[Women's health prevention indicator: a proposal for combining mammography and Papanicolaou smear]

This article proposes a women's health prevention indicator (WHPI) reflecting the combined status of mammography and Papanicolaou (Pap) smear according to the recommendations for age and considering the time elapsed since the last exam/test. The WHPI classifies prevention status into desirable, alert, or risk categories. The risk category includes women of all ages who never had a Pap smear, those aged >60 years who had a Pap smear more than 3 years ago but never had a mammography, and those aged ≥71 years who are up to date with the Pap smear but never had a mammography. The desirable category includes women with a Pap smear in the past 3 years, except women aged ≥41 who never had a mammography and those aged ≥51 years who had a mammography more than 2 years earlier. The alert category includes women whose Pap smear is more than three years old with the exception of those ≥61 years who never had a mammography and those aged ≥71 years whose mammography is more than 2 years old. For women who had experienced a Pap smear in the past 3 years, the alert category includes those aged 41-50 years who never had mammography, those aged 51-70 years with mammography older than 2 years or no mammography, and those aged ≥71 years with mammography older than 2 years. Applying the WHPI to data from the National Household Sample Survey of 2008 revealed that 24.8% of Brazilian women were at risk and 24.2% were in the alert category. The Northeast and the North had the highest risk rates (31.5% and 29.6% respectively). Of those >70 years old, 49.5% were in the risk category. The WHPI can be used to assess public initiatives and compare preventive status within and across regions.