Adaptação de protocolo clínico para rastreamento e controle do câncer de colo do útero em mulheres privadas de liberdade

Abstract

The study aimed to adapt a clinical protocol for cervical cancer screening and control in women deprived of liberty for use by professionals in prison settings. This methodological study, conducted from June to February 2025, followed the recommendations of the ADAPTE tool, approved by the Research Ethics Committee of the Federal University of Ceará, under opinion number 6,745,715, and will be implemented in women's prisons in the state of Ceará. The organizing committee and panel were composed of members experienced in research and prison health care, including nurses, a psychologist, and a pharmacist. During the adaptation phase, an integrative review was conducted to retrieve guidelines and other supporting materials. The guiding question was: "What is the appropriate cervical cancer screening for women deprived of liberty treated in the prison system?" Therefore, the recommendations of 19 materials, predominantly from Brazil and the United States, were adapted. In May 2025, the nine-member panel met in person to make a final decision on the recommendations and develop a draft of the adapted protocol. The clinical protocol contains seven chapters: Introduction, Vaccination, Screening, Outcomes and Treatments, Sexual and Reproductive Health Care, Breast Exams, and Additional Information. The analysis of the materials compared the original content with the Brazilian prison context, and adjustments were made to ensure the protocol's applicability and effectiveness. The main adjustments were the removal of recommendations that were incompatible with the prison context. Therefore, the adapted guidelines establish an evidence-based model to ensure care for women deprived of liberty and reduce the incidence of cervical cancer in prisons, contributing to equity in care.