Cervical cancer control limiting factors and facilitators: a literature review.

Viviane Aparecida Siqueira Lopes,José Mendes Ribeiro

doi:10.1590/1413-81232018249.32592017

Viviane Aparecida Siqueira Lopes, José Mendes Ribeiro

Open Access

https://doi.org/10.1590/1413-81232018249.32592017

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Abstract

This paper reviews the limiting factors and facilitators of access to Brazilian cervical cancer care public health services. This review employed bibliographic database Medline (interface with the Virtual Health Library/BVS and PubMed) and Lilacs / SciELO portals. We sought publications for the period 2011-2016 based on the use of specific terms from the sources consulted, regarding "cervical neoplasms" and "access to health services". We found 704 papers initially, which were shortlisted to 31 following adopted criteria, which were further reduced to 19 papers to make up the final selection. Access facilitating aspects such as wide coverage of the Pap smear test and coverage of biopsies equivalent to the number of altered prevention tests were mentioned. However, access limiting aspects such as inadequate Pap smear's periodicity, difficulties in scheduling appointments and exams, high rate of advanced staging and delays in diagnosis and treatment onset were also reported.

Highlights

Cervical cancer (CC) is an important public health issue, causing the death of 5,430 women in Brazil in 2013
Some 16,340 new cases are expected to occur, with an estimated risk of 15.85 cases for every 100,000 women[1]. This cancer is mainly caused by persistent infection via sexually transmitted oncogenic subtypes of the Human Papillomavirus (HPV), which is responsible for about 70% of cervical cancers[2]
It aimed to highlight the barriers to access to health services for CC control and to record advances related to this access, signaled in papers addressing the Brazilian public health system and published in a recent period related to secondary prevention or early detection, diagnosis and treatment of CC

Summary

Introduction

Cervical cancer (CC) is an important public health issue, causing the death of 5,430 women in Brazil in 2013. Other more comprehensive studies build on the process that begins with the desire to obtain health care, seeking health services, entering facilities thereof, through continuity of care, achieving its results, and is understood as a “broad realm”[14]. The latter are consistent with the definition of access as the “use of health services appropriate to people’s needs at the appropriate time and place”[14]. It aimed to highlight the barriers to access to health services for CC control and to record advances related to this access, signaled in papers addressing the Brazilian public health system and published in a recent period related to secondary prevention or early detection, diagnosis and treatment of CC

Methods

Results and discussion

Study design