O câncer de colo do útero é a terceira neoplasia mais incidente entre as brasileiras, com taxa de mortalidade acima de 5/100 mil mulheres, apesar de possuir bom prognóstico quando diagnosticado em fases precoces. No Brasil, políticas públicas voltadas para o câncer de colo do útero vêm sendo desenvolvidas desde a década de 1970 e incluíram diversos programas de rastreamento, que conseguiram aumentar o acesso ao teste de Papanicolau, com patamar de cobertura estável nos últimos anos, em torno dos 83%. Em 2014, a vacina anti-HPV foi incluída no Calendário Nacional de Vacinação. O mais recente Plano de Ações Estratégicas possui metas de aumento da cobertura de exame citopatológico e tratamento de todas as mulheres com lesões precursoras. Outras duas iniciativas foram criadas: o Programa de Qualificação de Ginecologistas para Assistência Secundária às Mulheres com Alterações Citológicas Relacionadas às Lesões Intraepiteliais e ao Câncer de Colo do Útero e a formalização da Rede Colaborativa para a Prevenção do Câncer de Colo do útero. Mesmo com o constante avanço dessas medidas, mais de 70% das brasileiras são diagnosticadas em fases avançadas da doença, o que impacta negativamente no prognóstico. A análise dos protocolos de tratamento voltados para a saúde coletiva mostra defasagem em relação ao cenário internacional e nacional preconizado por sociedades médicas, especialmente no tratamento de fases tardias da doença. Apesar dos avanços na difusão de medidas preventivas e alcance de ampla cobertura do rastreamento, o câncer de colo do útero continua a ser um problema de saúde importante no país.

Cardiovascular (CV) diseases are the major cause of women mortality: around 8.5 million deaths every year 1 , which increases the demand for prevention strategies that take into account the particularities of its evolution. 2,3 CV risk assessment in women involves not only traditional risk factors, but specific ones (gestational complications and hormonal alterations), as well as those that have a higher impact on women's health, such as autoimmune and psychiatric diseases. 3 Regarding traditional risk factors, it must also be considered that they have different impacts on women. 4,5 We know that women's CV risk increases in the postmenopausal period when she loses her hormonal protection. However, CV health of younger women is

Background Obesity is increasing in younger populations, and is associated with a high cardiovascular (CV) risk, however, it is not clear whether metabolically healthy obesity (MHO) may have a lower CV risk or if it is just an earlier stage of the disease. Objective To evaluate the prevalence and CV risk factors associated with MHO in a young population assisted by a Family Health Care unit in a large urban center in Brazil. Methods A cross-sectional population study for CV risk assessment in adults aged 20-50 years old from a FHC unit in Rio de Janeiro. Demographic, anthropometric data and CV risk factors were recorded. All underwent office blood pressure (OBP) measurements, laboratory evaluation (lipid and glycidic profile). Obesity was defined as a BMI ≥ 30 kg/m2 and MHO are those who have less than 3 of the following criteria: hypertension, diabetes, total cholesterol ≥ 200 mg/dL, HDL<40 mg/dL (men) and 50 mg/dL (women), triglycerides>150 mg/dL and increased waist circumference. Results A total of 632 individuals were evaluated (60% female; mean age 37 ± 9 years). The prevalence of obesity was 26%, of which 73% were classified as MHO. Obeses are older, with a higher prevalence of physical inactivity (51% vs 41%, p = 0.03), hypertension (44% vs 19%, p < 0.001), dyslipidemia (50% vs 36%, p = 0.002) and diabetes (7% vs 2%, p = 0.001) with higher systolic OBP. MHO compared to unhealthy ones are significantly younger and smoke less. Despite being obese, they have lower BMI (33.6 vs 35.2 kg/m2, p = 0.02) and abdominal circumference (102 vs 110 cm, p = 0.03), with lower diastolic BP. Conclusions MHO was more prevalent in this young population and seems to have a lower CV risk, however it is not clear whether these younger and less obese individuals are only at an earlier stage of the disease. Perhaps the CV diseases onset is postponed for a few years. Even so, these individuals should not be excluded from public health policies as a form of primary prevention. Key messages In this young population, MHO was more prevalent and presented a lower CV risk. The follow-up of MHO will show if they are really healthy or if they are at an early stage of the disease.

Objective:To evaluate the prevalence and cardiovascular (CV) risk factors associated with metabolically healthy obesity (MHO) in a young population assisted by a Family Health Care unit in a large urban center.Design and method:A cross-sectional population study for CV risk assessment in adults aged 20–50 years old from a Family Health Care unit. Demographic, anthropometric data and CV risk factors were recorded. All underwent office blood pressure (BP) measurements, laboratory evaluation (lipid and glycidic profile). Obesity was defined as a body mass index (BMI) > 30 kg/m2 and MHO are those who have less than 3 of the following criteria for metabolic syndrome: office BP higher or equal to 130 x 85 mmHg, hypertension, fasting blood sugar higher or equal to 100 mg/dL, HDL < 40 mg/dL (men) and 50 mg/dL (women), triglycerides > 150 mg/dL and waist circumference > 102 cm (men) and > 88 cm (women).Results:A total of 632 individuals were evaluated (60% female; mean age 37 ± 9 years). The prevalence of obesity was 26%, of which 73% were classified as MHO.Obeses are older, with a higher prevalence of physical inactivity (51% vs 41%, p = 0.03), hypertension (44% vs 19%, p < 0.001), dyslipidemia (50% vs 36%, p = 0.002), and diabetes (7% vs 2%, p = 0.001) with higher systolic OBP.MHO compared to unhealthy ones are significantly younger and smoke less. Despite being obese, they have lower BMI (33.6 vs 35.2 kg/m2, p = 0.02) and abdominal circumference (102 vs 110 cm, p = 0.03), with lower diastolic BP.Conclusions:MHO was more prevalent in this young population and seems to have a lower CV risk, however it is not clear whether these younger and less obese individuals are only at an earlier stage of the disease. Perhaps the CV diseases onset is postponed for a few years. Even so, these individuals should not be excluded from public health policies as a form of primary prevention