Cobertura do exame citopatológico na cidade de Pelotas, Brasil

Abstract

In 1995, cervical cancer was the fourth most important cause of death among women in the state of Rio Grande do Sul, Brazil. There are no available studies on Pap smear examination coverage in Pelotas, which is the largest city in the southern part of Rio Grande do Sul. Accordingly, in 1992 a population-based, cross-sectional study was carried out among 20 to 69 year-old women residing in urban areas of the city. The objectives of the study were to ascertain any Pap smear testing in the 3 years prior to the study, to determine the coverage of cervical cancer screening, and to identify any factors associated with the performance of Pap tests in Pelotas. Social class was chosen as the determining variable. To categorize social class, two classifications were used: Bronfman's classification and the classification used by the Brazilian Association of Market Research Institutes. Among the 934 women interviewed, 606 (65%) had had a Pap smear test in the 3 years before the study. The multivariate analysis revealed significant differences regarding performance of such tests in terms of social class, age, and frequency of medical consultations per year. No significant differences were found in terms of education, type of health service used, or hospitalizations during the year prior to the study. This study reveals that coverage of cervical cancer screening for women between 20 and 69 years of age in Pelotas is higher than the coverage found in other parts of the country or even of the world. However, for women in lower social classes, coverage was found to be between 52 and 56%. These data can contribute to the development of measures aimed at increasing cervical cancer screening among specific sectors of the population.

Factors related to inadequate cervical cancer screening in two Brazilian state capitals

“…Some studies have found lower rates of cervical cancer screening among younger women (15-24 years old, less than 20 years old, 15-29 years old, 25-29 years old), while others have found them among older age groups (50-69 years old, 60-69 years old, and 55-59 years old). 4 Nascimento et al, 5 Costa et al, 3 and Quadros et al 8 found high rates of cervical cancer screening failure among women who had never undergone breast self-examination and did not attend medical visits in the year prior to the study, which was not evaluated in the present study.…”

“…Pinho et al 6 reported that the main reasons for not undergoing testing were: not having gynecological problems, being embarrassed or afraid of undergoing testing, and reported diffi culty in gaining access to a health care unit. In another study, Costa et al 3 concluded that the lower the social condition the less women would undergo cervical screening and that coverage was lower in older women. Quadros et al 8 showed that black and low income women were proportionally less likely to undergo screening.…”

Cobertura e fatores associados à não realização do exame preventivo de Papanicolaou em São Luís, Maranhão

“…Em São Paulo, a realização do Papanicolaou pelo menos uma vez na vida passou de 68,9% em 1987 13 para 86,1% em 2000 14 . Em Pelotas, a realização do preventivo nos últimos três anos foi de 65% em 1992 15 , 72,2% em 1999/2000 16 e 68,8% em 2002 17 . Em 1994, segundo pesquisa feita pelo Ibope, 64% das mulheres com mais de 15 anos de idade haviam feito o exame pelo menos uma vez na vida 1 .…”

Mulheres vivenciando o adoecer em face do câncer cérvico-uterino

“…Como se observa, as mulheres conviviam com insuficientes recursos financeiros. Segundo informações gerais, mulheres mais pobres apresentam mais comprometimento do câncer cérvico-uterino (11) . Em reforço à idéia anterior, pesquisadores afirmam que as dificuldades socio-econômicas agem como facilitadores ou como barreiras de acesso aos serviços de saúde (12) .…”