Review of the Brazilian Guidelines for Cervical Cancer Screening, 2016

Abstract

It is about to be published the second edition of the Brazilian Guidelines for Cervical Cancer Screening, as part of another publication of the Brazilian National Cancer Institute (Instituto Nacional de Câncer [Inca]). For the development of the document participated the members of the Collaborative Network for Qualification of Diagnosis and Treatment of Precursor Lesions of Cervical Cancer, of which are part: the Health Care Bureau of the Brazilian Ministry of Health, the Inca – National Institute of Cancer, the Brazilian National Institute of Women, Child and Adolescent Health (Instituto Nacional da Saude da Mulher, da Crianca e do Adolescente Fernandes Figueira [Fiocruz]), the Institute of Gynecology of the Universidade Federal do Rio de Janeiro (UFRJ) and the Brazilian Society of Lower Genital Tract Pathology and Colposcopy (Associacao Brasileira de Patologia do Trato Genital Inferior e Colposcopia), the member of the Committee of Experts on Strengthening of Prevention and Qualification actions of Diagnosis and Treatment of Cervical and Breast Cancers (Comite de Especialistas para o Fortalecimento das Acoes de Prevencao e Qualificacao do Diagnostico e Tratamento dos Cânceres do Colo do Utero e de Mama) (both created under Decree no 1.472/GM/MS, from June 24, 2011), and invited experts. They totaled more than 60 professionals directly involved in the women care for prevention and early detection of cervical cancer, including the presidency of the Brazilian Society of Cytopathology (Sociedade Brasileira de Citopatologia) and some of associates. The process involved review, discussion and search for consensus of the theoretical foundation and the recommendations on the first edition, in virtual meetings between August 2, 2013 and June 6, 2014. All meetings may be reviewed by accessing the links on the Guideline itself. The resulting texts were re-discussed and ratified in attendance workshop, held on 4 and 6 August 2014, in Rio de Janeiro, and submitted to public consultation. During the process, the contributions received were incorporated into the final text. Those which suggested using technology non-existing in the Unified Health System (Sistema Unico de Saude [SUS]) were excluded, since they depend on feasibility assessment of incorporation by the Ministry of Health before joining the recommendations for SUS. In its second edition, the Guidelines contain some updates compared to the previous: • the introductory text of each chapter, which presents the rationale for the recommendations was reviewed and updated; • new recommendations were incorporated and some had a clearer written; • flowcharts have been simplified; • a chapter of Complementary Topics was incorporated, in which some situations that can be faced in more than one cytological diagnosis are addressed; • the recommendations for women up to 20 years have been extended to up to 24 years; • the new international colposcopy terminology was used. Soon, the second edition of the Brazilian Guidelines for Cervical Cancer Screening will be published, and at that time we will make full disclosure. While we await the publication, we present in the current number of this journal, a review article that discusses the different screening strategies for cervical cancer that are being used in several countries.