A realização periódica de exames citopatológicos com qualidade é atualmente a forma utilizada mundialmente no rastreamento do câncer do colo do útero (CCU), entretanto durante a pandemia do COVID-19 os exames foram suspensos temporariamente dando-se prioridade as urgências e emergências nas unidades de saúde. Objetivo: Avaliar a qualidade dos exames citopatológicos do colo do útero em um município de tríplice fronteira no Paraná, por meio dos indicadores preconizados pelo Ministério da Saúde, comparando-os entre os períodos antes e durante a pandemia de COVID-19. Método: Pesquisa quantitativa, com base no sistema de informação do câncer, dos resultados de 106.029 exames citopatológicos de colo do útero das mulheres residentes no município de Foz do Iguaçu- PR, de janeiro 2014 a outubro 2021, através da análise do monitoramento interno da qualidade. Resultados: A porcentagem de exames insatisfatórios foi a 1,6%, a JEC teve uma amplitude de 36,5% a 89,3% e o total de exames realizados no período da pandemia COVID-19 reduziu com variação de 26% a 40%. O total de exames com resultados alterados foram 3.377, tendo uma variação IP% chegando a mais de seis vezes e meia, 1,0% a 6,5%, e HSIL% variou seis vezes, de 0,2% a 1,2%. Conclusão: Durante a pandemia do COVID-19, nosso estudo evidenciou um maior número de exames alterados, e uma preponderância dos carcinomas e adenocarcinomas in situ e invasivos. Esses dados podem auxiliar os gestores locais em estratégias para um adequado acompanhamento e tratamento dessas mulheres com lesões precursoras e/ou câncer do colo útero.

The history of muscle biopsy dates back to 1860, when Duchenne first performed a biopsy on a patient with symptoms of myopathy (1) . Since then, the basic and clinical science of muscle and muscle disease has gone through three stages of development: the classical period, the modern stage and the molecular era.

Objectives: To investigate whether the interval between diagnosis and initiation of treatment above 60 days in women who underwent outpatient treatment between 2000 and 2015 by the SUS in Minas Gerais, Brazil, is associated with the patients' macroregions of residence. Methods: Non-concurrent longitudinal study of a cohort of 8872 women from Minas Gerais who underwent outpatient cancer treatment (chemotherapy or radiotherapy) under expenses of SUS in the same state, from 2000 to 2015. The response variable was the interval between diagnosis and initiation of treatment of women with cervical cancer (up to 60 days or more than 60 days) and the explanatory variable was the patients' macroregion of residence (13 macroregions of residence). The covariates were age, cancer stage at diagnosis, first treatment received, number of comorbidities, and distance between municipality of residence and treatment. Logistic regression was used to assess associations. Results: The average number of days to start treatment was 50.7 days, and most started within 60 days (61.9%). About 83% of women had their treatment in the same macroregion of residence; however, only 40% of women had their treatment in the municipality where they live. It was found after all adjustments that living in any of the 12 non-A health macroregions increases the chance to start treatment after 60 days from diagnosis. The highest magnitude of association were found in the F macroregion, with OR equal to 4.27 (95% CI; 3.32-5.50). Conclusions: There is a disparity in the timely treatment of women among health macroregions of the state of Minas Gerais. Investigations of the possible inequalities and barriers in the itinerary of women with cervical cancer that influence timely treatment are needed.