Secondary cervical cancer prevention in routine prenatal care — coverage, results and lessons for the future

Abstract

Objectives: Cervical cancer is the fourth most common type of cancer among women worldwide and one of the most common malignancies diagnosed in gravidas. Therefore, routine antenatal Pap smear is such an important examination. The aim of the study was to assess the prevalence of Pap smear performance during prenatal care and to determine possible factors affecting it. Material and methods: A self-composed questionnaire was distributed among 638 women managed in a tertiary obstetric referral center. 33 questions regarded cervical cancer prevention and risk factors. Results: 96.9% of respondents had undergone Pap smear and 80.6% had it performed during pregnancy. For 11.5% women Pap smear in pregnancy was the first one in their life. The most common reasons for lack of Pap smear performance were: no subjective need to perform it (40.9%), no doctor's recommendation (28.6%) and lack of gynecological care (16.3%). Among professionally active women the percentage of those who had not undergone Pap smear during pregnancy was statistically higher (28.5%) than among those who were on sick leave (13.5%) (p = 0.0003). Also, younger women were at risk of less frequent participation in cervical cancer screening Conclusions: Although performance of Pap smear among surveyed patients was relatively high, there was a significant group of women who had undergone their first test during pregnancy, which makes secondary cervical cancer prevention in prenatal care a useful prophylactic strategy. Special attention should be given to younger and professionally active women.

Women’s country of birth and failure to catch up an overdue cervical cancer cytological screening participation during pregnancy in France, an observational study based on survey sources

“…In our study, the youngest pregnant women had had fewer Pap tests than those older than 30 years. In the Polish study by Kusczborska et al, age was the only factor associated with Pap tests both before and during the current pregnancy, but it enrolled women younger than 25 years, who are normally not subject to Polish screening guidelines [ 48 ]. In Brazil, Monteiro et al and Cesar et al found that young age (younger than 35 years old, respectively) was associated with lower Pap testing rates during pregnancy [ 49 , 50 ].…”

Overall survival (OS) in patients after chemotherapy for cervical cancer in Poland in years 2008–2015

“…Secondary prevention measures such as screening programs (the Pap tests) also lead to the drop in the cervical cancer death rate [10][11][12]. Whereas in Poland, since 2005, programs of early diagnosis of cervical cancer in the form of cytological tests are characterized by an unsatisfactory response from women to invitations -about 20%, which results in presently high percentage of cases and diagnoses of clinically advanced forms of cervical cancer [12].…”

Rastreamento do câncer de colo de útero no pré-natal

“…Além disso, é importante que esse conhecimento se estenda às mulheres gestantes, visto que o período gestacional não impede o surgimento de neoplasias cervicais. Para a maioria das mulheres, a gravidez é um período de supervisão à saúde, o que torna o momento oportuno para a prevenção secundária do câncer cervical (Kuczbourska et al, 2019;Gasparin et al, 2020).…”