Keywords
HPV
rastreamento
LEEP
saúde pública
How to Cite
Abstract
Adenocarcinoma in situ (AIS) of the uterine cervix is a premalignant glandular lesion, often asymptomatic and closely linked to persistent HPV-18 infection. This retrospective epidemiological study analyzed 224 AIS cases reported in Pará (Brazil) from 2020 to 2025 using data from the Cancer Information System (SISCAN). A sharp increase was observed in 2023, attributed to diagnostic delays during the COVID-19 pandemic and suboptimal vaccine coverage. Spatial analysis revealed a concentration of cases in municipalities with better diagnostic infrastructure, highlighting inequities in access. The study supports LEEP as a low-morbidity, cost-effective alternative to cold knife conization (CKC) and recommends the adoption of the p16/Ki-67 immunohistochemical panel, expanded rescue vaccination efforts, and diagnostic decentralization via telepathology. The integration of these measures may significantly reduce AIS incidence in underserved areas like Pará. This study offers original data to guide regional public health strategies aligned with global cervical cancer elimination goals.
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