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[Associated factors for women's non-compliance for cervical cancer screening]
Dulce María Hernández-Hernández1, Filiberto Linaldi-Yépez, Teresa Apresa-García
1Unidad de Investigación Médica en Enferedades Oncológicas, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico. dulcema@servidot.unam.mx
Objective:
To identify the associated factors for non-compliance among women for the cervical cancer screening program.
Methods:
A case-control study was carried out in which cases were women who were just diagnosed with cervical cancer (confirmed with pathological study); controls were women not having cervical cancer (negative pathological study). Cases and controls had the same age, lived in the same geographical area and were selected from the primary care facilities. Lack of compliance for cervical cancer screening was defined as the time since the last cytology (no previous Pap test or > or =3 years since last Pap test). A logistic regression analysis served to identify the associated factors to the lack of compliance.
Results:
There were 279 cases and 392 controls included in the study. The rate of non-compliance among cases was 76.7% and among controls was 29.6%. Among cases 45.5% had never undergone Pap test compared with 9.9% of controls. Main risk factors for non-compliance to attend to cervical cancer screening were age > 65 years (aOR = 2.9, 95% CI 1.6-5-3); illiteracy (aOR = 3.8, 95% CI 1.7-6); use of public transportation to attend to the preventive service (aOR = 2.3, 95% CI 1.2-6.4); more than five pregnancies (aOR = 3.0, 95% CI 1.6-5.3) and lack of knowledge about cervical cancer (aOR = 4.2, 95% CI 3.6-7.2).
Conclusion:
The rate of non-compliance close to 30% was high; social and cultural risk factors were the most relevant.
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