Validation of a New Low-Cost, Methanol-Based Fixative for Cervical Cytology and Human Papillomavirus Detection

Importancia de la adecuación de la muestra citológica en la pesquisa de cáncer de cuello uterino

Objetivo: revisión realizada para destacar la importancia de una muestra citológica óptima para la pesquisa de cáncer de cuello uterino y sus lesiones precursoras, con fines preventivos de diagnóstico y conocimiento de los lineamientos de manejo clínico vigentes, mediante una adecuada muestra. Material y metodología. se realizó una búsqueda electrónica en la base de datos PubMed utilizando los siguientes términos y combinaciones: cervical cytology, screening cervical cáncer, Bethesda system, adecuacy, false negatives, clinical follow-up. Las variables fueron la adecuación de la muestra citológica para pesquisa de cáncer de cuello uterino establecida por el sistema Bethesda y el seguimiento clínico vigente.  Resultados: la evaluación de la calidad de la muestra citológica se considera como principal aporte de garantía de calidad del sistema Bethesda para el informe de los hallazgos. Existen lineamientos de manejo clínico relacionados con la adecuada muestra y el seguimiento clínico establecidos hace más de una década y que aún son vigentes. Conclusiones:  una muestra citológica óptima permite detectar una mayor proporción de lesiones del cuello uterino significativas, contribuye a la efectividad clínica de la pesquisa de cáncer y establece el mejor cuidado para la paciente. Es necesario concientizar al personal involucrado sobre la importancia de obtener muestras adecuadas.

Prevalence of human papillomavirus (HPV) in Brazil: A systematic review and meta-analysis

OBJECTIVES

This study aimed to estimate the prevalence of genital, anal and oral HPV infection in Brazil through systematic review and meta-analysis.

METHODS

We searched EMBASE, LILACS, MEDLINE, Web of Science and SciELO from inception to December 2018. Original research articles that assessed the prevalence of genital (i.e., cervical, penile), anal and oral HPV infection in Brazil were selected in pairs by independent authors. No sex, age, HPV vaccination, language or date restrictions were applied. HPV prevalence was estimated and stratified according to risk factors population and by geographic area throughout the country. The study prevalence was pooled using a random effects model. Analysis was performed using R (version 3.5.2), packages meta version 4.9-4 and metaphor 2.0-0. This review is registered on PROSPERO under protocol number CRD42016032751.

RESULTS

We identified 3,351 references. After the screening process, 139 of them were eligible for this systematic review (57,513 total participants). Prevalence of cervical HPV was 25.41% (95% CI 22.71-28.32). Additionally, prevalence was 36.21% (95% CI 23.40, 51.33) in the penile region, 25.68% (95%CI 14.64, 41.04) in the anal region, and 11.89% (95%CI 6.26, 21.43) in the oral region. Subgroup analysis showed prevalence in each anatomic site was higher in high-risk populations.

CONCLUSION

The prevalence of HPV is high in the Brazilian population and varies by population risk and anatomic body site, with lower rates in the oral cavity compared to that in the cervical, penile and anal region. Studies on HPV have primarily been developed to evaluate infection and cancer in the cervical region. There is a profound lack of HPV data in many geographic regions of Brazil and for different anatomic sites.