Abstract
To assess the adherence to a cervical cancer screening program and to identify reported reasons for inadequate screening in women receiving care as part of the Family Health Strategy. A selective prevalence study on cervical cancer screening in women receiving care as part of the Family Health Strategy in the cities of Duque de Caxias and Nova Iguaçu in the state of Rio de Janeiro, southeastern Brazil, nine years after they participated in a previous study of the Brazilian National Cancer Institute. Only those women who were not diagnosed with CIN II or more severe lesions by histopathology, did not undergo hysterectomy during the study period and still resided in the communities were eligible to participate in the study. Information on exam sites, test results and schedules, sociodemographic characteristics and reported reasons of non-adherence was obtained. Data were collected through interviews and medical record review. The prevalence of adherence to screening was estimated, and the chi-square test was used to compare proportions between the variables studied and their relationship with the reported reasons of non-adherence to screening. A total of 764 women were interviewed, 70.7% of whom received adequate cervical cancer screening. The reported reasons for inadequate screening included: no risk perception (44.6%), social barriers (26.3%), perceived barriers to action (22.3%) and institutional barriers (21.4%). These reasons were proportionately higher among residents of Nova Iguaçu than among residents of Duque de Caxias (p<0.01), except for institutional barriers (p=0.19). Although difficulties and barriers were reported, there was good adherence to cervical cancer screening among the women studied. Health providers should receive proper training for complying with the Brazilian Ministry of Health guidelines of regular testing and to facilitate access to screening.
Highlights
To assess the adherence to a cervical cancer screening program and to identify reported reasons for inadequate screening in women receiving care as part of the Family Health Strategy
Tem sido observada queda na tendência de mortalidade em todas as capitais das regiões brasileiras e nos demais municípios das regiões Sul e Sudeste
Em estudo realizado no município de Juiz de Fora, Minas Gerais21, 26,6% das mulheres com filhos menores de dois anos, que frequentaram o pré-natal, estavam com o exame preventivo para câncer do colo do útero atrasado, sinalizando a existência de oportunidades perdidas de prevenção
Summary
Uterine cervical neoplasms/ prevention & control Mass screening Family health Women’s health. OBJETIVOS: Avaliar a adesão ao rastreamento para câncer do colo do útero em população assistida pela Estratégia Saúde da Família (ESF) e identificar as causas referidas da não adesão. MÉTODOS: Estudo de prevalência seletiva sobre rastreamento para câncer do colo do útero entre mulheres assistidas pela ESF dos municípios de Duque de Caxias e Nova Iguaçu, nove anos após a participação em estudo conduzido pelo Instituto Nacional de Câncer. Os resultados e os intervalos dos exames, as características socioeconômicas e demográficas, e as causas referidas de não adesão. As causas referidas para não adesão à coleta dos exames foram: não percepção de risco (44,6%), barreiras sociais (26,3%), barreiras percebidas à ação (22,3%) e barreiras institucionais (21,4%). CONCLUSÕES: Apesar das dificuldades e barreiras apontadas pelas mulheres, observou-se boa adesão ao rastreamento do câncer do colo do útero. Há necessidade de treinamento dos profissionais para cumprimento das recomendações do Ministério da Saúde quanto à regularidade de exames e facilitação do acesso ao rastreamento
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