Cervical Cytopathological Exams in Women Under 25 in Rio Grande do Sul from 2019 to 2023

Purpose: In Brazil, cervical cytopathological screening is recommended for women aged 25 to 64, where the prevalence of precursor lesions and cervical cancer is highest. However, exams are frequently conducted in women under 25, often due to early sexual debut, multiple sexual partners, or clinical signs indicative of HPV infection. This study aimed to analyze the patterns, abnormalities, and demographic characteristics associated with cytopathological exams in women under 25 in the Brazilian state of Rio Grande do Sul between 2019 and 2023. Methods: Data were retrieved from the Brazilian Cancer Information System (SISCAN) for cytopathological exams conducted in Rio Grande do Sul. Analyses included the number of exams based on their indication, adequacy, cytological abnormalities, and patient demographics, such as age range and race/ethnicity. Results: Between 2019 and 2023, 259,924 cytopathological exams were performed in women under 25 in Rio Grande do Sul. Among these, 99.5% were adequate for analysis, 56% showed cytological abnormalities, and 98.3% were conducted for screening purposes. The majority of exams involved women aged 20 to 24 years (69.6%), followed by those aged 15 to 19 years (29.6%). Regarding race/ethnicity, 82% of patients were White, 6% Black, 5.9% Asian, and 2.9% Mixed-race. Conclusion: The data underscore a high frequency of cervical cytopathological exams performed outside the recommended age range, emphasizing the need for stricter adherence to national screening guidelines. The predominance of White women reflects both the demographic composition of the region and disparities in healthcare access. Although early sexual debut may justify screening in younger populations, it increases the risk of overdiagnosis, as many cytological abnormalities are unlikely to progress to invasive cancer. This overdiagnosis may lead to unnecessary clinical interventions, resulting in physical and psychological harm. Targeted educational initiatives are essential to promote guideline adherence, address disparities in healthcare access, and optimize resource allocation, ultimately enhancing cervical cancer prevention strategies. Citation Format: Gabriela Macelaro, João Paulo Fortti. Cervical Cytopathological Exams in Women Under 25 in Rio Grande do Sul, a State of Brazil: An Analysis of Data from 2019 to 2023 [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 41.