Coverage of the Pap testing, breast ultrasound and mammography in women residents in a low-middle income city in Brazil : challenging for reducing inequalities
The cervical and breast screening tests for the detection of cancer is recognized as essential to the improvement of the mortality indicators of the female population. The aim of this study was to analyze the coverage of the Pap testing breast ultrasound and mammography in public or private services.
METHODS:
Household survey conducted with a representative sample in two stages of 515 women aged 19-102 years in 2013 in the city of Praia Grande, Brazil that has good coverage of primary care services. Independent variables included sociodemographic characteristics, health insurance and medical specialty. Dependents variables were breast ultrasound and mammography with cut point age in 40 years and Pap testing (cytology) with age categorized in “25-64”; “> 64 and <25” years. Pearson Qui-squared test or the Fisher exact test was applied for differences between proportions. The significance level was 5%.
RESULTS: The majority (73,8%) was aged between 19-59 years and 66% of them has low middle income. 21% had some health insurance positive associated with their income. The majority of the women did not run neither Pap Testing (70,3%) nor mammography (86%) in the last year, without statically differences between ages recommended for the screening tests by Brazilian Health Ministry or the medical specialty used (family doctors or gynecologist). Among all women that had run the tests most of them attended the public sector Pap Testing (65%) and mammography (63%). The breast ultrasound was ran for only 7% of the women, most of them were conducted in the private health sector. Women with health insurance have higher covers than the others, although the rates are still low
CONCLUSIONS: The results show that guaranteeing the access to a good complementary test net is essential for an appropriate primary care, inducing health improvement and contributing to reduce health inequalities. (Sponsor by CNPq-Brasil)