[Prevalence of epithelial squamous cell abnormalities and associated factors in women of a rural town of Colombia].
BACKGROUND
In spite of implementation of cytology-based cervical cancer screening in Colombia, mortality rates remain stable. The description of factors associated to cervical pre-neoplasic lesions is needed to establish strategies for mortality prevention.


OBJECTIVE
The prevalence of epithelial squamous cell abnormalities was determined to explore the association of cytology abnormalities with described risk factors.


METHODS
This population-based, cross-sectional study included 739 women randomly selected by age. A validated face-to-face questionnaire and conventional cervical cytology were used to collect the information. To establish the association between cervical abnormalities and some qualitative variables, the independent chi squared test was used. We also calculated prevalence ratio with their 95% confidence intervals. A logistic regression model was used to explore variables that potentially explain cytology abnormalities.


RESULTS
The prevalence of squamous cell abnormality was 15.8%. Among women with abnormal cytology, 10% presented atypical squamous cells of undetermined significance, 3.9% low grade squamous intra-epithelial lesion and 1.9% high grade squamous intra-epithelial lesion. The adjusted logistical regression analysis showed that history of sexual transmitted disease, two or more sexual partners during entire life and previous abnormal cytology were associated with cytology abnormalities.


CONCLUSIONS
The relation of epithelial squamous cell abnormalities with sexual behavior history reflexes the link between human papiloma virus infection and cervical cancer pre-neoplasic lesions. The frequency of use and knowledge about the purpose of cytology were factors that suggested other diagnostic limitations such as quality of cervical cytology or barriers to access health care. These latter factors may be the underlying basis for the high cervical cancer mortality rates.
Grisales
Hugo
H
Grupo Demografía y Salud, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia.
Vanegas
Angela Patricia
AP
Gaviria
Angela M
AM
Castaño
Jorge
J
Mora
Martín Alonso
MA
Borrero
Mauricio
M
Rojas
Carlos
C
Arbeláez
María Patricia
MP
Sánchez
Gloria I
GI
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003105:Colombia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D018307:Neoplasms, Squamous Cell / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology* / Q000517:prevention & control; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology* / Q000517:prevention & control