Risk factors of cervical neoplasia in a low income sector under control program in a developing country

Abstract

1545 Background: There are a high number of risk factors (RF) in cervical neoplasias, most of them related with human papilloma virus infection: women with history of multiple sex partners (MSP), with early onset of sexual intercourse (EOSI),and non-previous cervical Papanicolaou (Pap) smear (NPAP).Objective: To determine the presence of RF in the studied population, the frecuency and types of lesions found, and the correlation between non-previous pap smear and underlying pathology. Methods: The population included in the study were 14,021 patients from institutions of public (PU) (n = 7523) and private (PRI) (n = 6499) sectors in the province of Tucumán–the average age being 34 and 43 years old, respectively–studied between 2007 and 2008, in a routine screening for CC with Pap testing. Both sectors include mostly low income people with none or limited health insurance. All testings were performed under methodologic norms of a CC Detection Program. The RF analized were: NPAP, EOSI, and MSP. Cervical lesions were studied with Bethesda System 2001. The statistic applied was the exploratory analysis. Results: NPAP in PU n = 4562 (75.76%), PRI n = 3247 (81.66%). EOSI with mean age being in PU 17 years old (sD 3.55) and PRI 19 (sD 5.33).MSP above 4 partners PU n= 482 (6.55%) PRI n= 161 (2.75%).Frecuency of LSIL in PU n= 30 (0,40%) PRI n = 50 (0.80%).HSIL in PU n = 29 (0.39%) PRI n = 28 (0.45%).Ca INV in PU n = 6 (0.08%) PRI n = 3 (0.05%). ASCUS in PU n = 24 (0.32%) PRI n = 10 (0.16%). Asociation between NPAP and cervical pathology was found p = 0.024 < 0.05 given that 100/142 (70.42%) patients with lesion had NPAP and 42/142 (29.57%) paitents had previous Pap. Conclusions: The results in this sample indicate low Pap coverture is mantained in PU and PRI sectors and the need to approach the population under 20 years old in Tucuman, Argentina, to prevent CC. No significant financial relationships to disclose.