Assessment of cytology laboratory performance within the Brazilian Unified Health System

Abstract

Objective: To assess the profile of cytopathology laboratories which render services to the Brazilian Unified Health System (SUS), and to create quality indicators for cytopathological exams. Methods: A postal survey of 1,028 laboratories that render services to the SUS and participated in the Cervix Cancer Information System (SISCOLO) in the year 2002. Information concerning cytopathological exams from the SISCOLO, available on the Internet (www.datasus.gov.br) for the same year was analyzed. Results: Out of the 1,028 laboratories which reported results of cervix-vaginal cytopathology exams to DATASUS in 2002, 739 answered the survey (71.9%). From these, 18.9% processed 15,000 exams or more in that year; 70.2% were private; 50.2% were vinculated to municipal administrations; and 48.7% performed histopathological exams. In 74.8% of cases, a physician was in charge of the technical responsibility. Out of 10,505.773 exams included in the SISCOLO in 2002, 1.66% of samples were considered unsatisfactory. The following alterations were detected: atypical squamous cells of undetermined significance (ASCUS), 1.26%; human papillomavirus (HPV), 0.93%; cervical intraepithelial neoplasia I (CIN I), 0.84%, CIN II = 0.20%, CIN III = 0.17%; invasive squamous carcinoma, 0.05%, atypical glandular cells of undetermined significance (AGUS), 0.14%, in situ adenocarcinoma, 0.01; and invasive adenocarcinoma, 0.01%. Conclusion: This study made it possible to assess the profile of cytopathology laboratories, which rendered services to the SUS in 2002, and the SISCOLO proved to be an excellent tool to assess the quality of cytopathological exams performed in Brazil.