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Among the types of cancer that affect women, breast cancer is the most common, accounting for nearly 25% of all cases. The increase in mortality from this cancer occurs mainly due to the lack of adherence to the screening tests, which generates late diagnosis and delay in appropriate therapy. This study aimed to identify factors involved in the adherence of women to breast cancer screening tests. It is an study with a cross-sectional design, carried out in five primary health care units/centers, in Goiânia, GO, Brazil. The sample consisted of 320 women, aged 40-69 years, who were not pregnant, who waited for care in these units. For data collection, a semi-structured interview script was used, followed by a pilot study. The Chi-square test or Fisher's exact test were used to verify the association between women's health behavior, use of service and knowledge about breast cancer, and adherence of women to breast cancer screening tests, with significance level of 5%. Have already heard of screening exams (p = 0.001), had an annual gynecological visit (p <0.001), received a professional recommendation (p <0.001, p <0.001 and p = 0.002) and had a gynecological visit to less than 3 years (P <0.001) was associated with the practice of all screening tests, considering the clinical breast examination (ECM), mammography (MMG) and ultrasound (USG). Women in the appropriate weight (p <0.029) and those who received a visit from a health professional and/or community health agent (p <0.009) performed more ECM. Women between 50 and 69 years of age and those with children had more MMG examination (p <0.001). Recognizing the recommended age (p = 0.01) and attending primary health care units for more than one year (p <0.024) favored the performance of USG. Women who had a health insurence performed more ECM (p <0.018) and MMG (p <0.065) and knew the exams (p = 0.020 and p = 0.021) and had a family history of cancer (p <0.007 and p <0.034) favored ECM and USG practice. Therefore, the causes that lead to non-compliance to recommendations on breast cancer screening exams are multifactorial, but the health professional deserves to be highlighted, since he is the main source of information for these women, being fundamental in the deconstruction of sociocultural, knowledge and organizational issues surrounding the screening of breast cancer.

OBJETIVO: Avaliar a utilidade da estesiometria corneal na triagem da retinopatia diabética. MÉTODOS: Foi realizado um estudo transversal (N=575) em um programa de triagem de retinopatia diabética da Cidade de São Paulo, SP. A sensibilidade corneal foi aferida utilizando-se o estesiômetro de Cochet-Bonnet. A avaliação da retinopatia diabética foi obtida por meio da fundoscopia indireta. A validade do uso da estesiometria corneal na identificação de pacientes com retinopatia diabética foi avaliada por meio de curvas de sensibilidade e especificidade (Receiver Operating Characteristics (ROC) curve). RESULTADOS: A análise da sensibilidade e da especificidade da estesiometria corneal na detecção dos diferentes graus de retinopatia, utilizando-se diferentes pontos de corte, mostrou resultados inferiores a 80%. O melhor resultado obtido ocorreu na identificação de pacientes com retinopatia diabética proliferativa, mostrando sensibilidade de 72,2% e especificidade de 57,4%. CONCLUSÕES: Na série analisada, a estesiometria corneal não se mostrou um bom indicador da presença da retinopatia diabética.

Screening tests of 62,814 blood donations carried out between October 85 and October 87 in all five blood banks of Goiânia, Central Brazil, were analysed. The private institutions (3 blood banks) collected 80% of all donations and the remaining were collected by public blood banks. Seroprevalence of HIV, HBsAg, Chagas' disease and syphilis were compared with data obtained in the surveillance system and from previous surveys in an attempt to validate this source of health information. A seroprevalence of 0.07% for AIDS (one ELISA test) was calculated, which may suggest the presence of 1900 infected individuals, in the population of the State of Goiás as a whole. This figure seems reasonably close to the official data obtained by compulsory notification. For Chagas' disease, hepatitis B and syphilis seroprevalence of 3.3%, 1.3% and 4.1% were obtained, respectively. The potential usefulness and the limitations of screening in blood banks as a source of realible morbidity indicator is discussed.

É analisada a eficácia da telerradiografía de tórax como técnica de "screening" em população hospitalar. Utilizando-se uma técnica prospectiva não concorrente, é evidenciado que pouco benefício traz ao paciente a chapa de tórax AP na internação, na primeira consulta ou no pré-operatório em geral. Para sete em cada 100 pacientes foi diagnosticado importante patologia assintomática. Nenhum paciente entre 0 e 19 anos teve anormalidade evidenciada pela chapa. Recomenda-se, para esta faixa, a eliminação do exame, e para pacientes acima de 20 anos a introdução da abreugrafia, ao invés da telerradiografia de tórax.

Objective: This study monitors trends in access to cancer screening, focusing on mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA), assessing the magnitude of inequality in the city of São Paulo from&nbsp;2003&nbsp;to&nbsp;2015 according to education level. Method: This is a cross-sectional population-based study conducted with data from the&nbsp;2003, 2008, and&nbsp;2015 editions of the Health Survey of the City of São Paulo (ISA-Capital). Outcome variables were the proportion of mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA) tests according to the protocols. Inequality was measured by education level according to years of study. For static analysis, Poisson regression was used to estimate proportion ratios. Results: The proportion of Pap smears remained stationary at a high level (&gt;89%) throughout the study period, while access to mammography and PSA tests significantly increased in the&nbsp;2003‒2015&nbsp;period. The present results indicate inequalities in access to cancer screening due to education, and being more expressive for mammography and PSA tests. However, this inequality significantly decreased over the period analyzed comparing the most educated individuals with those with the lowest educational level. In addition, an increase in the proportion of tests performed in the Brazilian Unified Health System was identified, especially for mammography and PSA tests, in the period&nbsp;2003‒2015. Conclusions: The inequalities observed in the access to preventive exams were influenced by the level of education. The offer of exams was expanded, more significantly for mammography and PSA, especially among the less educated group.

INTRODUCTION: Several studies have shown a proximal shift of colorectal cancer (CRC) during the last decades. However, few have analyzed the changing distribution of adenomas over time. AIM: The aim of this study was to compare the site and the characteristics of colorectal adenomas, in a single center, during two periods. METHODS: We conducted a retrospective, observational study in a single hospital of adenomas removed during a total colonoscopy in two one-year periods: 2003 (period 1) and 2012 (period 2). Patients with inflammatory bowel disease, familial adenomatous polyposis, hereditary non-polyposis colorectal cancer syndrome, or history of CRC were excluded from the study. The χ(2) statistical test was performed. P values less than 0.05 were considered statistically significant. RESULTS: During the two considered periods, a total of 864 adenomas from 2394 complete colonoscopies were analyzed: 333 adenomas from 998 colonoscopies during period 1 and 531 adenomas from 1396 colonoscopies during period 2. There was a significant increase in the proportion of adenomatous polyps in the proximal colon from period 1 to 2 (30.6% to 38.8% (p = 0.015)). Comparing the advanced features of adenomas between the two periods, it was noted that in period 2, the number of adenomas with size ≥1 cm (p = 0.001), high-grade dysplasia (p = 0.001), and villous features (p < 0.0001) had a significant increase compared to period 1. CONCLUSION: Incidence of adenomatous polyps in the proximal colon as well as adenomas with advanced features has increased in the last years. This finding may have important implications regarding methods of CRC screening.

Introduction: In 2011, the Portuguese Health Direction Department issued new diagnostic and management guidelines for Gestational Diabetes, which led to a substantial change in the screening of this condition. If, on the one hand, they allow an earlier diagnosis, on the other hand, the threshold of 92 mg/dL of fasting glycemia in the first visit to all pregnant women raises the issue of overdiagnosis, in addition to the lack of scientific evidence that supports it. In this study, we aimed to compare the maternal-fetal outcomes associated with pregnancies, which were considered as low-risk under the previous standards, but which, according to the current, would be classified as Gestational Diabetes.Material and Methods: This was a cohort study with retrospective data of patients from 8 health units in the 2008-2010, which met the following inclusion criteria: single fetal pregnancy, knowledge of the fasting glycemia determination in the 1st trimester, and the outcome of pregnancy. Pregnant women with a previous diagnosis of diabetes were excluded. The sample was divided into two groups: pregnant women who, in the first prenatal visit, had a fasting glycemia value between 92-139 mg/dL and pregnant women with a value below 92 mg/dL. Women diagnosed with gestational diabetes were excluded from these two groups.Results: A sample of 229 users (100%) was obtained. There were 17 (7.4%) cases of Gestational Diabetes. For compare, 212 women were counted, in which 205 (89.5%) had a fasting glycemia value lower than 92 mg/dL and 7 (3.1%) had an equal or higher value. The groups were similar in terms of sociodemographic characteristics, lifestyles, personal and family history. There were no statistically significant differences between the groups regarding complications of pregnancy (p=0.340), pregnancy outcome (p=0.156), delivery (p=0.431) or newborn (p=0.339). Discussion and Conclusion: Pregnant women with fasting glycemia ≥ 92 mg/dL had no worse obstetric and perinatal outcomes compared to those with a lower value. Thus, we question the interest in differentiating pregnant women by the value of glycemia in the first visit, using this cut-off point, and the benefit of the applicability of the current standards.Keywords: Gestational Diabetes; Complications; Mass screening; Standards.

Understanding the overuse and underuse of cervical cancer (CC) screening plays a role in preventing such behaviours, allowing to maximize the CC screening uptake. Aim: To assess the predictors of being over-screened and never/under-screened in CC screening in Northeast Portugal. Methods: This is a part of a larger cross-sectional survey carried out in two public health centres in Northeast Portugal (October 2017 to June 2018). Data collection was based on a face-to-face interview. This analysis included 764 women (aged 25–60 years) classified according to the use of CC screening into guideline-consistent screened, overscreened and unscreened/under-screened. Multivariate logistic regression models were conducted to assess predictors of being over-screened and never/under-screened. Adjusted odds ratio (OR) and respective 95% confidence interval (95% CI) were obtained. Results: One-fourth (n = 197) of participants were unscreened/under-screened and 50.0% (n = 382) of them were classified as over-screened. Regular visits with primary care physicians (OR = 0.44; 95% CI: 0.26–0.76) and higher age (OR = 0.98; 95% CI: 0.96–1.00) reduced the odds of being unscreened/under-screened. Women who received prescription/recommendation for CC screening from primary care physician (OR = 1.89; 95% CI: 1.09–3.29) or both primary care physician and nurse (OR = 2.62; 95% CI: 1.10–6.22) were more likely to be over-screened. Higher level of CC health literacy decreases the odds of being over-screened (OR = 0.95; 95% CI: 0.90–1.00) and unscreened/ under-screened (OR = 0.87; 95% CI: 0.82–0.92). The majority of over-screened (52.2%) and of underscreened (44.2%) women reported that their screening frequency was based on healthcare provider prescription. Among never-screened women, 60.2% reported that no one prescribed screening. Conclusion: The increase in CC health literacy can maximize CC screening uptake. Primary healthcare providers could play a role in preventing the overuse and underuse of CC screening.