[Motives for abandoning the healthcare process for precancerous lesions of the uterine cervix].
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.
Hernández-Alemán
Francisco R
FR
Coordinación de Areas Médicas, UMAE Hospital de Oncologia, Centro Médico Nacional Siglo XXI.
Ornelas-Bernal
Laura A
LA
Apresa-García
Teresa
T
Sánchez-Garduño
Sandra
S
Martínez-Rodríguez
Oscar A
OA
Hernández-Hernández
Dulce Maria
DM
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