RESUMO
BACKGROUND: Our objective was to determine the main factors associated with increased utilization of a cervical cancer screening program (CCSP) in a population with a high mortality rate due to cervical cancer. METHODS: A population-based study was carried out in the Mexican state of Morelos, Mexico. The study population included 3,197 women between the ages of 15 and 49 years who were selected at random using a State Household Sampling Framework in the State of Morelos's 33 municipalities. The sample included 2,094 women with a history of a previous Papanicolaou (Pap) test. RESULTS: A previous experience of good screening quality is strongly associated with greater use of the CCSP (OR = 4.2; 95% confidence interval [CI], 1.6-10.9). The educational level of the head of the family is related to more frequent use of Pap smear services. Women whose husbands have 13 or more years of education (OR = 1.8; 95% CI 1.1-2.9) were more likely to have been screened. Similarly, women who had used two or more family planning methods (OR = 1.6; 95% CI 1.2-2.1) and those who knew why the Pap test was given (OR = 3.0; 95% CI 2.1-4.3) had a better history of Pap screening. CONCLUSIONS: In areas where coverage of cervical cancer screening is low, a CCSP that guarantees the quality of all the different elements of care is essential if obstacles to cervical cancer prevention are to be eliminated. It is of particular importance to take into account and satisfy the perceptions and expectations of the women at risk.
Assuntos
Programas de Rastreamento/normas , Qualidade da Assistência à Saúde , Neoplasias do Colo do Útero/prevenção & controle , Serviços de Saúde da Mulher , Adolescente , Adulto , Feminino , Serviços de Saúde , Humanos , Masculino , Programas de Rastreamento/psicologia , México , Pessoa de Meia-Idade , Teste de Papanicolaou , Inquéritos e Questionários , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/mortalidade , Esfregaço Vaginal/estatística & dados numéricosRESUMO
Objetivo. Determinar los principales factores relacionados con la participación en un programa de detección oportuna de cáncer (DOC) en una población con elevada mortalidad por cáncer cervical (CACU). Material y métodos. En el estado de Morelos se desarrolló un estudio con base poblacional que incluyó 3 197 mujeres de entre 15 y 49 años de edad seleccionadas aleatoriamente de un marco muestral de viviendas de los 33 municipios que componen dicha entidad. Resultados. El conocimiento de la utilidad de la prueba de Papanicolaou (Pap) (RM 29.6, IC95 por ciento 23.6-37) y la historia previa de síntomas ginecológicos (RM 1.7; IC95 por ciento 1.2-2-4) predisponen a utilizar el programa de DOC. Los factores asociados a la utilización de la prueba de Pap fueron que las mujeres tuvieran antecedentes en la utilización de uno (RM 1.4; IC95 por ciento 1.1-18), dos ó más métodos de planificación familiar (RM 2.1; IC95 por ciento 1.6-2.8). Conclusiones. En el estado de Morelos, Mexico, el tamizaje en CACU se ofrece predominantemente en forma oportunista, por lo que el antecedente de utilización de los servicios de salud constituye el principal determinante para la utilización del programa de DOC. Estos resultados revelan la necesidad de establecer estrategias alternativas para integrar a las mujeres que no tienen acceso a dichos servicios de atención médica, ya que constituyen el grupo de más alto riesgo para contraer CACU
