INTRODUCTION: The early identification of precursor lesions followed by appropriate treatment prevents development of cervical cancer and its consequences OBJECTIVE: The present study evaluated the influence of the Covid-19 pandemic on cervical cancer screening by comparing the quantity of tests to detect cervical cellular changes performed in Sao Paulo state in 2019, prior to the detection of SARS-CoV-2 in Brazil, to the first (2020) and second (2021) years following its appearance. MATERIALS AND METHODS: Data from Fundação Oncocentro de São Paulo (FOSP), the agency that analyses approximately 220,000 Pap tests annually, was reviewed. RESULTS: A median of 1835 Papanicolaou (Pap) tests were performed in 55 municipalities in 2019. This was reduced to 815 tests in 2020, a 56% decrease (p = 0.0026). In 2021, the median number was 1745, a 53% increase over 2020 levels (p = 0.0233). The 26 municipalities with >1000 tests in 2020 had a median reduction from 4433 in 2019 to 2580 in 2020 (p = 0. 0046). The 29 municipalities with <1000 tests had a median reduction from 951 in 2019 to 554 in 2020 (p < 0.0001). There was a 44% reduction in the number of follow-up cytological evaluations from 2019 to 2020, followed by a 30% increase the following year. However, the percentage of women with a normal finding or with any abnormality remained unchanged. The findings from a histological evaluation of women in Sao Paulo city indicated that the percent of cases positive for CIN-1 (p<0.0410) and CIN-3 (p<0.0012) increased in 2020 and 2021 as compared to 2019 levels. CONCLUSION: A reduction in testing for cervical cancer in the first year of the Covid-19 pandemic, accompanied by an elevated incidence of precancerous lesions in each of the first two years following its initiation, may portend a subsequent increased occurrence of cervical cancer in Brazil.


中文翻译：

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COVID-19 大流行对巴西圣保罗州宫颈癌筛查的影响

简介：早期识别前体病变并采取适当的治疗可预防宫颈癌的发展及其后果 目的：本研究通过比较检测宫颈细胞变化的测试数量，评估了 Covid-19 大流行对宫颈癌筛查的影响2019 年在圣保罗州，在巴西检测到 SARS-CoV-2 之前，到其出现后的第一年（2020 年）和第二年（2021 年）。材料和方法：对圣保罗肿瘤中心 (FOSP) 的数据进行了审查，该机构每年分析约 220,000 次巴氏涂片检查。结果：2019 年，55 个城市平均进行了 1835 次巴氏 (Pap) 检测。到 2020 年，这一数字减少到 815 次，下降了 56% (p = 0.0026)。2021 年，中位数为 1745，比 2020 年水平增加 53% (p = 0.0233)。2020 年检测次数超过 1000 次的 26 个城市的中位数从 2019 年的 4433 次减少到 2020 年的 2580 次（p = 0. 0046）。测试数量<1000的29个城市的中位数从2019年的951个减少到2020年的554个（p < 0.0001）。2019年至2020年，后续细胞学评估数量减少了44%，次年增加了30%。然而，发现正常或有任何异常的女性比例保持不变。对圣保罗市妇女的组织学评估结果表明，与 2019 年水平相比，2020 年和 2021 年 CIN-1 (p<0.0410) 和 CIN-3 (p<0.0012) 阳性病例的百分比有所增加。结论：Covid-19 大流行第一年宫颈癌检测减少，伴随着大流行后头两年每年癌前病变发生率上升，可能预示着巴西宫颈癌发病率随后增加。