High prevalence of cervical cancer in the Marajó archipelago: an active search study

Abstract

The aim of this study was to estimate the prevalence and risk factors associated with cervical cancer in priority municipalities of the Marajó archipelago. We conducted a study from March 2013 to February 2015 in four municipalities of Marajó. Women were recruited through oral communication. After signing the informed consent form and answering a structured questionnaire the women underwent the Papanicolaou test. The descriptive analyses were performed using frequency distribution and by medians with the standard deviation. The association of risk factors with cervical cancer was evaluated through non-parametric tests. A total of 405 women was included, with a mean age of 40.5 years. The majority had low literacy level and 42% living with a monthly family income below U$ 200. Suggestive results of invasive cervical cancer (ICC) were demonstrated in seven samples, with an overall prevalence of 1.7% and a total of 75 cases of cellular atypia was observed (18.5%). The results of ICC were more expressive between women without full primary education (p=0.0481) and between housewives (p=0,0219). We demonstrated a high prevalence of CC in isolated municipalities of the Marajó archipelago, Brazilian Amazon. Furthermore, the observed prevalence was vastly higher than that found in northern Brazil, which has the most worrisome picture in the country. CC cases were more frequent among women with low literacy level and among those who declared themselves homemakers. Our results emphasize the necessity for improvement of the screening program in the region.