title: [The factors that determine participation in cervical cancer screening in the state of Morelos].
abstract: OBJECTIVE
  To determine the main factors associated to participation in an early detection program of cancer (DPC), in a population with a high cervical cancer (CC) mortality rate.
  
  
  METHODS
  A population-based, cross-sectional study was performed in the state of Morelos, which included 3,197 women aged between 15 and 49 years, randomly selected from a household sample frame of the 33 municipalities of the state.
  
  
  RESULTS
  Awareness of the utility of the Papanicolaou (Pap) test (OR 29.6, 95% CI 23.6-37) and a former history of gynecological symptoms (OR 1.7, 95% CI 1.2-2.4) predisposed to greater use of the DPC. Factors associated to the use of the Pap test were precedents of using one contraceptive (OR 1.4, 95% CI 1.1-1.8) or two or more contraceptives (OR 2.1, 95% CI 1.6-2.8).
  
  
  CONCLUSIONS
  In the state of Morelos, Mexico, screening for cervical cancer is offered opportunistically in the context of health care use. Therefore, the precedent of using health care services is the main determining factor for use of the DPC program. These results reveal the need to design alternative strategies to promote participation among women who have no access to health services, since they constitute the population group at highest risk of developing CC.
authors.affiliation: Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México. elazcano@insp3.insp.mx
authors.forename: E C
authors.initials: EC
authors.lastname: Lazcano-Ponce
authors.forename: S
authors.initials: S
authors.lastname: Moss
authors.forename: A
authors.initials: A
authors.lastname: Cruz-Valdez
authors.forename: P
authors.initials: P
authors.lastname: Alonso de Ruiz
authors.forename: S
authors.initials: S
authors.lastname: Casares-Queralt
authors.forename: C J
authors.initials: CJ
authors.lastname: Martínez-León
authors.forename: M
authors.initials: M
authors.lastname: Hernández-Avila
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000458:organization & administration* / Q000706:statistics & numerical data; D008800:Mexico; D008875:Middle Aged; D065006:Papanicolaou Test; D010349:Patient Compliance / Q000706:statistics & numerical data; D011897:Random Allocation; D012307:Risk Factors; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D014626:Vaginal Smears / Q000706:statistics & numerical data