Prevalência e fatores associados a não realização do exame citopatológico do colo do útero na zona norte do município de Juiz de Fora

Abstract

Among the various types of neoplasias, cervix cancer is considered a public health problem in Brazil having high incidence and it is responsible for the death of a significant number of women yearly. Since the disease natural evolution is well known and its testing at early stages available (when there is chance of cure), it has been observed that over time the incidence of this type of cancer remains high and its diagnosis often made at advanced stages, raising concerns then as to how effective the actions of prevention are. Based on this fact, this study aimed to estimate the prevalence of non-performance of such tests in the population north of the city of Juiz de Fora / MG and identify possible factors associated with such nonperformance and the situation of not being up-to-date with Pap smear test (more than three years overdue). As such, we opted to carry out a cross-sectional study through a household survey. The data collection instrument used was a standardized questionnaire seeking information focusing on the household and the woman. The sample was calculated with complex geographical stratification and clustering totaling 308 women with children under two years. Two outcomes have been chosen: "no Pap smear testing" and " test taken on delay." The bivariate statistical analysis was performed by applying the chi-square statistic to measure the association between independent variables and the outcomes. For multivariate analysis logistic regression was adopted, seeking to measure the association of each independent variable with outcomes controlled by other independent variables. At the end of the study it has been found a prevalence of non-performance of such tests of 21.3% (IC95%: 17.0- 26.4). The variable that showed significant association with the outcome not undergoing the test in the logistic regression model was the education of women (OR:0,413; IC95%: 0,223-0,766). As to the outcome review in arrears, the variables that were statistically significant in the final model were: marital status (OR: 0,152; IC95%: 0,027-0,845), performing pelvic examination during prenatal care (OR 0,341; IC95%: 0,185-0,629) and number of prenatal visits (OR 0,092; IC95%: 0,034-0,252). It has been concluded that the prevalence of non-Pap smear testing in the above population is slightly below than that indicated by the World Health Organization and also that this varied according to some characteristics of women evaluated in this study. Also special attention is the finding that the realization of prenatal care was not crucial to attaining the second Pap smear frequency recommended.