Girianelli Vania Reis, Thuler Luiz Claudio Santos, Azevedo e Silva Gulnar
Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Rev Bras Ginecol Obstet. 2014 May;36(5):198-204. doi: 10.1590/s0100-7203201400050003.
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.
评估宫颈癌筛查项目的依从性，并确定作为家庭健康战略一部分接受护理的女性中报告的筛查不足的原因。
对巴西东南部里约热内卢州卡希亚斯公爵城和新伊瓜苏市作为家庭健康战略一部分接受护理的女性进行宫颈癌筛查的选择性患病率研究，这是她们参与巴西国家癌症研究所先前研究九年后。只有那些在组织病理学上未被诊断为CIN II或更严重病变、在研究期间未接受子宫切除术且仍居住在社区的女性才有资格参与研究。获取了关于检查地点、检测结果和时间表、社会人口学特征以及报告的不依从原因的信息。通过访谈和病历审查收集数据。估计了筛查依从性的患病率，并使用卡方检验比较所研究变量之间的比例及其与报告的筛查不依从原因的关系。
共采访了764名女性，其中70.7%接受了充分的宫颈癌筛查。报告的筛查不足的原因包括：无风险感知（44.6%）、社会障碍（26.3%）、行动感知障碍（22.3%）和机构障碍（21.4%）。除机构障碍外（p = 0.19），这些原因在新伊瓜苏居民中的比例高于卡希亚斯公爵城居民（p<0.01）。
尽管报告了困难和障碍，但在所研究的女性中对宫颈癌筛查的依从性良好。卫生保健提供者应接受适当培训，以遵守巴西卫生部定期检测的指南，并促进获得筛查服务。
