Prevenção do câncer de colo do útero: um modelo teórico para analisar o acesso e a utilização do teste de Papanicolaou

Abstract

Several studies have indicated that the prevailing high incidence and mortality rates of cervical cancer, mainly in developing countries, are due to the low quality and coverage of the cervical smear or Papanicolaou (Pap) test. This article intends to analise some aspects related to measures of control and prevention of cervical cancer, such as the effectiveness of the Pap test, the operational and scientific rationale of public health policies for the prevention of cervical cancer and coverage of the Papanicolaou test in many countries. It also intends to review the explanatory models that have been proposed to analyze access to this service. For this latter objective, we investigated the factors associated to the use of the Pap test described within the epidemiological literature and we proposed a new approach in the investigation of these factors, incorporating social, cultural and organizational aspects in the analysis of access to and use of this practice so that measures of prevention and control may be more coherent with the needs and the rights of women.

Prevalência do exame preventivo de câncer do colo do útero em Rio Branco, Acre, Brasil, e fatores associados à não-realização do exame

“…No Brasil, é indicado para mulheres que já tiveram relação sexual, especialmente dos 25 aos 59 anos de idade, com periodicidade anual, sendo trienal quando dois exames anuais seguidos apresentarem resultados negativos para displasia ou neoplasia 6,7,8 .…”

Women cancer prevention and pharmaceutical contribution

“…E29: In my day we just resorted to the doctor when something bothered. Do not experience gynecological problems was one reason that contributed to non-regularity of preventive examinations (Pinho, França-Junior, 2003) while screening should be performed in asymptomatic individuals identified as high risk for any given disease (WHO, 2005). The sense of embarrassment was another sentiment associated with resistance in the implementation of preventive examinations of the cervix (Duavy et al, 2007) and the screening of breast cancer by mammography (Marinho et al, 2002).…”

“…E30: I thought to do preventive checks every year was something for younger women, I went only once in a while. The lack of time to go to the doctor was an equally important reason pointed out by interviewees and is considered a barrier to prevent cancer in women (Pinho, França-Junior, 2003). E2: The problem is that these consultations are time consuming; I cannot take a day off work!…”

Análise Dos Laudos De Papanicolaou Realizados Em Uma Unidade Básica De Saúde

“…O exame de Papanicolaou, técnica amplamente difundida há mais de 40 anos (6) , consiste na coleta e análise das células oriundas da ectocérvice e da endocérvice, resultantes da raspagem do colo do útero, exposto pela introdução do espéculo vaginal e decorrente da consulta ginecológica de rotina, com a finalidade de verificar a existência de alterações pré-malignas ou malignas em suas células, possibilitando a detecção precoce e a realização do tratamento oportuno (7) .…”