Evaluation of the cervical cancer screening programme in Mexico: a population-based case-control study.
BACKGROUND
This study presents the evaluation of the Mexico City Cervical Cancer Screening Programme (CCSP). Uterine cervical cancer (CC) is still a major public health problem in Mexico. Various actions aimed at reducing mortality from CC have been unsuccessful with an estimated 62000 deaths reported between 1980 and 1995.


METHODS
The authors performed a study of cases and controls chosen on a population basis that included a sample of 233 cases of cancer in situ, and 397 cases of invasive cervical cancer obtained from eight hospitals, and a sample of 1005 controls representative of the general population. The results are presented stratified by case type, classified according to whether the cancer is invasive or not.


RESULTS
The results show low impact of the cervical cancer screening programme in Mexico. Women who had a history of use of the Papanicolaou smear (PAP), who did not seek testing due to gynaecological symptoms and who had received their PAP results, had a 2.63 times lower risk of developing invasive cervical cancer (OR = 0.38; 95% CI: 0.28-0.52).


CONCLUSIONS
The principal findings of this study in relation to the low impact of the screening programme in Mexico, are the low level of existing coverage and late use of health services by women at risk.
Hernández-Avila
M
M
Center for Research in Populational Health, National Institute Public Health, Cuernavaca, State of Morelos, Mexico.
Lazcano-Ponce
E C
EC
de Ruíz
P A
PA
Romieu
I
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000401:mortality / Q000473:pathology; D016022:Case-Control Studies; D002423:Cause of Death; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000706:statistics & numerical data*; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D065006:Papanicolaou Test; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology; D014626:Vaginal Smears / Q000706:statistics & numerical data