Adherence to cervical cancer screening among woman from communities assisted by the Family Health Strategy at the Baixada Fluminense, Rio de Janeiro State, Brazil

PURPOSE: To assess the adherence to a cervical cancer screening program and to identify reported reasons for inadequate screening in women receiving care as part of the Family Health Strategy. METHODS: A selective prevalence study on cervical cancer screening in women receiving care as part of the Family Health Strategy in the cities of Duque de Caxias and Nova Iguacu in the state of Rio de Janeiro, southeastern Brazil, nine years after they participated in a previous study of the Brazilian National Cancer Institute. Only those women who were not diagnosed with CIN II or more severe lesions by histopathology, did not undergo hysterectomy during the study period and still resided in the communities were eligible to participate in the study. Information on exam sites, test results and schedules, sociodemographic characteristics and reported reasons of non-adherence was obtained. Data were collected through interviews and medical record review. The prevalence of adherence to screening was estimated, and the chi-square test was used to compare proportions between the variables studied and their relationship with the reported reasons of non-adherence to screening. RESULTS: A total of 764 women were interviewed, 70.7% of whom received adequate cervical cancer screening. The reported reasons for inadequate screening included: no risk perception (44.6%), social barriers (26.3%), perceived barriers to action (22.3%) and institutional barriers (21.4%). These reasons were proportionately higher among residents of Nova Iguacu than among residents of Duque de Caxias (p<0.01), except for institutional barriers (p= 0.19). CONCLUSIONS: Although difficulties and barriers were reported, there was good adherence to cervical cancer screening among the women studied. Health providers should receive proper training for complying with the Brazilian Ministry of Health guidelines of regular testing and to facilitate access to screening.