Abstract
Cervical cancer is the third most common cause of cancer among women worldwide, and Pap smears are the best screening strategy for its detection. This study evaluated the prevalence and the associated factors of the non-performance of Pap smears among pregnant women above the age of 25 during prenatal care in the municipality of Rio Grande, Brazil, in 2013. The multivariate analysis was performed by Poisson regression evaluated by prevalence ratio (PR). Of the 1,474 pregnant women included in the study, 21.6% (95% CI, 19.5%-23.7%) had not been screened. The adjusted analysis evidenced a PR for the non-performance among puerperae with 0-4 years schooling of 2.14 (95% CI, 1.35-3.38) compared to those with 12 years or more. Reporting previous abortion and alcohol use during pregnancy showed a PR of 1.38 (1.10-1.73) and 1.39 (1.04-1.84) of not doing so compared to the other, respectively. Finally, performing 1-5 prenatal visits evidenced a PR of 1.35 (1.03-1.77) compared to the others. A high proportion of pregnant women non-performing Pap smears and non-compliance with the basic recommendation by the Brazilian Ministry of Health has been found. Health professionals should reinforce the need for this test and active search for pregnant women in the community with the profile described herein.
Highlights
Cervical cancer is the third most frequent tumor in the Brazilian female population, behind only breast and colorectal cancer
Despite having performed at least one prenatal care visit, two out of ten pregnant women had not been submitted to Pap smears, and they should have been
The main factors associated with the failure to perform were low schooling, previous abortion, alcohol intake during gestation and a low number of prenatal care visits
Summary
Cervical cancer is the third most frequent tumor in the Brazilian female population, behind only breast and colorectal cancer It is the fourth cause of cancer death among women in Brazil, with a mortality rate of 4.4/100,0001. Provided it is diagnosed early, only skin cancer has a more significant potential for prevention and cure than cervical cancer. Its main screening strategy is the conventional Pap smears (Papanicolaou). This test is recommended for women between 25 and 64 years of age and with a triennial frequency for those with two consecutive negative results[2]. Half of the cases are diagnosed in advanced stages of the disease, when the prognosis is worse[3]
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