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Da Agência Senado | 13/06/2024, 09h44

O presidente Luiz Inácio Lula da Silva sancionou com um veto a Lei 14.886, de 2024, que institui o Programa Nacional de Vacinação em Escolas Públicas. O plano tem como objetivo elevar a cobertura vacinal da população, especialmente entre os alunos da educação infantil e do ensino fundamental. O texto foi publicado na quarta-feira (12), em edição extra do Diário Oficial da União.

Lula vetou um artigo do projeto de lei (PL) 826/2019, aprovado em maio pelo Senado. O dispositivo dava prazo de cinco dias para a escola enviar à unidade de saúde a lista de alunos que não comparecessem à campanha vacinação. Os pais também seriam notificados e orientados a buscar o posto de saúde mais próximo. Para o Poder Executivo, a medida "ensejaria potencial conflito de competência" entre os profissionais das áreas de educação e saúde.

O que diz a lei

A Lei 14.886, de 2024, obriga todos os estabelecimentos que recebam recursos públicos a participar do Programa Nacional de Vacinação em Escolas Públicas. As escolas particulares também podem participar, caso manifestem interesse.

De acordo com o texto, o estabelecimento de ensino deve entrar em contato com a unidade de saúde mais próxima para informar a quantidade de alunos matriculados e agendar a data de vacinação. A escola deve comunicar as famílias, com pelo menos cinco dias de antecedência, a data de visita da equipe de saúde.

A vacinação nas escolas deve ocorrer após o início da Campanha Nacional de Vacinação contra a Influenza e contemplar vacinas de rotina e de campanhas. Se o aluno não tiver o cartão de vacinação, a unidade de saúde responsável deve fornecer um novo documento. Se houver disponibilidade de doses, os adultos da comunidade escolar também podem ser vacinados.

Tramitação

A Lei 14.886, de 2024, é resultado do PL 826/2019, da Câmara dos Deputados. No Senado, a matéria recebeu relatórios favoráveis dos senadores Humberto Costa (PT-PE), na Comissão de Assuntos Sociais, e Marcelo Castro (MDB-PI), na Comissão de Educação e no Plenário.
Agência Senado (Reprodução autorizada mediante citação da Agência Senado)

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Lula sanciona Programa Nacional de Vacinação em Escolas Públicas

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O presidente Luiz Inácio Lula da Silva sancionou com um veto a Lei 14.886, de 2024, que institui o Programa Nacional de Vacinação em Escolas Públicas. O plano tem como objetivo elevar a cobertura vacinal da população, especialmente entre os alunos da educação infantil e do ensino fundamental.

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LEI  Nº 14.748 ATUALIÇÃO  POLITICA  NACIONAL DE PREVENÇÃO E CONTROLE DO CÂNCER NO SUS E PROGRAMA DE NAVEGAÇÃO DA PESSOA COM CÂNCER 

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LEI  Nº 14.748 ATUALIÇÃO  POLITICA  NACIONAL DE PREVENÇÃO E CONTROLE DO CÂNCER NO SUS E PROGRAMA DE NAVEGAÇÃO DA PESSOA COM CÂNCER 

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resenha do artigo de criterios de validacao clinica 

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resenha do artigo de criterios de validacao clinica 

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Testagem HPV PARA RASTREAMENTO CCU  REVISAO VALIDACAO CLINICA 2024

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atualizaçã validação clinica 2ª geração teste HPV  2024

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atualizaçã validação clinica 2ª geração teste HPV  2024

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Journal of Medical Virology - 2024 - Arbyn - Criteria for second generation comparator tests in validation of novel HPV DNA

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novo  criterios validacao teste HPV  2024

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novo  criterios validacao teste HPV  2024

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Journal of Medical Virology - 2024 - Arbyn - Criteria for second generation comparator tests in validation of novel HPV DNA

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aspectos cons rastreamento organizado iarc

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aspectos cons rastreamento organizado iarc

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international consensus on the essential org screening BMC 2022

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journal.pone.0273375 EMPIRCAL METAANALISE ED SCRENNING CCU

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The cervical cancer epidemic that screening has prevented in 2004  LANCET

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PIIS1198743X19304914P rimary HPV-based cervical cancer screening in Europeimplementation status, challenges, and future plans 2019

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disease facility-based monitoring guidance WHO 2022

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As ações de controle do câncer do colo do útero devem ser monitoradas e avaliadas, de forma contínua, a fim de se identificar os avanços e também as dificuldades e limites a serem superados na organização da linha de cuidado dessa neoplasia.

Diversos sistemas de informação do Sistema Único de Saúde (SUS) e pesquisas de âmbito nacional podem contribuir com dados úteis nesse processo.

Esta seção do site do Controle do Câncer do Colo do Útero apresenta dados atuais, em perspectiva histórica, oriundos de vários sistemas de informação, como o Sistema de Informação Ambulatorial (SIA), o Sistema de Informação de Mortalidade (SIM), o Sistema de Informação do Câncer (Siscan) e de inquéritos nacionais como o Vigitel Brasil e a Pesquisa Nacional de Saúde.

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Apresenta dados sobre detecção precoce do câncer do colo do útero para monitoramento e avaliação

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Australian Institute of Health and Welfare

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Cancer screening involves testing for signs of cancer or precancerous conditions in people without obvious symptoms. The National Cervical Screening Program (NCSP) is one of Australia's three population-based cancer screening programs. It aims to reduce cervical cancer cases, illness, and deaths by detecting precancerous abnormalities before any potential progression to cervical cancer.

The NCSP is a highly successful public health initiative in Australia, halving cervical cancer incidence and mortality since it was introduced in 1991. This has been achieved through organised, population-based cervical screening to detect precancerous changes, allowing treatment before any progression to cervical cancer, thereby preventing this disease.

A renewed NCSP was introduced on 1 December 2017 that included a change from 2-yearly Pap tests for the target age group 20-69 to 5-yearly human papillomavirus (HPV) tests, followed by a liquid-based cytology (LBC) test if oncogenic (cancer-causing) HPV is found, for the target age group 25-74.

This is the fifth report to present data for the renewed NCSP. Data included in this report are for the calendar years 2018, 2019, 2020, 2021, and 2022.

Terminology

This report uses the terms 'participants' and 'invitees' when referring to data collected under the NCSP. These data are not restricted by sex or gender, with all cervical screening participants and invitees included in these data. For NCSP data, participants and invitees may include women, transgender men, intersex people, and non-binary people.

This report uses the term 'women' to mean 'female' when referring to cancer incidence data and cancer mortality data as these data sources are based on sex assigned at birth. However, it should be noted that some people may not identify with this term.

Recruitment

Participation and coverage in the renewed NCSP can now be measured as 5 years of data are available. Participation is restricted to only screening HPV tests, whereas coverage is not restricted in this way, and is a better indication of overall participation in cervical screening.

Over the 5 years 2018-2022, more than 4.7 million participants aged 25-74 had a screening HPV test (primary screening or 12-month repeat HPV test). Participation has been determined to be 68% of the eligible population.

Over the 5 years 2018-2022, more than 5.2 million participants aged 25-74 had an HPV or LBC test for any reason. Coverage has been determined to be 77% of the eligible population.

Screening

Screening HPV test positivity is the proportion of valid primary screening HPV tests that detected oncogenic HPV. In 2022, for participants aged 25-74:

positivity was 2% for oncogenic HPV 16 and 18 (the two types of HPV that cause most cervical cancers)

positivity was 8% for oncogenic HPV other than 16 and 18

positivity was 10% for any oncogenic HPV type.

Assessment

Participants considered at higher risk of a significant cervical abnormality are referred for colposcopy, which is the examination of the cervix using a magnifying instrument called a colposcope and is the first step in assessment.

In 2021, of the participants aged 25-74 at higher risk of a significant cervical abnormality, 63% had a colposcopy within 3 months. Median time to colposcopy was 56 days.

Diagnosis

Detection of high-grade abnormalities provides an opportunity for treatment before possible progression to cervical cancer.

In 2022, for every 1,000 participants screened, 14 participants had a high-grade abnormality detected by histology. In contrast, for every 1,000 participants screened, 1 had a cervical cancer detected. This reflects that the aim of cervical screening is not to detect cervical cancer, but to prevent it through the detection of high-grade abnormalities.

Outcomes

In 2019, 869 women aged 25-74 were diagnosed with cervical cancer, which is 11 new cases per 100,000 women in the population.

In 2021, 179 women aged 25-74 died from cervical cancer, which is 2 deaths per 100,000 women in the population.

Aboriginal and Torres Strait Islander participants

Cervical screening outcomes are reported for Aboriginal and Torres Strait Islander participants for HPV screening test positivity, colposcopy rate, and high-grade cervical abnormality detection rate at the national level for the first time in this report.

In 2022, for Aboriginal and Torres Strait Islander participants aged 25-74 positivity was:

2% for oncogenic HPV 16 and 18 (the two types of HPV that cause most cervical cancers)

12% for oncogenic HPV other than 16 and 18

14% for any oncogenic HPV type.

In 2021, of the Aboriginal and Torres Strait Islander participants aged 25-74 at higher risk of a significant cervical abnormality, 51% had a colposcopy within 3 months.

In 2022, for every 1,000 Aboriginal and Torres Strait Islander participants aged 25-74 screened, 20 had a high-grade abnormality detected, providing an opportunity for treatment prior to any possible progression to cervical cancer.

In 2015-2019, 167 Aboriginal and Torres Strait Islander women aged 25-74 were diagnosed with cervical cancer. After adjusting for age, incidence among Aboriginal and Torres Strait Islander women was 2.1 times the rate of non-Indigenous women.

In 2017-2021, 58 Aboriginal and Torres Strait Islander women aged 25-74 died from cervical cancer. After adjusting for age, mortality among Aboriginal and Torres Strait Islander women was 3.5 times the rate of non-Indigenous women.

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National Cervical Screening Program monitoring report 2023, Summary

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This is the fifth report to monitor the National Cervical Screening Program since it introduced 5-yearly HPV tests in December 2017. In 2018@2022, there were more than 5.2 million participants aged...

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Date Posted, by DCP Staff

'Last Mile' Initiative Will Test Alternative Approach to Screening Through the SHIP Trial Network
The 'Last Mile' Initiative SHIP Trial Network was announced today at the White House Cervical Cancer Forum by NCI Director Dr. Kimryn Rathmell.
On January 25, 2024, the National Cancer Institute (NCI), part of the National Institutes of Health, with public and private partners, is launching a new clinical trial network to gather data on a "self-collection" method of human papillomavirus (HPV) testing to prevent cervical cancer. This method, if determined viable, could open new opportunities for improving uptake of cervical cancer screening.

The NCI Cervical Cancer 'Last Mile' Initiative is a partnership bringing together multiple federal and private sector stakeholders to contribute evidence on the accuracy and clinical effectiveness of self-collection-based HPV testing for cervical cancer screening.

The initiative is supporting the Self-collection for HPV testing to Improve Cervical Cancer Prevention ( SHIP) Trial Network to conduct independent, non-competitive evaluations of the clinical performance of HPV testing using multiple self-collection device and assay combinations that are under review by the Food and Drug Administration (FDA).

Finding Ways to Make HPV Testing More Accessible

Cervical cancer, caused by HPV, is highly preventable by HPV vaccination and by early detection and treatment of cervical precancerous changes. Yet, more than half of all cases of cervical cancer diagnosed in the U.S. occur in individuals who have never been or are infrequently screened.

People are not screened adequately due to reasons as varied as physical and geographic inaccessibility (e.g., residents of rural and urban underserved areas); financial insecurity or lack of health insurance coverage; lack of awareness or understanding of the importance of screening; social, personal, or religious preferences; physical disability and medical conditions; or history of sexual, physical, or psychological trauma that preclude a pelvic examination for sample collection by a clinician.

"The 'Last Mile' Initiative has the potential to add self-collection as a screening modality to reach at least some of these underserved and underscreened individuals in the U.S.," said NCI Principal Deputy Director Douglas R. Lowy, M.D.

The current standard approach to cervical screening involves clinic visits for specimen collection via pelvic examinations performed by clinicians. As an alternative, individuals could collect vaginal samples at home and send them in for HPV testing. Self-collection could also be offered during other health care visits when a pelvic examination is not practical or not preferred.

While the self-collection method has been implemented in other countries, the FDA is currently reviewing the evidence to consider approval of this approach for use in the U.S. Through the 'Last Mile' Initiative, NCI has been engaged in discussions with the FDA's Center for Devices and Radiological Health (CDRH) and industry partners who have current FDA-approved assays for primary HPV testing by a clinician-collected sample.

"The SHIP Trial will generate independent clinical evidence on accuracy, usability, acceptability, and effectiveness to inform the FDA's reviews for extending current regulatory approvals to include self-collection as an alternative sample collection approach," said Vikrant Sahasrabuddhe, M.B.B.S., Dr.P.H., of the NCI Division of Cancer Prevention (DCP), who will co-lead the SHIP Trial.

The SHIP Trial design has been integrated with the regulatory pathways recommended by the FDA, and NCI expects SHIP Trial data to be submitted on a rolling basis to inform the FDA's review and regulatory actions. Industry partners can refer to this data for both pre-approval and post-approval submissions to fulfill regulatory requirements.

A Nationwide Research Network

The SHIP Trial Network is comprised of a Coordinating Center at the NCI Frederick National Laboratory for Cancer Research (FNLCR) operated by Leidos Biomedical Research, Inc., in Frederick, Maryland, and a multi-center infrastructure supported through 25 Clinical Enrollment Sites across the U.S. (listed below). The Coordinating Center will facilitate protocol development, onboard Clinical Enrollment Sites, and provide centralized support for ethics review, data management, quality assurance monitoring, specimen shipment and logistics, and specimen repositories. It is expected that participant enrollment will commence by the second quarter of 2024.

"The SHIP Trial Clinical Enrollment Sites cover a wide spectrum of health system settings and have the potential to enroll geographically, socioeconomically, racially, and ethnically diverse participants. Demonstrating that underserved populations are willing to participate in self-collection-based cervical cancer screening could help us reach those populations with the greatest need," said DCP Director Philip Castle, Ph.D., M.P.H., who will co-lead the SHIP Trial with Dr. Sahasrabuddhe and principal investigators at the Clinical Enrollment Sites.

NCI is also partnering with professional societies to revise and update clinical practice guidelines for integrating self-collection approaches into clinical practice after regulatory approvals. In addition, NCI is developing a publicly accessible repository of self-collection instructions and educational materials for clinicians, community health workers, and people who may use the testing method in the future.

SHIP Trial Coordinating Center

NCI FNLCR operated by Leidos Biomedical Research, Inc., Frederick, Maryland

SHIP Trial Clinical Enrollment Sites

1. Emory University School of Medicine, Atlanta

2. Rutgers New Jersey Medical School, Newark, New Jersey

3. University of Michigan Medical School, Ann Arbor, Michigan

4. University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina

5. University of Texas MD Anderson Cancer Center, Houston

6. University of Oklahoma Stephenson Cancer Center, Oklahoma City

7. University of New Mexico Health Sciences Center, Albuquerque, New Mexico

8. University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh

9. University of Alabama at Birmingham School of Medicine, Birmingham, Alabama

10. Johns Hopkins University School of Medicine, Baltimore

11. Louisiana State University Health Sciences Center, New Orleans

12. University of Miami Sylvester Comprehensive Cancer Center, Miami

13. Virginia Commonwealth University School of Medicine, Richmond, Virginia

14. Weill Cornell Medicine and New York Presbyterian Hospitals, New York

15. Cleveland Clinic Ob/Gyn and Women's Health Institute, Cleveland

16. University of Washington School of Public Health, Seattle

17. University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico

18. Minneapolis VA Healthcare System, Minneapolis

19. Yale New Haven Health, New Haven, Connecticut

20. University of Pennsylvania Abramson Cancer Center, Philadelphia

21. University of Mississippi Medical Center, Jackson, Mississippi

22. University of Utah Huntsman Cancer Institute, Salt Lake City

23. University of Cincinnati College of Medicine, Cincinnati

24. University of Louisville School of Medicine, Louisville, Kentucky

25. University of California San Francisco School of Medicine, San Francisco

Related links

NCI Cervical Cancer 'Last Mile' Initiative

Cancer Healthcast: NCI 'Last Mile' Initiative Innovates Self-Sampling for HPV Screening

Relevant publications:

Primary Human Papillomavirus Testing and Other New Technologies for Cervical Cancer Screening. Einstein MH, Zhou N, Gabor L, Sahasrabuddhe VV. Obstet Gynecol. 2023 Nov 1;142(5):1036-1043. PMID: 37708516

HPV testing of self-samples: Influence of collection and sample handling procedures on clinical accuracy to detect cervical precancer. Arbyn M, Latsuzbaia A, Castle PE, Sahasrabuddhe VV, Broeck DV. Lancet Reg Health Eur. 2022 Feb 17;14:100332. PMID: 35243475

Meta-analysis of agreement/concordance statistics in studies comparing self- vs clinician-collected samples for HPV testing in cervical cancer screening. Arbyn M, Castle PE, Schiffman M, Wentzensen N, Heckman-Stoddard B, Sahasrabuddhe VV. Int J Cancer. 2022 Jul 15;151(2):308-312. PMID: 35179777

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NCI Launches Network to Study Self-Collection for HPV Testing to Prevent Cervical Cancer

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'Last Mile' Initiative Will Test Alternative Approach to Screening Through the SHIP Trial Network The 'Last Mile' Initiative SHIP Trial Network was announced

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O objetivo é oferecer aos interessados no tema, especialmente gestores e profissionais de saúde, subsídios para compreender, planejar e avaliar as ações de controle deste câncer, no contexto da atenção integral à saúde da mulher e da Estratégia de Saúde da Família como coordenadora dos cuidados primários no Brasil.

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Apresenta as ações para o controle do câncer do colo do útero

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Departamento de Análise em Saúde e Vigilância de Doenças Não Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde. Plano de ações estratégicas para o enfrentamento das doenças crônicas e agravos não transmissíveis no Brasil 2021-2030. https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/publicacoes-svs/doencas-cronicas-nao-transmissiveis-dcnt/09-plano-de-dant-2022_2030.pdf (acessado em 04/Mar/2024).

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Departamento de Análise em Saúde e Vigilância de Doenças Não Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde. Plano de ações estratégicas para o enfrentamento das doenças crônicas e agravos não transmissíveis no Brasil 2021-2030. https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/publicacoes-svs/doencas-cronicas-nao-transmissiveis-dcnt/09-plano-de-dant-2022_2030.pdf (acessado em 04/Mar/2024).

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» https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/publicacoes-svs/doencas-cronicas-nao-transmissiveis-dcnt/09-plano-de-dant-2022_2030.pdf

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Cancer outcomes in Australia are among the best in the world, but they are not experienced equally by all Australians. ¹⁻³ The fragmented way healthcare is usually delivered can increase morbidity, heighten distress, and increase out-of-pocket costs, especially for people with complex needs. 4, 5 This policy proposes how navigation in cancer care could facilitate timely access to support for individuals, families and carers to navigate the health system and address holistic, emotional, and educational/informational needs to achieve equity in cancer care. Figure 1 outlines the definition of navigation for the purposes of this policy.

Navigation in cancer care should aim to ensure timely and equitable access to healthcare and support services for all Australians irrespective of the type or location of cancer.

Figure 1. Navigation in cancer care

Navigation is a response to a complex and fragmented health system, as part of the care coordination process, helping people navigate their way through the health system, and access community, social and psychosocial services that can address personal barriers to care. Navigation support services should be person-centred, with those requiring the most help, receiving dedicated assistance and support, and those able to more independently navigate the healthcare system receiving adequate, but less intensive assistance (refer to Figure 2). The way that people navigate these services depends on their diagnosis, and where they access treatment. ⁶ Without appropriate navigation support, some people can become lost in the health system, unable to access timely, appropriate, and well-coordinated cancer services. 7, 8 Navigation support is a fundamental component of ensuring everyone has timely and appropriate access to healthcare and support services. ⁹
Figure 2. Care coordination and navigation (adapted from Fitch 2008). Navigation in Cancer Care
Components of navigation in the context of cancer care include but are not limited to: care coordination; education/information provision; empowerment (psychosocial counselling, emotional and peer support); advocacy; logistics; and connecting the person with financial assistance. ¹¹ There is evidence that navigation support contributes to improving access and continuity of care, seemingly offering a promising approach to better integration of care (refer to benefits of navigation in Figure 3). 11, 12
Cancer Care Coordination
Consistent, individualised and safe assistance is offered to people affected by cancer, families, and carers to overcome person and system-level barriers to timely access to health, support and psychosocial care throughout the cancer experience. ¹
Person-Centred Care
The deliberate organisation between two or more participants (including the person with cancer) involved in care to facilitate the appropriate and timely delivery of healthcare and support services. ² Care coordination is a comprehensive process that operates at a clinical, organisational, administrative and policy level.
Priority Populations
Integrated healthcare services and support that are delivered in a setting and manner that is responsive to individuals and their goals, values, and preferences.
1. Kline RM, Rocque GB, Rohan EA, et al. Patient Navigation in Cancer: The Business Case to Support Clinical Needs. Journal of Oncology Practice 2019; 15: 585-590. DOI: 10.1200/jop.19.00230. 2. McDonald K M, Sundaram V, Bravata D M, et al. Care Coordination. In: Shojania KG, McDonald K M, Wachter R M, et al. (eds) Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies. Rockville (US): Agency for Healthcare Research and Quality, 2007.

1. Tervonen HE, Aranda S, Roder D, et al. Differences in impact of Aboriginal and Torres Strait Islander status on cancer stage and survival by level of socio-economic disadvantage and remoteness of residence-A population-based cohort study in Australia. Cancer Epidemiology 2016; 41: 132-138. DOI: https://doi.org/10.1016/j.canep.2016.02.006.

2. Tervonen HE, Walton R, Roder D, et al. Socio-demographic disadvantage and distant summary stage of cancer at diagnosis-A population-based study in New South Wales. Cancer Epidemiology 2016; 40: 87-94. DOI: https://doi.org/10.1016/j.canep.2015.10.032.

3. Australian Institute of Health and Welfare. Cancer in Australia. 2019. Canberra (AU).

4. Conway A, O'Donnell C and Yates P. The Effectiveness of the Nurse Care Coordinator Role on Patient-Reported and Health Service Outcomes: A Systematic Review. Evaluation &amp; the Health Professions 2019; 42: 263-296. DOI: 10.1177/0163278717734610.

5. 5. Panozzo S, Collins A, McLachlan S-A, et al. Scope of Practice, Role Legitimacy, and Role Potential for Cancer Care Coordinators. Asia-Pacific Journal of Oncology Nursing 2019; 6: 356-362. DOI: https://doi.org/10.4103/apjon.apjon_29_19.

6. McGrath Foundation. Specialist nurse advanced cancer scoping report. 2021.

7. Walsh J, Harrison J, Young J, et al. What are the current barriers to effective cancer care coordination? A qualitative study. BMC health services research 2010; 10: 132.

8. Sabesan S, Olver I, Poulsen M, et al. What teleoncology models of care are available to health services in Australia and overseas? 2017. Sydney (AU).

9. Chan RJ, Hart N, Crawford-Williams F, et al. DEFINING THE UNMET NEEDS OF PEOPLE WITH ADVANCED SOLID AND HAEMATOLOGICAL CANCERS, AND THEIR CARERS. 2021.

10. Fitch MI. Supportive care framework. Can Oncol Nurs J 2008; 18: 6-24. DOI: 10.5737/1181912x181614.

11. Chan RJ, Milch VE, Crawford-Williams F, et al. Patient navigation across the cancer care continuum: An overview of systematic reviews and emerging literature. CA: A Cancer Journal for Clinicians 2023; 73: 565-589. DOI: https://doi.org/10.3322/caac.21788.

12. Budde H, Williams GA, Scarpetti G, et al. What are patient navigators and how can they improve integration of care? Report no. 44, 2022. Copenhagen (DK).

13. Kline RM, Rocque GB, Rohan EA, et al. Patient Navigation in Cancer: The Business Case to Support Clinical Needs. Journal of Oncology Practice 2019; 15: 585-590. DOI: 10.1200/jop.19.00230.

14. McDonald K M, Sundaram V, Bravata D M, et al. Care Coordination. In: Shojania KG, McDonald K M, Wachter R M, et al. (eds) Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies. Rockville (US): Agency for Healthcare Research and Quality, 2007.

Priority population groups, as defined in the Australian Cancer Plan (ACP), include Aboriginal and Torres Strait Islander Peoples, people living in rural and remote areas, lesbian, gay, bisexual, transgender, intersex, queer and asexual (LGBTIQA+) people, people from culturally and linguistically diverse backgrounds, people living with disability, people in lower socioeconomic groups, people living with a mental illness, older Australians, adolescents and young adults, and children.

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Navigation in Cancer Care | Introduction

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Read about Cancer Council's navigation priorities which support a person-centred approach to cancer navigation and aim to ensure equitable access for all to optimal cancer care.

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Australian Institute of Health and Welfare

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National Cervical Screening Program monitoring report 2022, Summary

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This is the fourth report to monitor the National Cervical Screening Program since it introduced 5-yearly HPV tests in December 2017. In 2018@2021, more than 4.2 million people aged 25@74…

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Virtual Course on Comprehensive Cervical Cancer Control in Latin America and the Caribbean

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This course aims to improve the training of health providers in all aspects related to the prevention and control of cervical cancer, including its natural history, primary prevention through vaccination against HPV, detection and treatment of cervical lesions precancerous, diagnosis and treatment of invasive cervical cancer, and provision of palliative care.

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Passo a passo Apresentação linha de cuidado ccu modificar par a grupo puv

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O que previne:

Infecções persistentes e lesões pré-cancerosas causadas pelos tipos de HPV 6,11,16,18. Também previne o câncer de colo do útero, da vulva, da vagina, do ânus e verrugas genitais (condiloma).

Do que é feita:

Trata-se de vacina inativada, portanto, não tem como causar a doença.

É composta pelas proteínas L1 dos papilomavírus humano (HPV) tipos 6,11,16,18, sulfato de hidroxifosfato de alumínio, cloreto de sódio, L-histidina, polissorbato 80, borato de sódio e água para injeção.

Indicação:

A vacina está disponível somente no PNI, portanto, as indicações e esquemas são os estipulados pelo Programa.

Meninas e meninos de 9 anos a 14 anos.

Pessoas de 9 a 45 anos nas seguintes condições:

convivendo com HIV/Aids; pacientes oncológicos em quimioterapia e/ou radioterapia;

transplantados de órgãos sólidos ou de medula óssea;

vítimas de abuso sexual;

com imunodeficiência primária ou erro inato da imunidade;

Usuários de Profilaxia Pré-Exposição (PrEP) entre 15 e 45 anos;

Pessoas com papilomatose respiratória recorrente (PRR) a partir de 2 anos.

Contraindicação:

Gestantes e pessoas que apresentaram anafilaxia após receber uma dose da vacina ou a algum de seus componentes.

Esquemas de doses:

Meninos e meninas de 9 a 14 anos: dose única.

Vítimas de violência sexual entre 9 e 45 anos: de acordo com a recomendação prevista em bula para a faixa etária:

Nove a 14 anos: duas doses;

A partir de 15 anos: três doses, com intervalos de dois meses entre a primeira e a segunda dose e de seis meses entre a primeira e a terceira doses (esquema 0 - 2 - 6 meses);

Pessoas com esquema incompleto deverão completá-lo;

Pessoas com papilomatose recorrente a partir de 2 anos de idade: três doses (esquema 0 - 2 - 6 meses);

Pessoas até 45 anos nas seguintes condições: convivendo com HIV/Aids; pacientes oncológicos em quimioterapia e/ou radioterapia; transplantados de órgãos sólidos ou de medula óssea, com imunodeficiência primária ou erro inato da imunidade. O esquema é de três doses (0 - 2 - 6 meses), independentemente da idade.

Usuários de Profilaxia Pré-Exposição (PrEP) para o HIV não vacinados de 15 a 45 anos: três doses (0 - 2 - 6 meses). Pessoas com esquemas incompletos deverão completar esquema de três doses.

OBS: O PNI estabeleceu, temporariamente, estratégia de resgate de adolescentes até 19 anos não vacinados, com uma dose.

Via de aplicação:

Intramuscular.

Cuidados antes, durante e após a vacinação:

Antes da vacinação, é preciso questionar a mulher sobre a possibilidade de gravidez. Contudo, se a vacina for aplicada sem que se saiba da gravidez, nenhuma intervenção se faz necessária.

Não são necessários cuidados especiais antes da vacinação.

Em caso de febre, deve-se adiar a vacinação até que ocorra a melhora.

Compressas frias aliviam a reação no local da aplicação.

Qualquer sintoma grave e/ou inesperado após a vacinação deve ser notificado ao serviço que a realizou.

Sintomas de eventos adversos graves ou persistentes, que se prolongam por mais de 24 a 72 horas (dependendo do sintoma), devem ser investigados para verificação de outras causas.

Efeitos e eventos adversos:

Na Inglaterra, após dois anos de incorporação da vacina no calendário do governo, e da administração de 4,5 milhões de doses, somaram-se 4.703 eventos adversos. Desse total, 17% foram manifestações no local da aplicação (dor, vermelhidão e inchaço); 11%, manifestações alérgicas (urticária e prurido); e 37%, manifestações gerais como náuseas, vômitos e dor de cabeça. Foram registradas ainda reações psicogênicas (21%) descritas como pânico e desmaios causados pelo medo da injeção e não pela vacina - principalmente em adolescentes e mulheres jovens. Não ocorreu nenhum caso de doença neurológica, paralisia ou doença autoimune.

Onde pode ser encontrada:

Nas Unidades Básicas de Saúde (UBS) para:

Crianças e adolescentes de 9 a 14 anos, em esquema de dose única;

Adolescentes de 9 a 19 anos que não receberam nenhuma dose (temporariamente).

Nas Unidades Básicas de Saúde (UBS) e/ou nos Centros de Referência para Imunobiológicos Especiais (CRIE) para:

Pessoas de 9 a 45 anos com as seguintes condições:

Com HIV/Aids

Transplantados;

Pacientes oncológicos em tratamento com radioterapia ou quimioterapia;

Com imunodeficiência primária ou erro inato da imunidade

Pessoas com papilomatose recorrente (PRR) a partir de 2 anos de idade, com prescrição médica. No caso de menores de 18 anos, é necessário autorização dos responsáveis.

Nos locais de assistência às vítimas de abuso sexual para:

Vítimas de violência sexual de 9 a 45 anos.

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O que previne: Infecções persistentes e lesões pré-cancerosas causadas pelos tipos de HPV 6,11,16,18. Também previne o câncer de colo do útero, da vulva, da vagina, do ânus e verrugas genitais (condiloma). Do que é feita: Trata-se de vacina inativada, portanto, não tem como causar a doença.

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Find Planning Resources We've collected lots of resources to help you in your sustainability planning. You can view all of them below, or use the filter to view resources for a single sustainability domain.

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Find Planning Resources We've collected lots of resources to help you in your sustainability planning. You can view all of them below, or use the filter to view resources for a single sustainability domain.

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PORTARIA SAES/MS Nº 688, DE 28 DE AGOSTO DE 2023

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PORTARIA SAES/MS Nº 688, DE 28 DE AGOSTO DE 2023

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Altera a Portaria de Consolidação SAES/MS nº 1, de 22 de fevereiro de 2022, para dispor sobre a habilitação de estabelecimentos de saúde na alta complexidade em oncologia.

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LEI  Nº 14.748 ATUALIÇÃO  POLITICA  NACIONAL DE PREVENÇÃO E CONTROLE DO CÂNCER NO SUS E PROGRAMA DE NAVEGAÇÃO DA PESSOA COM CÂNCER 

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LEI  Nº 14.748 ATUALIÇÃO  POLITICA  NACIONAL DE PREVENÇÃO E CONTROLE DO CÂNCER NO SUS E PROGRAMA DE NAVEGAÇÃO DA PESSOA COM CÂNCER 

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PORTARIA SECTICS/MS Nº 3, DE 7 DE MARÇO DE 2024 Tornou pública a decisão de incorporar, no âmbito do Sistema Único de Saúde - SUS, os testes moleculares para detecção de HPV oncogênico, p

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PORTARIA SECTICS/MS Nº 3, DE 7 DE MARÇO DE 2024 Tornou pública a decisão de incorporar, no âmbito do Sistema Único de Saúde - SUS, os testes moleculares para detecção de HPV oncogênico, p

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Portal da Imprensa Nacional do Brasil. Diário Oficial da União.

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Da Agência Senado | 13/06/2024, 09h44

O presidente Luiz Inácio Lula da Silva sancionou com um veto a Lei 14.886, de 2024, que institui o Programa Nacional de Vacinação em Escolas Públicas. O plano tem como objetivo elevar a cobertura vacinal da população, especialmente entre os alunos da educação infantil e do ensino fundamental. O texto foi publicado na quarta-feira (12), em edição extra do Diário Oficial da União.

Lula vetou um artigo do projeto de lei (PL) 826/2019, aprovado em maio pelo Senado. O dispositivo dava prazo de cinco dias para a escola enviar à unidade de saúde a lista de alunos que não comparecessem à campanha vacinação. Os pais também seriam notificados e orientados a buscar o posto de saúde mais próximo. Para o Poder Executivo, a medida "ensejaria potencial conflito de competência" entre os profissionais das áreas de educação e saúde.

O que diz a lei

A Lei 14.886, de 2024, obriga todos os estabelecimentos que recebam recursos públicos a participar do Programa Nacional de Vacinação em Escolas Públicas. As escolas particulares também podem participar, caso manifestem interesse.

De acordo com o texto, o estabelecimento de ensino deve entrar em contato com a unidade de saúde mais próxima para informar a quantidade de alunos matriculados e agendar a data de vacinação. A escola deve comunicar as famílias, com pelo menos cinco dias de antecedência, a data de visita da equipe de saúde.

A vacinação nas escolas deve ocorrer após o início da Campanha Nacional de Vacinação contra a Influenza e contemplar vacinas de rotina e de campanhas. Se o aluno não tiver o cartão de vacinação, a unidade de saúde responsável deve fornecer um novo documento. Se houver disponibilidade de doses, os adultos da comunidade escolar também podem ser vacinados.

Tramitação

A Lei 14.886, de 2024, é resultado do PL 826/2019, da Câmara dos Deputados. No Senado, a matéria recebeu relatórios favoráveis dos senadores Humberto Costa (PT-PE), na Comissão de Assuntos Sociais, e Marcelo Castro (MDB-PI), na Comissão de Educação e no Plenário.
Agência Senado (Reprodução autorizada mediante citação da Agência Senado)

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Lula sanciona Programa Nacional de Vacinação em Escolas Públicas

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O presidente Luiz Inácio Lula da Silva sancionou com um veto a Lei 14.886, de 2024, que institui o Programa Nacional de Vacinação em Escolas Públicas. O plano tem como objetivo elevar a cobertura vacinal da população, especialmente entre os alunos da educação infantil e do ensino fundamental.

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Ministério da Saúde adota esquema de vacinação em dose única contra o HPV

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Estratégia busca intensificar proteção contra o câncer de colo de útero e outras complicações associadas ao vírus e permite dobrar a capacidade de imunização com o estoque atual da pasta

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LEI Nº 14.758 DE 19 DE DEZEMBRO DE 2023 institui a Política Nacional de Prevenção e Controle do Câncer no âmbito do Sistema Único de Saúde (SUS) e o Programa Nacional de Navegação da Pessoa com Diagnóstico de Câncer; e altera a Lei nº 8.080, de 19 de setembro de 1990 (Lei Orgânica da Saúde).

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LEI Nº 14.758 DE 19 DE DEZEMBRO DE 2023 institui a Política Nacional de Prevenção e Controle do Câncer no âmbito do Sistema Único de Saúde (SUS) e o Programa Nacional de Navegação da Pessoa com Diagnóstico de Câncer; e altera a Lei nº 8.080, de 19 de setembro de 1990 (Lei Orgânica da Saúde).

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Ferramentas e Diretrizes em PIE - brasil evipnet

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O desenvolvimento das capacidades institucionais em Políticas Informadas por Evidências perpassa a elaboração de ferramentas metodológicas, como diretrizes metodológicas e outras ferramentas que a compõe.

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body { margin: 0; font-family: Arial, Helvetica, sans-serif; } .topnav { overflow: hidden; background-color: #DBDBDD; } .topnav a { float: left; color: black; text-align: center; padding: 14px 16px; text-decoration: none; font-size: 17px; font-weight: bold; } .topnav a:hover { background-color: #149AD6; color: white; } .topnav a.active { background-color: #149AD6; color: white; }

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An ambitious 10-year action plan to achieve equitable access to quality cancer care in Canada and ensure a sustainable system for the future

View your jurisdiction's progress towards the cancer strategy priorities

View progress

How is the Strategy helping me and those I care about?

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Cancer Strategy - Canadian Partnership Against Cancer

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Le Partenariat canadien contre le cancer a publié la version actualisée de la Stratégie canadienne de lutte contre le cancer - une feuille de route sur 10 ans visant à améliorer l'équité au sein du système de lutte contre le cancer et à soutenir ceux qui ont le plus besoin d'aide, tout en se concentrant sur la mise en place d'un système de santé durable pour l'avenir.

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nationalcancerplan - National Cancer Institute

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The President's Cancer Panel monitors progress toward the goals of the National Cancer Plan.

We know that our continued progress against cancer is the direct result of advances made possible by investment from federal, state, and local governments, along with private investment, and by the sustained efforts of researchers around the world and millions of people with cancer, their caregivers, and advocates.

Building on these tremendous efforts and to realize the vision laid out by President Biden and First Lady Biden as part of the Cancer Moonshot℠, the National Cancer Plan provides a framework for everyone-across the federal government and all of society-to collaborate in ending cancer as we know it.

What's in the National Cancer Plan?

The plan has three elements:

Eight goals that we must achieve to prevent cancer, reduce deaths from cancer, and ensure the best possible quality of life for people living with cancer

A set of strategies associated with each goal, describing essential research and other activities needed to maximize benefits for everyone

A call to action that is also at the center of the Cancer Moonshot: that everyone-every organization and individual-do their part to help end cancer as we know it

Importantly, this plan is a living document that will evolve over time as research continues, advances are made, and lessons are learned across the cancer care community.

How does the National Cancer Plan relate to the Cancer Moonshot?

The plan outlines goals designed to support the aims of the Cancer Moonshot and provides a framework for ways to meaningfully contribute to achieving these goals. Projects currently under way as part of Cancer Moonshot are featured through the plan and connected to other cancer research efforts.

The plan considers the entire landscape of cancer in the United States and is a foundational effort to align the cancer research and care community in the fight against cancer. Just as the White House has invited people far and wide to share their stories and actions, so too will the National Cancer Institute (NCI) be calling on everyone to share what they are doing to meet the goals of the National Cancer Plan.

Why is now a good time for the National Cancer Plan?

The National Cancer Act of 1971 gave broad authority to the director of NCI to develop a National Cancer Program to include NCI, other components of the National Institutes of Health, and other federal and nonfederal cancer programs. More than 50 years later, this program has come to represent a far more complex ecosystem of people from across the cancer community working to create a world where cancer does not significantly impact someone's life.

NCI stands ready to collaborate across the federal government and beyond to accomplish more together than we can separately. With unprecedented scientific opportunities, passion, and commitment from diverse areas of our society, the time is right for a comprehensive National Cancer Plan to advance the National Cancer Program and demonstrate international leadership in meeting the global challenge to reduce the impact of cancer.
"The National Cancer Plan represents a commitment to achieving a society where most cancers are prevented and where every person diagnosed with cancer lives a full and active life." -NCI Director Monica M. Bertagnolli, M.D.

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Learn about what's in the National Cancer Plan and why it's needed.

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Patient-centred care informs and involves patients in their care and respects and responds to the preferences, needs and values of patients, families and carers.

A patient-centred focus increases the experience and satisfaction of patients, their families and carers, and staff, as well as safety and cost-effectiveness (ACSQHC 2019a).

Patient-centred care means:

patients are informed and involved in decisions about their cancer and the treatment, post-treatment and recovery program ahead

patients, their families and carers are provided with access to appropriate and accessible health information

respect for the cultural and religious beliefs of patients and their families is demonstrated when discussing the diagnosis of cancer

active communication is used to engage patients, their families and carers in the care process - an essential step for children, adolescents, young adult and adult patients to be informed and have an age appropriate understanding.

care processes are mutually beneficial for patients and providers

special needs are addressed - for example, the needs of people with disabilities or mental health issues.

Informed choice and consent
An informed patient has greater confidence and competence to manage their cancer journey.

Health professionals are responsible for enabling patients to make informed choices according to their preferences, needs and values. Patients should be provided with:

individualised and timely information and guidance about their treatment

details of their care, including the advantages and disadvantages of each treatment, the associated potential side effects, the likely outcomes on their performance status (how well a patient is able to carry out activities of daily life) and subsequently their quality of life and any financial implications, at each stage of the pathway (ACSQHC 2020).

Health professionals have a legal responsibility to obtain consent for all procedures from either the patient or their substitute decision-maker if they are not deemed competent.
Referral choices and informed financial consent
Patients have the right to receive the information they need to be able to make an informed decision on where to be referred for treatment. Treating specialists and practitioners should clearly explain the costs or how to find out the costs of services, tests and treatment options upfront to avoid consumers experiencing 'bill shock'.

At the time of referral, the patient's general practitioner or other referring doctor should discuss the different options for referral, waiting periods, expertise, if there are likely to be out-of-pocket costs and the range of services available. This will enable patients to make an informed choice of specialist and health service. Referral decisions influence the care patients receive along the pathway and the direct and indirect costs they and their carers may incur. Different referrals have different costs:

referral to a public hospital, which may involve some costs

initial referral to a private specialist with associated costs, with the option of ongoing treatment in a public hospital at any time

referral to a patient's choice of practitioner for immediate and ongoing private hospital management with associated costs.

Patients should be made aware that even though public hospital health care is 'free' to all Australian citizens and most permanent residents of Australia, there are still associated direct costs such as:

over-the-counter medication and prescriptions

wound dressings

travel costs

parking fees

tests that are not covered by Medicare.

A cancer diagnosis and treatment may affect a patient's or carer's income. This is an indirect cost associated with cancer. Social work support is essential to help patients and their families deal with this issue. Patients should be advised not to undergo private care with significant out-of-pocket expenses if financially constrained. Specialists in private practice need to explain costs at the start of each new treatment to acknowledge the cumulative out-of-pocket expenses that patients can incur.

For more information on informed financial consent see Cancer Council's ' Standard for informed financial consent '.

Financial counselling services can provide advice on dealing with financial difficulties. These services can be accessed publicly (via social workers at hospitals, financial counsellors at neighbourhood houses or rural financial aid), privately or through cancer support services such as local charity groups or social work services.

For practical and financial assistance, patients may consider Cancer Council's financial services.

Patients and carers should be made aware of other forms of potential financial support that may be available, including whether the diagnosis or treatment triggers any insurance or access to superannuation, patient-assisted travel schemes, Centrelink, or other forms of social security.
Shared care
Shared care between a cancer specialist and primary care health professional is delivered in two or more settings by two or more professionals. The primary care provider is usually a general practitioner but can include nurses and allied health practitioners. Shared care can be delivered throughout the care pathway including during treatment, follow-up care, survivorship care and end-of-life care.

Shared care offers several advantages to patients, including the potential for treatment closer to home and more efficient care with less duplication and greater coordination. Evidence comparing shared care and specialised care indicates equivalence in outcomes including recurrence rate, cancer survival and quality of life (Cancer Research in Primary Care 2016).

Telehealth can enable efficient shared care and should be explored for all patients. Patients in some rural or remote locations may access specialists via Medicare Benefit Scheme funded telehealth consultations. General practitioners working in rural or remote locations should be aware of specialist multidisciplinary teams with facilities to reduce the travel burden and costs for patients.

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Patient-centred care informs and involves patients in their care and respects and responds to the preferences, needs and values of patients, families and carers. A patient-centred focus increases the experience and satisfaction of patients, their families and carers, and staff, as well as safety and cost-effectiveness (ACSQHC 2019a).

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Documents selected by the World Health Organization

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Overview

This WHO checklist is for any organization or person supporting the routine use of evidence in the process of policy-making. Evidence-informed policy-making (EIPM) is essential for achieving the Sustainable Development Goals (SDGs) and universal health coverage (UHC). Its importance is emphasized in WHO's Thirteenth General Programme of Work 2019-2023 (GPW13). This checklist was developed by the WHO Secretariat of Evidence-Informed Policy Network (EVIPNet) to assist its Member countries in institutionalizing EIPM. Government agencies (i.e. the staff of the Ministry of Health), knowledge intermediaries and researchers focused on strengthening EIPM will find in this checklist some key steps and tools to help their work. While the health sector is a key target group for EVIPNet, this tool can be applied by stakeholders from different social sectors.

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Supporting the routine use of evidence during the policy-making process: a WHO checklist

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By routinely making use of evidence in policy-making, governments are likely to achieve more effective policy development for societal progress. This tool can be used (i) to bring awareness about the importance of evidence use, (ii) when a country is initiating activities towards institutionalizing evidence use in policies (i.e.

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A test to detect human papillomavirus (HPV) in cervical samples was developed based on the evidence that persistent infection with certain HPV types was necessary for the development of nearly 95% of cervical cancers. There is now compelling evidence that HPV tests are superior to cervical cytology (Pap smear) or visual inspection of the cervix with acetic acid (VIA) in detecting cervical precancer and cancer; thus, they are the most suitable cervical screening test.

In November 2020, the World Health Organization (WHO) launched a global initiative to accelerate the elimination of cervical cancer as a public health problem worldwide. Elimination of this virus-induced cancer is feasible through vaccination against HPV, screening with HPV testing, and appropriate treatment of the screen-detected precancers and cancers. Prevention of cervical cancer will have a far-reaching global impact, given that more than 300 000 women per year still die from this cancer and that more than 80% of these deaths occur in low- and middle-income countries.

Modelling studies have shown that achievement of the following targets by all countries by 2030 will reduce cervical cancer incidence to fewer than 4 new cases per 100 000 women per year globally (from 13.3 new cases per 100 000 women in 2020) by 2100:

90% of girls are fully vaccinated with the HPV vaccine by the age of 15 years;

70% of women are screened using a high-performance test (e.g. HPV test) by the age of 35 years, and again by the age of 45 years;

90% of women diagnosed with cervical precancer or cancer receive appropriate treatment.

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Using HPV tests for cervical cancer screening and managing HPV-positive women - a practical online guide

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A test to detect human papillomavirus (HPV) in cervical samples was developed based on the evidence that persistent infection with certain HPV types was necessary for the development of nearly 95% of cervical cancers.

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Virtual Course on Comprehensive Cervical Cancer Control in Latin America and the Caribbean

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This course aims to improve the training of health providers in all aspects related to the prevention and control of cervical cancer, including its natural history, primary prevention through vaccination against HPV, detection and treatment of cervical lesions precancerous, diagnosis and treatment of invasive cervical cancer, and provision of palliative care.