Abstract
Introduction: Adolescence is a period in the life of a woman characterized by significant physical and psychological changes. In various places in the world it is also the period in which sexual activity usually begins. Sexual activity has been occurring increasingly earlier in adolescents.Objective: To evaluate the prevalence of Pap smear abnormalities in adolescents and young women (MJA) compared to adult women (MA). Methods: Cross-sectional study of cervical uterine cytology obtained from women in Santo Andre (SP, Brazil) between January 2009 and December 2011, comparing the cytological results between MJA (age: 14-24 years) and MA (age: 25 years or over). Results: 92,118 exams evaluated; 76,752 in the MA group and 15,366 in the MJA group. Of the total, 89,723 were normal and 2,395 abnormal (1,278 [53.4%] corresponded to atypical squamous cells of undetermined significance [ASCUS], 900 [37.6%] to low-grade squamous intraepithelial lesion [LSIL] and 217 [9.1%] to high-grade squamous intraepithelial lesion [HSIL]). There were 510 (3.3%) abnormal tests in the MJA group and 1,885 (2.5%) in the MA group, of which 217 (42.5%) and 1061 (56.3%), respectively, were classified as ASCUS, 280 (54.9%) and 620 (32.9%), respectively, as LSIL, and 13 (2.5%) and 204 (10.8%), respectively, as HSIL. Conclusion: The most frequent abnormality in the MJA group was LSIL and in the MA group was ASCUS. HSIL was 4 times more frequent in adult women in comparison to young women and adolescents.
Highlights
Adolescence is a period in the life of a woman characterized by significant physical and psychological changes
A survey carried out in 2006 by the Centro Brasileiro de Análise e Planejamento do Ministério da Saúde found that the average age for initiating sexual activity in adolescents was 15.2 years (32.6%), adolescents with a higher level of education (9-11 years of education) started sexual activity at a later age [1]
All of the cytopathology tests of women screened in the municipality of Santo André were included in the study, but test results relating to the following were excluded: insuficient material for analysis, acellular or hypocellular material, and slide analysis impaired by the presence of blood, artifacts caused by drying and external contaminants
Summary
Adolescence is a period in the life of a woman characterized by significant physical and psychological changes. A survey carried out in 2006 by the Centro Brasileiro de Análise e Planejamento do Ministério da Saúde found that the average age for initiating sexual activity in adolescents was 15.2 years (32.6%), adolescents with a higher level of education (9-11 years of education) started sexual activity at a later age (on average 18.2 years old) [1]. Data from the Pesquisa Nacional de Saúde do Escolar (PeNSE), 2009, covering the main cities in Brazil, have shown that approximately 30.5% of ninth-grade students have already initiated sexual activity, a larger proportion being boys (43.7%) in comparison to girls (18.7%). In 2012, the percentages were 40.1% for boys and 18.3% for girls [2]
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