Barriers to follow-up of abnormal Papanicolaou smears among women in Leon, Nicaragua.

Abstract:

:Cervical cancer screening programmes only succeed when the coverage, screening, treatment and follow-up of any abnormal results are of high quality. This study investigates the screening coverage and the quality of the follow-up of cervical cancer screening of women in León, Nicaragua, as well as the factors affecting coverage and barriers to follow-up. Two hundred and thirty-four sexually active women attending a public health centre (54), a public health post (63), or the gynaecology department of the public HEODRA hospital (117), were invited to answer an orally administered questionnaire. The screening coverage of cervical cancer was calculated and the follow-up after finding an abnormal screening result was assessed. The coverage was 60.6% (95% confidence interval 54.4-66.8%). One hundred and sixty-eight women (87%) were informed about the results. Eighteen (10, 7%) of the women who were informed about the results, were advised to have follow-up and 12 (66, 7%) of them did. Barriers to follow-up were financial constraints, pregnancy, postponement and absence of instruments/electricity. This study shows that the screening coverage and cytology services are adequate, but that there is insufficient follow-up and/or treatment after an abnormal screening result. In order to achieve a lower incidence and mortality of cervical cancer, follow-up and treatment after an abnormal screening result need to be improved. A visual inspection with acetic acid may be an attractive alternative.

journal_name

Trop Doct

journal_title

Tropical doctor

authors

Vastbinder MB,Castillo C,Bekkers RL

doi

10.1258/td.2009.090076

subject

Has Abstract

pub_date

2010-01-01 00:00:00

pages

22-6

issue

1

eissn

0049-4755

issn

1758-1133

pii

td.2009.090076

journal_volume

40

pub_type

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