Assessment of the cervical cancer screening in the Family Health Strategy in Amparo, Sao Paulo State, Brazil

Uterine cervical cancer mortality has not been declining. The territorial distribution and registration of families in Brazil's Family Health Strategy help identify women that have performed a Pap smear or that have not had one for more than three years. This study analyzed whether cervical cancer screening in Amparo, Sao Paulo State, Brazil, made progress in complying with the prevailing guidelines during the seven years of experience with the Strategy. The annual examination rate remained high, with a slight trend towards greater intervals between follow-up tests. Distribution of tests tended to increase in the 40-59-year age bracket and decrease in the over-60 age group, while annual coverage tended to decrease. The proportions of excess tests varied from 61.2% to 65.5%. Concluding, the upgrading of cervical cancer screening was slight, and did not change the opportunistic pattern of follow-up tests. Considering that community health agents can act to increase the coverage of these measures, it is essential to train them for this work.26238339

Cobertura e fatores associados à realização do exame de detecção do câncer de colo de útero em área urbana no Sul do Brasil: estudo de base populacional Cervical cancer screening coverage and associated factors in a city in southern Brazil: a population-based study

A cobertura do teste de Papanicolaou e fatores associados foram investigados entre mulheres de 20 a 59 anos de idade, residentes na área urbana de Florianópolis, Santa Catarina, Brasil. Foi realizado estudo transversal de base populacional com amostra aleatória por conglomerados. Examinaram-se dois desfechos: realização do Papanicolaou em algum momento na vida e exames em atraso (período maior que três anos desde o último teste ou nunca realizado). Entre 952 mulheres entrevistadas, 93% (IC95%: 91,5-94,7) realizaram o teste pelo menos uma vez na vida e 14% (IC95%: 11,8-16,2) estavam com o procedimento em atraso. Por meio da regressão de Poisson, constatou-se que estado civil, escolaridade, doenças crônicas autorreferidas e consulta médica foram fatores significativamente associados com ambos os desfechos. Idade, renda e internação hospitalar no último ano estiveram associadas somente com a realização do Papanicolaou na vida. A cobertura do teste de Papanicolaou foi elevada, porém existem disparidades socioeconômicas e demográficas, além do predomínio do rastreamento oportunístico.<br>This study focused on coverage of screening for cervical cancer and associated factors in women 20 to 59 years of age in Florianópolis, Santa Catarina State, Brazil, in 2009. This was a cross-sectional study using cluster random sampling. Two outcomes were examined: a history of at least one Papanicolaou test and delaying the test (never performed or performed more than three years previously). Among 952 women, 93% (95%CI: 91.5-94.7) had ever had a Pap smear, whereas 14% (95%CI: 11.8-16.2) had delayed the test. According to Poisson regression, both outcomes were associated with marital status, schooling, presence of chronic disease, and consulting a physician for other reasons. Age, income, and hospitalization in the previous year were only associated with ever having a Pap smear. Although test coverage was high, much of the screening was opportunistic. In addition, various social, economic, and demographic disparities influenced the odds of being screened