Coverage and focus of a cervical cancer prevention program in southern Brazil
de Quadros, C.Alberto.Temes.; Victora, C.Gomes.; da Costa, J.Soares.Dias.
Revista Panamericana de Salud Publica 16(4): 223-232
2004
ISSN/ISBN: 1020-4989 PMID: 15615596 Document Number: 241559
Objective: To determine the coverage and focus of cervical cancer screening (Pap smear) in a population-based sample in Pelotas, Rio Grande do Sul, Brazil. Methods: A cross-sectional cluster survey including 1730 sexually active women aged 20 years or older was performed. Information on social, demographic and behavioural variables, knowledge of and use of the Pap test was collected between February and April 2002. Results: Of women aged 25-59 years, who were the target population of the national cervical cancer screening programme, 78.7% had at least one Pap test in their lifetime, and 68.8% had a Pap test in the last 3 years. Statistical analysis for focus of the programme showed that of the 637 women who reported having a Pap test in the previous year, only 20.6% actually required one. The remainder were either outside the age range or had another test less than 30 months previously. The 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 3 or more risk factors). Focus was inversely related to socioeconomic status. Conclusion: The coverage rates are similar to those reported in other national studies, but this is the first report to examine the focus of the national programme. The coverage levels remain unacceptably low among women of low socioeconomic status and those at greatest risk for cervical cancer.