CLINICAL PROTOCOLS FOR CERVICAL CANCER SCREENING

Abstract

Cervical cancer screening is an essential public health strategy for the early detection of precancerous and cancerous lesions, aiming to reduce the incidence and mortality of the disease. In Brazil, the main clinical protocol is defined by the Ministry of Health, which recommends the Pap smear as the primary method. The target population is women aged 25 to 64 who have already begun sexual activity. The initial examination consists of two consecutive annual tests, and if both are negative, the frequency becomes every three years. The Pap smear should be collected in health units by trained professionals, following appropriate techniques to ensure sample quality. Results and management vary: if negative, routine screening continues; if benign changes are found, the test is repeated in 6 months or 1 year; in the case of low-grade lesions (LSIL), the test is repeated in 6 months or colposcopy is performed; high-grade lesions (HSIL) require colposcopy and biopsy for confirmation and treatment; Invasive cancer is referred for oncological treatment. HPV-DNA tests have been incorporated into some protocols, especially for women over 30, to increase the sensitivity of screening. Adherence to screening is fundamental, and awareness campaigns and facilitating access to tests are important strategies to increase coverage and reduce the impact of cervical cancer on the population.