[Quality indicators in the early detection of cervicouterine-cancer in primary health care units]. / Indicadores de calidad en la detección oportuna de cáncer cervicouterino en unidades de primer nivel de atención.

BACKGROUND: to determine the quality of a prompt cervical cancer detection program (TDC CC) according to the indicators for prevention and diagnosis. METHODS: cross-sectional and comparative study conducted in four primary care units. We selected 400 patients who attended preventive services to participate in the study of cervical cytology (Pap). The evaluation of the Program of TDC CC was obtained by the degree of fulfillment of quality and productivity outlined by an institutional program. The seven indicators were measured by the same scale. A descriptive statistics, adjusted kappa, and chi square with a level of significance of 95 % confidence interval was used. RESULTS: the average age was 40 ± 12.6 years. Most women (92.5 %) had information about the Pap screening method in CC, even thought only 25.3 % had this test done in the last three years. The inter-observer agreement was scored low by three cytotechnologists. The degree of compliance according to indicators of the 4 units was 35.7 %, and was rated as moderate. The best indicators were great productivity among cytotechnologists, the number and proportion of re-examined cytologies. CONCLUSIONS: most indicators were below the expected values.

[Associated factors for women's non-compliance for cervical cancer screening]. / Factores asociados con incumplimiento para tamizaje en cáncer de cérvix.

OBJECTIVE: To identify the associated factors for non-compliance among women for the cervical cancer screening program. METHODS: A case-control study was carried out in which cases were women who were just diagnosed with cervical cancer (confirmed with pathological study); controls were women not having cervical cancer (negative pathological study). Cases and controls had the same age, lived in the same geographical area and were selected from the primary care facilities. Lack of compliance for cervical cancer screening was defined as the time since the last cytology (no previous Pap test or > or =3 years since last Pap test). A logistic regression analysis served to identify the associated factors to the lack of compliance. RESULTS: There were 279 cases and 392 controls included in the study. The rate of non-compliance among cases was 76.7% and among controls was 29.6%. Among cases 45.5% had never undergone Pap test compared with 9.9% of controls. Main risk factors for non-compliance to attend to cervical cancer screening were age > 65 years (aOR = 2.9, 95% CI 1.6-5-3); illiteracy (aOR = 3.8, 95% CI 1.7-6); use of public transportation to attend to the preventive service (aOR = 2.3, 95% CI 1.2-6.4); more than five pregnancies (aOR = 3.0, 95% CI 1.6-5.3) and lack of knowledge about cervical cancer (aOR = 4.2, 95% CI 3.6-7.2). CONCLUSION: The rate of non-compliance close to 30% was high; social and cultural risk factors were the most relevant.