title: [Social determinants of dropout from diagnosis and treatment by women with abnormal Pap smears in Buenos Aires, Argentina].
abstract: OBJECTIVE
  Determine the extent and reasons why women with abnormal Pap smears drop out from diagnosis and treatment, and the relationship between women's socioeconomic characteristics and dropping out.
  
  
  METHODS
  Cross-sectional retrospective study. Analysis of secondary sources and household interviews with women with abnormal Pap smears seen in the public municipal system from 2009 to 2011.
  
  
  RESULTS
  Confirmed dropout in the study population was 18.3%. Women with the greatest probability of dropping out lived in homes where there were children under five (probability ratio [PR]: 2.4; 95% confidence interval [95%CI]: 1.2-4.8) and where there was overcrowding (PR: 2.9; 95%CI: 1.2-7.3). Women whose initial Pap smear was done in a primary care center had a 4.6 times greater probability of dropping out than those seen in a hospital (95%CI: 1.7-12.3). The main reasons reported for dropping out were problems with health services organization and domestic workload.
  
  
  CONCLUSIONS
  Women's living conditions and the organization and quality of health services affect dropout from diagnosis and treatment of precancerous lesions. Strategies need to be developed that address social determinants of dropping out as a way to ensure effectiveness of cervical cancer screening programs.
authors.affiliation: Consejo Nacional de Investigaciones Científicas y Técnicas, Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina, melisa@cedes.org.
authors.forename: Melisa
authors.initials: M
authors.lastname: Paolino
authors.affiliation: Agencia Internacional para la Investigación del Cáncer, Lyon, Francia.
authors.forename: Rengaswamy
authors.initials: R
authors.lastname: Sankaranarayanan
authors.affiliation: Consejo Nacional de Investigaciones Científicas y Técnicas, Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina, melisa@cedes.org.
authors.forename: Silvina
authors.initials: S
authors.lastname: Arrossi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina; D003441:Crowding; D055088:Early Detection of Cancer; D004522:Educational Status; D005191:Family Characteristics; D005260:Female; D019538:Health Care Surveys; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D019458:Insurance Coverage; D008875:Middle Aged; D009042:Motivation; D065006:Papanicolaou Test; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data; D011203:Poverty; D064890:Social Determinants of Health; D014505:Urban Population / Q000706:statistics & numerical data; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000191:economics / Q000523:psychology* / Q000628:therapy; D055815:Young Adult