Monteiro Paula Bruno, Monteiro Filho Marcelo Praxedes, de Figueirêdo Jéssica Teixeira, Saintrain Maria Vieira de Lima, Bruno Zenilda Vieira, Carvalho Francisco Herlânio Costa
Public Health Graduate Program, University of Fortaleza (UNIFOR), Fortaleza, Brazil. E-mail:
Asian Pac J Cancer Prev. 2017 Sep 27;18(9):2513-2518. doi: 10.22034/APJCP.2017.18.9.2513.
Background: Cervical cancer is one of the most serious threats to women’s lives. Therefore, the present study aimed to know the dynamics in the collection of cytologic samples during antenatal care as a method of cervical cancer screening and to identify the factors associated with its performance. Material and Methods: Analytical cross-sectional study carried out with pregnant and postpartum women in Fortaleza, Ceará, Northeastern Brazil. Data were collected using a questionnaire addressing sociodemographic variables, antenatal care, pregnancy and cytology-based screening for cervical cancer during antenatal care. Measures of central tendency were calculated and the Chi-squared test and Fisher’s exact test were used with a significance level of 5%. Results: Participants were 229 pregnant women and 89 postpartum women. Age ranged 18 to 43 years, with a mean of 27.9 years (SD=6.1). Only 35 (11%) participants had Pap smears during antenatal care. A total of 283 women did not have Pap smears during pregnancy; of these, 229 (80.9%) did not have the test because of lack of clear information from the health professional, 25 (8.8%) for fear of bleeding or abortion, and 29 (10.3%) because they had had the test before pregnancy. Undergoing cytology-based screening for cervical cancer was associated with high-risk pregnancy (p=0.002), antenatal care provided by a physician (p=0.003), knowledge about the possibility of having the test during pregnancy (p<0.001) and paid job (p=0.043). Conclusion: The percentage of cytology-based screening for cervical cancer during antenatal care was low. Therefore, health education is suggested to improve this figure. However, receiving antenatal care at MEAC, having consultations with a physician, and knowing that it is possible to have a Pap smear during pregnancy were significant protective factors for undergoing cytology screening during pregnancy.
宫颈癌是对女性生命最严重的威胁之一。因此，本研究旨在了解产前检查期间细胞学样本采集的动态情况，将其作为宫颈癌筛查的一种方法，并确定与其实施相关的因素。
对巴西东北部塞阿拉州福塔莱萨市的孕妇和产后妇女进行分析性横断面研究。通过问卷调查收集社会人口统计学变量、产前检查、妊娠情况以及产前检查期间基于细胞学的宫颈癌筛查等数据。计算集中趋势指标，并使用卡方检验和费舍尔精确检验，显著性水平为5%。
参与者包括229名孕妇和89名产后妇女。年龄在18至43岁之间，平均年龄为27.9岁（标准差=6.1）。只有35名（11%）参与者在产前检查期间进行了巴氏涂片检查。共有283名妇女在怀孕期间未进行巴氏涂片检查；其中，229名（80.9%）未进行检查是因为卫生专业人员未提供明确信息，25名（8.8%）是因为担心出血或流产，29名（10.3%）是因为在怀孕前已经进行过该检查。接受基于细胞学的宫颈癌筛查与高危妊娠（p=0.002）、由医生提供产前检查（p=0.003）、了解怀孕期间进行该检查的可能性（p<0.001）以及有带薪工作（p=0.043）相关。
产前检查期间基于细胞学的宫颈癌筛查比例较低。因此，建议开展健康教育以提高这一比例。然而，在综合卫生保健中心接受产前检查、与医生进行咨询以及了解怀孕期间可以进行巴氏涂片检查是怀孕期间接受细胞学筛查的重要保护因素。
