Inequalities in the early detection of cervical cancer: a reality in the Costa Rica

Authors

DOI:

https://doi.org/10.15517/psm.v19i2.48122

Keywords:

cervical cancer, PAP smaer, Inequalities in health

Abstract

Introduction: Cervical cancer is one of the most common cancer types that affects the health of women worldwide. Objective: To determine if there are differences in the use of Pap smears at the regional level in Costa Rica, in order to visualize the inequalities related to the early detection of cervical-uterine cancer. Methodology. This study was conducted based on information from the 2014 National Household Survey. This survey is representative at the national level. R-Studio was used to estimate two multinomial regression models. The first one was used to explain the time that has elapsed since the last time women had a Pap smear. The second one was used to explain the reasons why women had never had a Pap smear. Data on the incidence of cervical cancer, from the National Tumor Registry of the Ministry of Health, were used in order to estimate the in-situ/invasive ratio. Results: Women who participate less regularly in screening are those residing in the Chorotega, Central Pacific and Huetar Caribbean regions. Compared to women in the Central region, women in these three regions are 80% (OR=1.80; p<0.01), 52% (OR=1.52; p=0.031) and 58% (OR=1.58; p<0.01) respectively more likely to have had a Pap screening 5 or more years ago, as compared to 1 to 2 years ago. Discussion: According to the results of this research, the Chorotega Region presents the most disadvantageous conditions in terms of the use of PAP, which represents a higher risk for women to develop lesions and cervical cancer. Conclusions: In order to reduce gaps and improve conditions of access to prevention, it is necessary to coordinate institutional efforts, both governmental and non-governmental, as well as the participation and protagonism of women.

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References

Agresti, A. (1990). Categorical Data Analysis. John Wiley and Sons.

Caro-Porras, N. (2017). Análisis epidemiológico de mujeres con carcinoma epidermoide de cérvix, 2007-2015. Acta médica costarricense, 59(1), 22-27. Recuperado de http://www.scielo.sa.cr/scielo.php?script=sci_arttext&pid=S0001-60022017000100022&lng=en&tlng=es

Castillo, I., Aguilar, K., Balaguera, D., González, H. y Mejía, M. (2013). Factores asociados al uso adecuado de la citología cérvica-uterina por mujeres de Cartagena (Colombia). Hacia La Promoción de la Salud, 18(2), 123-134. Recuperado de http://www.scielo.org.co/pdf/hpsal/v18n2/v18n2a10.pdf

Castillo, I., Sepúlveda, Y., Vergara, L., Zambrano, Y., Carval, M. y Álvarez, J. (2017). Factores asociados al uso de la citología cervicouterina en estudiantes de enfermería de la ciudad de Cartagena. Investigaciones Andina, 19(35), 45-48. Recuperado de https://www.redalyc.org/pdf/2390/239058067003.pdf

CCSS.SA.CR. (4 de febrero de 2019). Costa Rica reduce a la mitad impacto del cáncer de cérvix con Papanicoláu. El País. Recuperado de https://www.elpais.cr/2019/02/04/costa-rica-reduce-a-la-mitad-impacto-del-cancer-de-cervix-con-papanicoláu/

Chavaro, N., Arroyo, G., Alcázar, L., Muruchi, G. y Pérez, I. (2009). Cáncer Cervicouterino. Anuales de Radiología México. 1(61-79). Recuperado de medigraphic.com/pdfs/anaradmex/arm-2009/arm091g.pdf

Forman, D. y Sierra, M. (2016). Cancer in Central and South America: Introduction. The International Journal of Cancer epidemiology, 44(Supp 1). DOI: http://dx.doi.org/10.1016/j.canep.2016.04.008

Gil, J. y Castañeda, J. (2005). Una Mirada Al Valor de p en Investigación. Rev Colomb Psiquiatr Bogotá, D.C., Colombia, 3, 414–24.

Good, P. y Hardin, J. (2003). Common Errors in Statistics (and How to Avoid Them). John Wiley & Sons.

Gutierrez y Alarcon. (2008). Nivel de pobreza asociado al estadio de gravedad del cáncer ginecológico. Facultad de Medicina, 69(4), 239-243. Recuperado de http://www.scielo.org.pe/pdf/afm/v69n4/a04v69n4.pdf

Instituto Nacional de Estadística y Censos. (2014). Encuesta Nacional de Hogares Julio 2014. Instructivo Para El Personal Entrevistador [Archivo PDF]. Recuperado de https://www.inec.cr/sites/default/files/documentos/empleo/metodologias/manuales/meenaho2014-02.pdf

Instituto Nacional de Salud, Perú. (2013). Determinantes sociales para cáncer de cuello uterino [Archivo PDF]. Recuperado de https://www.ins.gob.pe/repositorioaps/0/4/jer/evidencias/2013/notas/14.Determinantes%20sociales%20para%20c%C3%A1ncer%20de%20cuello%20uterino.pdf

Lumley, T. (2019). Survey: Analysis of Complex Survey Samples. Rstudio.

Mendenhal, W., Beaver, R.J. y Beaver, B.M. (2010). Introducción a la probabilidad y estadística. (13ª Ed.). CENCAGE Learning.

Ministerio de Planificación Nacional y Política Económica. (2017). Costa Rica Estadísticas Regionales 2010 – 2015. Recuperado de https://documentos.mideplan.go.cr/share/s/_Tn8-gJRRRC91CPSZw2SMA

Ministerio de Planificación Nacional y Política Económica. (2019). Costa Rica Índice de Desarrollo Social (IDS) 2017 (actualización de 2019). Recuperado de https://documentos.mideplan.go.cr/share/s/L0GWBZnfRceDJjpxwm7zFQ

Ministerio de Salud. (2007). Normas y Procedimientos de Atención Integral a la Mujer para la Prevención y Manejo del Cáncer de Cuello de Útero para el I, II y III Nivel de Atención y Normas de Laboratorios de Citología.

Polit, D. (1996). Data Analysis and Statistics for Nursing Research. Appleton & Lange.

Quirós, I. (2015). El programa de prevención de cáncer de cérvix en Costa Rica [Archivo PDF]. Recuperado de https://ecancer.org/en/journal/article/578-the-cervical-cancer-prevention-programme-in-costa-rica/pdf/es.

Santamaría-Ulloa, C y Valverde-Manzanares, C (2019). Inequality in the Incidence of Cervical Cancer: Costa Rica 1980–2010. Front. Oncol, 8, 664. doi:10.3389/fonc.2018.00664

Santamaría-Ulloa, C., Quirós-Rojas, I., Montero-López, M. y Quesada-Leitón, H. (2021). Women's Participation in Pap Smear Screening in a Developing Country: Evidence for Improving Health Systems. Front. Oncol, 11, 642-841. doi:10.3389/fonc.2021.642841

Solidoro, Santisteban, Andrés. (2010). Pobreza, inequidad y cáncer. Acta Médica Peruana, 27(3), 204-206. Recuperado de http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1728-59172010000300009&lng=es&tlng=es.

Venables, W. y Ripley, B. (2002). Modern Applied Statistics With S. (4th Ed.). Springer.

Wickham, H., François, R., Henry, L. y Müller, K. (2019). dplyr: A Grammar of Data Manipulation en R package version 0.8.3. Rstudio [Software]

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Published

2021-12-07

Issue

Volume 19, Issue 2: january-june 2022

Section

Special Section: INISA, 45 years caring for the health of Costa Rica

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