Barreras para la prevención y detección temprana de cáncer de cuello uterino

Abstract

<p>Objetivo: Identificar las barreras para la detección temprana del cáncer de cuello uterino. Método: Revisión integrativa de literatura, en bases de datos como Science Direct, Medline, SciELO y Scopus, publicados durante los últimos seis años, escritos en inglés, portugués y español. Resultados: Los aspectos socioculturales, las estrategias de prevención empleadas y la dificultad para acceder a la atención fueron las barreras encontradas en la revisión; igualmente, la poca aceptación de la vacuna contra el virus del papiloma humano y la no asistencia a la citología cérvico-vaginal inciden en la aparición de numerosos casos de lesiones preneoplásicas. Conclusiones: Se evidencia la necesidad de fortalecer las acciones de educación, información y abogacía del profesional de enfermería, que contribuyan a reducir la incidencia de esta patología, lo cual representa un reto importante para el personal de salud.</p>

Barriers to the non-acceptance of cervical cancer screenings (pap smear test) in women of childbearing age in a rural area of Peru

“…This research project found that the largest percentage of women in the Peruvian rural community of Marián had, over 4–6 years, declined to have a cervical cancer screening through a Papanicolaou test (52.5%), which is in contrast with the 79.5% of women in rural areas of Kenya [29] and 82.6% of women of various ethnicities in the United States of America who are inclined to submit to said screening, where 35.6% even prefer to have one done annually [14]. Nonetheless, what has been shown in the Peruvian community of Marián has a relation to the percentages of non-acceptance found in other studies carried out on rural populations of India (71%) [16], Central and South America (67% in Colombia [17] and 84% in Brazil [18]), in which cases the non-acceptance of the screenings by means of the Papanicolaou test was much greater, probably due to the fact that in these research cases, the lack of knowledge regarding the utility and benefits of the Papanicolaou test was considered an associated factor.…”

“…With regards to the socio-demographic barriers, the low coverage of the Papanicolaou test amongst the women in the rural area of Appalachia located in Virginia, United States of America, was related to low levels of income, deficient education levels and working from home (29%) [30], which were also the reasons mentioned in the study by Austad et al [31] on the rural populations of Guatemala, where scarce financial income ended up being crucial for 20% of the women. Likewise, two research studies done in Colombia reported the existence of socio-demographic barriers impeding the timely diagnosis of cervical cancer by means of the Papanicolaou test, such as age, civil status, education level and financial income [17, 32], all of which share not only a similarity to the findings of this investigation, in which said barriers were also associated, but also with the study by Ramírez on the Peruvian locality of Huánuco [19]. In addition, another research study developed by Barrionuevo with women of diverse rural areas in Peru also concluded that low education levels and scarce economic resources were the barriers of exclusion and inequality to cervical cancer screenings [22].…”

“…A study on rural populations in another Central American country like Guatemala showed that fears related to the Papanicolaou test procedure were also referenced by the women of said country (14.8%), as well as waiting periods for the delivery of the results (9%) [31], whereas in the case of Chile, where the healthcare system is much more organised than in the rest of South America, including in Peru, the reasons relating to fear, embarrassment, discomfort or maltreatment on the part of healthcare personnel were obstacles to having the Papanicolaou test done [34, 35], maltreatment that was similarly referenced by women in rural populations of Colombia [17, 32], with this situation also being mentioned by 71.5% of the women in this study, constituting a worrying actuality that merits further research and, if this is the case, immediate corrective actions on the part of the authorities.…”

“…As a result of what has been shown here, it is apparent that the coverage of screening using the Pap smear test is low in medium and low-income countries (43% on average) [13] compared to developed countries such as the USA (77.7%) [14], as well as that this situation affects women in rural and poor areas with greater emphasis [15], and we can observe that in Peru’s case, there is a difference in the performance of the test between urban and rural areas (64.5% and 56%, respectively) [6]. Likewise, according to recent statistics registered in developing countries, there is a high percentage of women in rural communities refusing cervical cancer screenings using the Pap test, with figures up to 71% in India [16], 67% in Colombia [17] and 84% in Brazil [18], and there are few studies [19–23] on the reasons behind this refusal by women from the rural areas of Peru, a geographic reality that pertains to the rural community of Marián, which was chosen for having the second highest cervical cancer screening refusal rate in the entire north sierra of Peru (53%), and the fact that there has not been a similar study undertaken in this geographic area [6].…”

Detección precoz del cáncer en la mujer, enorme desafío de salud en México. Algunas reflexiones

“…Según algunas investigaciones, (Aranguren- Pulido et al, 2017;Knaul et al, 2012), las dificultades de acceso a los servicios de salud es una de las razones Promoción de la salud, detección precoz de cáncer, neoplasia de la mama, neoplasia de cuello del útero Ensayo que propician una pobre participación de las mujeres en programas de detección oportuna de CaCu.…”