Avaliação da distribuição espacial da razão de citopatologia oncótica e mortalidade por câncer do colo do útero

Abstract

Cervical cancer, is serious public health problem for Brazil and the world. Knowing this, it is necessary to trace the cervical cancer by increasing the coverage of the Pap test in women. The general objective of the study is to evaluate the spatial distribution of the oncotic cytopathology ratio and Cancer Mortality of the Uterine Cervical Cancer in Brazil, in the historical series from 2008 to 2014. This is an epidemiological, retrospective, observational and ecological study, c'arried out in the 161 intermediate regions of urban articulation in Brazil. The study variables were the ratio of cytopathological examinations of the cervix, cervical cancer mortality rate, schooling, Gini index and HDI. As a data source, the Cervical Cancer Information System (SISCOLO), the Mortality Information System (SIM) and the United Nations Development Program (UNDP) were used. The Statistical Package for the Social Sciences (SPSS), version 22.0, serial number 10101141047 was used for the statistical analysis. The variable ratio of cervical cytopathological examinations and cervical cancer mortality rate were calculated in a descriptive way, through which mean, median and standard deviation were identified. The student's t test and the Chi-Square test were also performed between the intermediate regions of urban articulation. For the spatial analysis and construction of the maps, the TerraView program, version 4.2.2 was used. For the bivariate spatial analysis, the Geoda program, version 1.2 was used. It can be observed that the averages of the ratio of Brazil, in all the years involved, were above the cutoff point of the indicator studied, corresponding to 0.33, being the year of 2009 the highest average of the ratio. The mortality rate averages, starting in 2011, began to grow, reaching the highest average in 2014 (7.6). Regarding the cross-over of the oncotic cytopathology ratio and mortality rate, in most regions, they were classified with low ratio and high mortality. Regarding spatialisation, the lowest averages of Pap smears were found in the North and Northeast regions, where they formed clusters in Bom Map, with the classification of "Low-Low" in most municipalities. As for mortality, there is a worse average also in the North and Northeast regions, forming "Hight-Hight" clusters in some municipalities of the Northeast. In the bivariate analysis, it was observed that the cytopathological ratio is influenced by the schooling, Gini index and HDI. It is concluded that Pap smear coverage in Brazil is influenced by the socioeconomic inequalities of the country, being smaller in the North and Northeast, and in better conditions, in the South and Southeast.