1. Profile of the effectiveness of detection of atypia by the cervical cancer screening in the municipalities of Rio de Janeiro Sulafa Y.M. Ahmed*, R.T. Almeida and M.G.P. Silva
  2. 2. Introduction • Among all malignant tumors, cervical cancer is the one that can be most effectively controlled by screening. • Effective screening requires the monitoring of• Effective screening requires the monitoring of performance indicators for each of its phases. • By tradition, the analysis of these indicators is fragmented.
  3. 3. Brazilian Screening Program • Coverage of Pap smear test (87%) - public and private healthcare systems (IBGE, 2008). • Seventeen years of opportunistic Pap smears screening controlled by the actions of National Program Against Cervical Cancer. • The program's actions are monitored and managed by mean of the Cervical Cancer Information System (SISCOLO, in Portuguese). • SISCOLO provides information related to the cytopathology and histopathology exams performed by the Brazilian Public Healthcare System.
  4. 4. Objective To establish the effectiveness profile of the municipalities of the State of Rio de Janeiro/ Brazil related to the detection of atypia by means of adetection of atypia by means of a multivariate analysis.
  5. 5. Materials and Methods - Data Production of 65 535 Pap smear tests during year 2007 was obtained from SISCOLO for 90 municipalitiesfrom SISCOLO for 90 municipalities of Rio de Janeiro State, Brazil.
  6. 6. Materials and Methods - Variables • Atypia: positive exam for cancer precursor lesions. • Reference laboratory: exams carried out by the reference laboratory of the state. • Immature metaplasia: lesions without risk for progression to carcinoma (caused by an inflammatory process). Seven variables were used, which express the proportion of tests by the municipality for the following conditions: carried out by the reference laboratory of the state. • Adequability of slices: slices with material of the cervix area most susceptible to have cancer cells. • Age: exams of the women within the recommended age of program (25-59). inflammatory process). • Microflora absence: exams without detection of vaginal micro-organisms. • STD: Presence of micro- organism related to sexually transmitted diseases.
  7. 7. Materials and Methods - Statistical Analysis To characterize the profile of the municipalities, the cluster analysis technique was used by mean of hierarchical method (completehierarchical method (complete aggregation) and Euclidean distance applying the R Statistical Package.
  8. 8. Results – Identified Groups The cluster analysis identified four groups Group No. Municipalities Population % G1 20 51 G2 8 1 Total Population: 15 989 929 G2 8 1 G3 25 41 G4 37 7
  9. 9. Results - Dispersion of groups for the variables that best discriminate the groups
  10. 10. Results - Dispersion of groups for the variables that best discriminate the groups
  11. 11. Results - Dispersion of groups for the variables that best discriminate the groups
  12. 12. Results - Dispersion of groups for the variables that best discriminate the groups
  13. 13. Results - Dispersion of groups for the variables that best discriminate the groups
  14. 14. Results - Dispersion of groups for the variables that best discriminate the groups
  15. 15. Results - Dispersion of groups for the variables that best discriminate the groups
  16. 16. Results - Human Development Index for groups Dispersion of groups Human Development Index
  17. 17. Results - Human Development Index for groups Dispersion of groups Human Development Index
  18. 18. Discussion and Conclusion • The profile of the detection of atypia revealed 3 different levels of detections among the groups (G1, G 3-4, G2). • The reference laboratory seems to influence more the detection of atypia than the adequability of slices. • Socioeconomic factors seems either to influence the• Socioeconomic factors seems either to influence the detection of atypia (G2). • This profile shows that in order to increase the detection capacity, it seems more effective to improve the quality of the standard of Pap Smear tests and the adequability of slices than to increase the production of exams isolated.
  19. 19. Thanks! Sulafa YM Ahmed e-mail: sulafa@peb.ufrj.br Acknowledgement:Acknowledgement: TWAS-CNPq Postgraduate Fellowship Programme, HTAi Low and Middle Income Country Travel Grant, Coordination for the Improvement of Higher Education personnel

×