Research paper: Gynecological cancerFactors associated with cervical intraepithelial neoplasia (CIN2/CIN3), early stage and advanced stage of cervical cancer diagnosis in the Brazilian Amazonian regionPontes, Valéria B.a; Martins, Luís Felipe L.b; Szklo, Moysésc; Moreira, Miguel Ângelo M.d; Chaves, Cláudia Bessa P.e; de Almeida, Liz MariabAuthor Information aDepartment of Woman Health, Faculty of Medicine, Federal University of Pará (UFPA), Belém, Pará bDivision of Population Research, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil cEpidemiology Department, Johns Hopkins Bloomberg School of Public Health (JHU), Baltimore, Maryland, USA dGenetic Program, Research Coordination, Brazilian National Cancer Institute (INCA) eGynecology Oncology, Clinical Research Division, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil Received 24 May 2019 Accepted 7 August 2019 Correspondence to Liz Maria de Almeida, MD, MPH, PhD, Division of Population Research, Brazilian National Cancer Institute (INCA). Rua Marquês de Pombal 127, 7° andar, Centro, Rio de Janeiro - RJ, Brazill, Tel: +55 (21) 3207 5514; fax: +55 21 3207 5870; e-mail: firstname.lastname@example.org European Journal of Cancer Prevention: July 2020 - Volume 29 - Issue 4 - p 342-345 doi: 10.1097/CEJ.0000000000000546 Buy Metrics Abstract To understand the impact of demographic, behavioral and contextual factors on cervical cancer, we examined the profile of women classified according to cervical cancer staging [precursor lesions cervical intraephitelial neoplasia (CIN2/CIN3), early- and advanced-stage cancer]. Patients were identified in the main oncological reference hospital in Pará State, Brazil, from 2013 through 2015. Adjusted prevalence ratios and their respective 95% confidence intervals were estimated using Poisson regression with robust variance. The study included 172 cases of CIN2/CIN3 lesions, 158 of early stage and 552 of advanced stage of cervical cancer. The proportion of gynecological complaints as a reason for clinic visit was 2.3 times higher among patients at an early stage compared with patients with CIN2/CIN3 lesions. Compared with early-stage cancer groups, the prevalence of advanced-stage cancer was higher among older patients, those without paid activity (adjusted prevalence ratio = 1.15; confidence interval 95%: 1.03–1.29), those who never had a Pap test (adjusted prevalence ratio = 1.23; confidence interval 95%: 1.08–1.40), those who were seen at the hospital clinic due to gynecological complaints (adjusted prevalence ratio = 1.48; confidence interval 95%: 1.19–1.85) and those who underwent biopsy in the private care system (adjusted prevalence ratio = 1.12; confidence interval 95%: 1.02–1.22). These differences seem to reflect problems in the health system, low socioeconomic level and poor awareness of the importance of Pap tests among those with a diagnosis of advanced-stage cervical cancer. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.