Fatores associados à não realização do exame de Papanicolaou: um estudo de base populacional no Município de Campinas, São Paulo, Brasil

Abstract

This study analyzes the prevalence of non-submittal to Pap smears according to socioeconomic, demographic, and health-related behavioral variables in women 40 years or older in Campinas, São Paulo State. This was a cross-sectional population-based study with a sample of 290 women. Based on multivariate analysis, factors associated with not having Pap smears were: age (40-59 years), race/ethnicity (black or mixed-race), and schooling (< 4 years). The following reasons were cited for not having Pap smears: considered unnecessary (43.5%), embarrassment (28.1%), and barriers related to health services (13.7%). The Unified National Health System performed 43.2% of the reported Pap smears. Health services should promote more equitable access to the health care system and improve the quality of care for women, since Pap smears are an effective tool against cervical cancer. The study confirmed that women's failure to obtain Pap smears is associated with social and racial inequality, placing these women at increased risk of cervical cancer.

Fatores associados a não realização da mamografia e do exame clínico das mamas: um estudo de base populacional em Campinas, São Paulo, Brasil

“…Outros estudos brasileiros têm relatado menor acesso das mulheres negras aos exames de prevenção do câncer de mama 17,20 , de colo de útero 21,22 e a outros serviços de assistência ao pré-natal e parto 23 .…”

“…Essa restrição poderia ser a causa da maior proporção de mamografias realizadas em serviços não vinculados ao SUS, que teriam maior flexibilidade para a indicação e a realização do exame. Também tem sido observado em Campinas, que outras atividades relacionadas à saúde da mulher têm apresentado grande parcela de atendimentos realizados por planos e convênios de saúde que respondem por 46,8% do atendimento pré-natal do município 29 e 56,8% da realização do exame de citologia oncótica 21 .…”

Práticas preventivas de detecção de câncer em mulheres: comparação das estimativas dos inquéritos de saúde (ISA - Capital) e vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico (VIGITEL - São Paulo)

“…A household survey conducted in the city of Campinas in 2003 showed that the access to Pap smear was 83.3% for women aged 40 years or more 9 , and data from PNAD 2008 showed that in Brazil, the access to women aged 25 to 59 years reached 84.5%, increasing to 90.0% in the Southeast region 28 .…”

“…Likewise, data from PNAD 2008 showed that the access for women aged 50 to 69 years is higher than 70% in Brazil, reaching 81.9% in the Southeast region; however, fewer years of schooling and income are associated with the decreased access 28 . In relation to the Pap smear 9 , it was observed that factors that are independently associated with the non-realization of the exam were: being 40 to 59 years old, self-reporting color/ethnicity as brown or black, and having years of schooling equal or inferior to 4 years.…”

“…In Brazil, data from different population surveys have been used to estimate the coverage of mammography and Pap smear [5][6][7][8][9] .…”