title: [Factors associated with women's failure to submit to Pap smears: a population-based study in Campinas, São Paulo, Brazil].
abstract: This study analyzes the prevalence of non-submittal to Pap smears according to socioeconomic, demographic, and health-related behavioral variables in women 40 years or older in Campinas, São Paulo State. This was a cross-sectional population-based study with a sample of 290 women. Based on multivariate analysis, factors associated with not having Pap smears were: age (40-59 years), race/ethnicity (black or mixed-race), and schooling (< 4 years). The following reasons were cited for not having Pap smears: considered unnecessary (43.5%), embarrassment (28.1%), and barriers related to health services (13.7%). The Unified National Health System performed 43.2% of the reported Pap smears. Health services should promote more equitable access to the health care system and improve the quality of care for women, since Pap smears are an effective tool against cervical cancer. The study confirmed that women's failure to obtain Pap smears is associated with social and racial inequality, placing these women at increased risk of cervical cancer.
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brasil.
authors.forename: Vivian Mae Schmidt Lima
authors.initials: VM
authors.lastname: Amorim
authors.forename: Marilisa Berti de Azevedo
authors.initials: MB
authors.lastname: Barros
authors.forename: Chester Luiz Galvão
authors.initials: CL
authors.lastname: César
authors.forename: Luana
authors.initials: L
authors.lastname: Carandina
authors.forename: Moisés
authors.initials: M
authors.lastname: Goldbaum
mesh_terms: D000328:Adult; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D065006:Papanicolaou Test; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D016012:Poisson Distribution; D012044:Regression Analysis; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D014626:Vaginal Smears / Q000523:psychology*; D016387:Women's Health