Resumo
Cervical cancer is the third leading cancer in Brazil and national screening program targets women from 25 to 64 years, with the Papanicolaou (Pap) test as the standard method. A few countries or medical associations recommend the start of the screening at age 21, a policy that remains controversial, for the higher risk of unnecessary treatment and morbidities related. Previous studies reported that 1% of the cases diagnosed before the age of 25. The aim of this study is to assess evolution of cases diagnosed among females younger than 25 years old in a regional hospital and their evolution. Cases selected were diagnosed from 2001 to 2015 and medical records were analysed until 2018 in a cohort study, gathering 32 cases (1,6% of 2041 cervical cancer registries, only 2 of them under 20 years old). Data gathered was registered and survival was measured by Kaplan-Meier estimates. There was an increasing trend of cervical cancers (p=0,04), with a higher rate of adenocarcinomas (19%) and stage I cancers (56%). Five-year overall survival rate was 76%, with worse rates among females under 22 years old (66% vs. 82%) and adenocarcinomas (43% vs. 86%). Survival rates between stage I cancer were 100%, in contrast with 46% observed in advanced stages. Therefore, although less frequent, cervical cancer in younger females tend to rise; these findings also suggest a higher rate of adenocarcinoma, with worse survival rates in this histological type and in advanced clinical stages.
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