title: Factors that affect the quality of cytologic cervical cancer screening along the Mexico-United States border.
abstract: OBJECTIVE
  The purpose of this study was to identify the factors that affect the quality of cytologic cervical cancer screening conducted in public sector clinics in Sonora, Mexico.
  
  
  METHODS
  We assessed the quality of cervical cytology before and after a 2-hour training session and the implementation of cervical spatulas and endocervical brushes. Additionally, we conducted a cross-sectional study of reproductive aged women who attended public clinics in paired border communities in Sonora and Arizona. Cervical cytologic specimens (n=2436) were collected and compared for adequacy and cytologic diagnosis and for the prevalence of human papillomavirus infection.
  
  
  RESULTS
  The training intervention achieved significantly improved the rates of satisfactory but limited smears and unsatisfactory smears. The cross-sectional study revealed comparable quality indicators for cytologic specimens that were collected in Sonora and Arizona clinics.
  
  
  CONCLUSIONS
  A high-quality cytology-based cervical cancer screening program is possible in public sector clinics in Sonora, with indicators similar to those achieved in comparable Arizona clinics.
authors.affiliation: Department of Obstetrics and Gynecology, University of Arizona Health Sciences Center, Tucson 85724, USA.
authors.forename: Francisco
authors.initials: F
authors.lastname: Garcia
authors.forename: Elena
authors.initials: E
authors.lastname: Mendez de Galaz
authors.forename: Susie
authors.initials: S
authors.lastname: Baldwin
authors.forename: Mary
authors.initials: M
authors.lastname: Papenfuss
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
authors.forename: Kenneth
authors.initials: K
authors.lastname: Hatch
authors.forename: John
authors.initials: J
authors.lastname: Davis
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000592:standards*; D008800:Mexico / Q000453:epidemiology; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology; D010865:Pilot Projects; D015995:Prevalence; D011787:Quality of Health Care; D014412:Tumor Virus Infections / Q000150:complications / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000821:virology