de Quadros Carlos Alberto Temes, Victora Cesar Gomes, da Costa Juvenal Soares Dias
Programa de Pós-graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brazil.
Rev Panam Salud Publica. 2004 Oct;16(4):223-32. doi: 10.1590/s1020-49892004001000001.
To determine the coverage and focus of cervical cancer screening (Pap smears) in a population-based sample in Brazil.
Cross-sectional cluster survey covering 1730 women aged 20 years or older with a history of sexual activity. Information was collected on social, demographic and behavioral variables, knowledge of and use of the Pap test.
Of women aged 25-59 years, who are the target population of the national cervical cancer screening program, 78.7% had had at least one Pap test in their lifetime, and 68.8% had had a Pap test in the last 3 years. Statistics for focus of the program showed that of the 637 women who reported having a Pap test in the last year, only 20.6% actually required one. The remainder were either outside the age range or had had another test less than 30 months previously. Prevalence of not having been tested in the previous 3 years was highest among black (41.7%) and low-income women (64.3%), and among those at greatest risk for cervical cancer (62.3% for women with three or more risk factors). Focus was inversely related to socioeconomic status.
Coverage rates were similar to those reported in other national studies, but this is the first report to examine the focus of the national program. We show that 8 of every 10 Pap tests were not necessary. Coverage levels remain unacceptably low among women of low socioeconomic status and those at greatest risk for cervical cancer.
确定巴西一项基于人群的样本中宫颈癌筛查（巴氏涂片检查）的覆盖范围和重点。
对1730名20岁及以上有性活动史的女性进行横断面整群调查。收集了关于社会、人口和行为变量、巴氏试验的知识及使用情况的信息。
全国宫颈癌筛查计划的目标人群为25 - 59岁的女性，其中78.7%的女性一生中至少进行过一次巴氏试验，68.8%的女性在过去3年中进行过巴氏试验。该计划重点方面的统计数据显示，在报告去年进行过巴氏试验的637名女性中，实际上只有20.6%的人需要进行该项检查。其余的要么不在年龄范围内，要么在不到30个月前进行过其他检查。在过去3年中未接受检查的比例在黑人女性（41.7%）、低收入女性（64.3%）以及宫颈癌高危女性（有三个或更多危险因素的女性中为62.3%）中最高。重点与社会经济地位呈负相关。
覆盖率与其他全国性研究报告的相似，但这是第一份检查国家计划重点的报告。我们发现每10次巴氏试验中有8次是不必要的。社会经济地位低的女性和宫颈癌高危女性的覆盖水平仍然低得令人无法接受。
