Asistencia a citología del cuello uterino y sus determinantes en una población rural colombiana, 1998-1999

Abstract

RESUMENObjetivos Establecer la prevalencia de uso de la citología del cuello uterino e identificar los factores que determinan la asistencia a este examen. Métodos Estudio de corte transversal en voluntarias de un programa de prevención de cáncer de cuello uterino realizado en Mogotes, Colombia. Se calcularon razones de prevalencia (RP). La variable dependiente fue el antecedente de asistencia a citología. Se recolectaron características sociodemográficas, clínicas, familiares y de hábitos. Resultados La prevalencia de asistencia previa a citología fue 67,3 %. A mayor edad de la mujer aumentaba la probabilidad de tener una citología anterior. El uso de métodos de planificación familiar que requerían control (RP: 1,4; IC95%: 1,2-1,7) y la residencia rural (RP: 0,9; IC95%: 0,8-1,0) también fueron factores que determinaron su utilización. Conclusiones Estos datos confirman que vivir en zonas rurales está asociado con una menor oportunidad de la mujer para acceder al examen citológico.Palabras Clave: estudios transversales, prevalencia, frotis vaginal, accesibilidad a los servicios de salud (fuente: DeCS, BIREME) ABSTRACT

Inequities in cervical cancer screening among Colombian women: A multilevel analysis of a nationwide survey

“…The proportion of women who have had at least one Pap test varies across and within countries [14,15,[30][31][32][33]. In this 2010 study, we found that 87% of the women in Colombia have ever had a Pap test.…”

“…Other authors have reported that younger women have reduced probabilities of having Pap test [14,16,25,31,32], especially if residing in rural areas [14]. Although better coverage of subsidised health insurance in rural areas has been reported in Colombia [21], people with subsidised health insurance receive 40% less health care compared to those with contributory health insurance [21].…”

“…[32], and in 2005, in a nationwide sample, 90% of women between 25 and 69 years reported having a recent Pap test [15]. In contrast, a 1998-1999 study found that 67% of women had a Pap test in a municipality located in the Eastern region [14], and another study in 2007 identified that 56% of university students living in a city located in the Pacific region had at least one Pap test [33]. Notwithstanding, our results provide a recent nationwide figure of Pap testing among Colombian women, evaluating differences by socioeconomic and contextual factors.…”

“…In Colombia, women living in rural regions have a lower health status [35] and face high poverty levels, poor possibilities for having a job and receiving a fair income, and limited access to housing, education and health care [36]. Other problems in rural Colombia are the distance between one's home and a health care centre [14,24], violence and war, high vulnerability of youth and women [37], and a lack of knowledge about the SGSSS and the health care rights that citizens have [38].…”

“…Studies conducted in Colombia have identified differences in access to Pap testing between rural and urban areas and among geographic region of residence [13,14], educational level [15], wealth quintile [15], age group [15,16], and type of health insurance [16]. Colombia has an insurance-based health care system, the Sistema General de Seguridad Social en Salud (SGSSSthe General Social Security System in Health), with two schemes: contributory and subsidised [17].…”