[Motives for abandoning the healthcare process for precancerous lesions of the uterine cervix]. / Motivos de abandono en el proceso de atención médica de lesiones precursoras de cáncer cervicouterino.

ABSTRACT

OBJECTIVE: To determine factors associated with medical care abandon of women with CIN. MATERIAL AND METHODS: A nested case-control study in a cohort was done. Patients referred to clinical Dysplasia of Gyneco-Obstetrician Services in third level Hospitals were considered. CASES Patients who abandoned medical care. CONTROLS women who attend their medical appointments during follow-up. All subjects underwent structured interviews focused on social, clinical and health services factors in two different times, applied at the beginning of study and the end of follow-up. Clinical records were reviewed to obtain clinical information. ANALYSIS: Descriptive and inferential statistical was done. Non conditional Logistic Regression analysis was done to obtain adjusted association. RESULTS: Abandon cumulative incidence rate was 108/525 = 20.7% (I.C. 95% = 17.2-24.3); 60.2% happened in diagnosis phase, 17.7% ocured during therapeutic phase and 23.1% happened in surveillance phase. We studied 108 cases and 417 controls to analysis. Next adjusted risk factors were obtained Afraid to death (ORa = 4.2, IC.95% = 1.8-9.5), long appointments (ORa = 6.6, I.C.95% = 3.4-13.0), lack of privacity (ORa = 12.5, I.C.95% = 2.6-59.8), reject to treatment (ORa = 40.4, I.C.95% = 2.1-785.4), lack of information (ORa = 41.9, I.C.95% =14.2-124.1) and other factors. CONCLUSIONS: Patient perception, access and barriers in health services were the most important factors associated with medical care abandon.