Coverage and focus of a cervical cancer prevention program in southern Brazil.
OBJECTIVE
To determine the coverage and focus of cervical cancer screening (Pap smears) in a population-based sample in Brazil.


METHODS
Cross-sectional cluster survey covering 1730 women aged 20 years or older with a history of sexual activity. Information was collected on social, demographic and behavioral variables, knowledge of and use of the Pap test.


RESULTS
Of women aged 25-59 years, who are the target population of the national cervical cancer screening program, 78.7% had had at least one Pap test in their lifetime, and 68.8% had had a Pap test in the last 3 years. Statistics for focus of the program showed that of the 637 women who reported having a Pap test in the last year, only 20.6% actually required one. The remainder were either outside the age range or had had another test less than 30 months previously. Prevalence of not having been tested in the previous 3 years was highest among black (41.7%) and low-income women (64.3%), and among those at greatest risk for cervical cancer (62.3% for women with three or more risk factors). Focus was inversely related to socioeconomic status.


CONCLUSIONS
Coverage rates were similar to those reported in other national studies, but this is the first report to examine the focus of the national program. We show that 8 of every 10 Pap tests were not necessary. Coverage levels remain unacceptably low among women of low socioeconomic status and those at greatest risk for cervical cancer.
de Quadros
Carlos Alberto Temes
CA
Programa de Pós-graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brazil.
Victora
Cesar Gomes
CG
da Costa
Juvenal Soares Dias
JS
D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D065006:Papanicolaou Test; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D014626:Vaginal Smears / Q000706:statistics & numerical data*