title: The positive experience of screening quality among users of a cervical cancer detection center.
abstract: BACKGROUND
  Our objective was to determine the main factors associated with increased utilization of a cervical cancer screening program (CCSP) in a population with a high mortality rate due to cervical cancer.
  
  
  METHODS
  A population-based study was carried out in the Mexican state of Morelos, Mexico. The study population included 3,197 women between the ages of 15 and 49 years who were selected at random using a State Household Sampling Framework in the State of Morelos's 33 municipalities. The sample included 2,094 women with a history of a previous Papanicolaou (Pap) test.
  
  
  RESULTS
  A previous experience of good screening quality is strongly associated with greater use of the CCSP (OR = 4.2; 95% confidence interval [CI], 1.6-10.9). The educational level of the head of the family is related to more frequent use of Pap smear services. Women whose husbands have 13 or more years of education (OR = 1.8; 95% CI 1.1-2.9) were more likely to have been screened. Similarly, women who had used two or more family planning methods (OR = 1.6; 95% CI 1.2-2.1) and those who knew why the Pap test was given (OR = 3.0; 95% CI 2.1-4.3) had a better history of Pap screening.
  
  
  CONCLUSIONS
  In areas where coverage of cervical cancer screening is low, a CCSP that guarantees the quality of all the different elements of care is essential if obstacles to cervical cancer prevention are to be eliminated. It is of particular importance to take into account and satisfy the perceptions and expectations of the women at risk.
authors.affiliation: Dirección de Investigación en Enfermedades Crónicas, Instituto Nacional de Salud Pública (INSP), Secretaría de Salud (SSA), Av. Universidad 655, Col. Sta. Ma. Ahuacatitlán, 65208 Cuernavaca, Morelos, Mexico. elazcano@insp3.correo.mx
authors.forename: Eduardo César
authors.initials: EC
authors.lastname: Lazcano-Ponce
authors.forename: Sue
authors.initials: S
authors.lastname: Moss
authors.forename: Aurelio
authors.initials: A
authors.lastname: Cruz-Valdez
authors.forename: Patricia Alonso
authors.initials: PA
authors.lastname: de Ruíz
authors.forename: Carlos Javier
authors.initials: CJ
authors.lastname: Martínez-León
authors.forename: Salvador
authors.initials: S
authors.lastname: Casares-Queralt
authors.forename: Mauricio
authors.initials: M
authors.lastname: Hernández-Avila
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006296:Health Services; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology / Q000592:standards*; D008800:Mexico; D008875:Middle Aged; D065006:Papanicolaou Test; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control*; D014626:Vaginal Smears / Q000706:statistics & numerical data; D014932:Women's Health Services