title: [Motives for abandoning the healthcare process for precancerous lesions of the uterine cervix].
abstract: OBJECTIVE
  To determine factors associated with medical care abandon of women with CIN.
  
  
  METHODS
  A nested case-control study in a cohort was done. Patients referred to clinical Dysplasia of Gyneco-Obstetrician Services in third level Hospitals were considered.
  
  
  METHODS
  Patients who abandoned medical care.
  
  
  METHODS
  women who attend their medical appointments during follow-up. All subjects underwent structured interviews focused on social, clinical and health services factors in two different times, applied at the beginning of study and the end of follow-up. Clinical records were reviewed to obtain clinical information.
  
  
  METHODS
  Descriptive and inferential statistical was done. Non conditional Logistic Regression analysis was done to obtain adjusted association.
  
  
  RESULTS
  Abandon cumulative incidence rate was 108/525 = 20.7% (I.C. 95% = 17.2-24.3); 60.2% happened in diagnosis phase, 17.7% ocured during therapeutic phase and 23.1% happened in surveillance phase. We studied 108 cases and 417 controls to analysis. Next adjusted risk factors were obtained: Afraid to death (ORa = 4.2, IC.95% = 1.8-9.5), long appointments (ORa = 6.6, I.C.95% = 3.4-13.0), lack of privacity (ORa = 12.5, I.C.95% = 2.6-59.8), reject to treatment (ORa = 40.4, I.C.95% = 2.1-785.4), lack of information (ORa = 41.9, I.C.95% =14.2-124.1) and other factors.
  
  
  CONCLUSIONS
  Patient perception, access and barriers in health services were the most important factors associated with medical care abandon.
authors.affiliation: Coordinación de Areas Médicas, UMAE Hospital de Oncologia, Centro Médico Nacional Siglo XXI.
authors.forename: Francisco R
authors.initials: FR
authors.lastname: Hernández-Alemán
authors.forename: Laura A
authors.initials: LA
authors.lastname: Ornelas-Bernal
authors.forename: Teresa
authors.initials: T
authors.lastname: Apresa-García
authors.forename: Sandra
authors.initials: S
authors.lastname: Sánchez-Garduño
authors.forename: Oscar A
authors.initials: OA
authors.lastname: Martínez-Rodríguez
authors.forename: Dulce Maria
authors.initials: DM
authors.lastname: Hernández-Hernández
mesh_terms: D000328:Adult; D001294:Attitude to Health; D016022:Case-Control Studies; D015331:Cohort Studies; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007406:Interview, Psychological; D008800:Mexico; D008875:Middle Aged; D009042:Motivation; D010352:Patient Dropouts / Q000523:psychology* / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D018579:Patient Selection; D011230:Precancerous Conditions / Q000523:psychology* / Q000628:therapy; D012307:Risk Factors; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000469:parasitology* / Q000628:therapy; D002578:Uterine Cervical Dysplasia / Q000523:psychology* / Q000628:therapy