Pap smears should be done every three years; test detects cervical cancer

At least 81.3% of Brazilian women aged between 25 and 64 said they had had a Pap smear in the last three years, according to the Epidemiological Bulletin released by the Ministry of Health at the end of March this year.

The exam is the main screening strategy for the prevention and early detection of cervical cancer – a preventable type of the disease, which is the third most common among women, excluding non-melanoma skin cancer. The government’s goal is that at least 85% of them do the screening.

Data were collected between August 2019 and March 2020 during the National Health Survey, carried out by the IBGE (Brazilian Institute of Geography and Statistics) in partnership with the Ministry of Health. This is a population-based household survey that had a sample of 90,846 interviews.

In Brazil, the recommendation of the Ministry of Health is that the exam should be performed by women between 25 and 64 years of age who have already had sexual intercourse. It should be done annually and, after two negative results, every three years. The INCA (National Cancer Institute) estimates that there are 16,000 new cases of the disease per year, which led to more than 6,500 deaths in 2019.

What is Papanicolaou?

According to Ana Paula Beck, a gynecologist at Hospital Israelita Albert Einstein, the pap smear is an exam made from the collection of cells from the cervix and vagina of a woman.

“The analysis of the material evaluates the cells present mainly for the early detection of cervical cancer. But it can also detect other infections such as [vaginose causada pela bactéria] Gardnerella vaginalis or even HPV [papilomavírus humano]if requested in the same sample”, he says.

According to Beck, most cases of cervical cancer are associated with infection with the HPV virus – especially by four subtypes that are at higher risk (16, 18, 45 and 48).

Because it is a slow-growing cancer — it is estimated that it can take up to 10 years for the tumor to appear —, it is essential to perform the exam regularly, for prevention and early detection, which will result in the application of less aggressive treatments and with greater chance of cure.

“If there was an infection with a subtype of HPV with a higher risk for cancer, it will cause lesions and gradually change the results of the Pap smear. That’s why it’s so important to have the exam regularly, and that the collection is done properly”, says the gynecologist.

Cases of infection of other HPV subtypes are considered low risk and, usually, can manifest in the form of genital warts, which must also be treated, but do not progress to a malignant form.

ideal frequency

According to data from the latest bulletin from the Ministry of Health, the results indicate that brown women with a lower level of education and income do less Pap smears. In addition, important differences were observed between regions – only five states were able to reach the screening target in 85% of women, which is a warning sign for the doctor.

“An 80% rate of women undergoing Pap smears is not bad. However, the ideal is to identify whether we are reaching the population that really needs the exam. It is one thing to individualize this research with data from the office and another thing is public health. higher risk patients have not been tested for more than 10 years, while others at low risk do so annually”, he highlights.