Educational interventions for cervical cancer prevention: a scoping review

OBJECTIVES

to identify, map and describe characteristics of educational interventions for cervical cancer prevention in adult women.

METHODS

a scoping review conducted on eleven databases and the gray literature, including studies that described educational interventions aimed at preventing cervical cancer in adult women.

RESULTS

thirty-three articles with 151,457 participants were analyzed. The most used educational strategies were participatory discussions and educational leaflets. Most of the interventions took place in a single session, ranging from 40 to 60 minutes. The most used theoretical model in interventions to improve women's compliance with Pap smear was the Health Belief Model.

CONCLUSIONS

group discussions, lectures and educational brochures can increase knowledge and reduce barriers to cervical cancer prevention. Theory-based and culturally sensitive interventions can have a positive impact on women's health.

Cytological screening for cervical cancer and associated factors in the penitentiary population of Peru

OBJECTIVE

To determine the prevalence and factors associated with the screening of cervical cancer by Papanicolaou in the penitentiary population of Peru.

METHOD

A cross-sectional study was conducted using data from the 2016 National Penitentiary Population Census of Peru. The dependent variable was the cytological screening of cervical cancer during the last year. The independent variables were classified as facilitators, sociodemographic predisposers, and generators of need for the use of health services.The multivariate association was estimated through adjusted prevalence ratios (aPR) and 95% confidence intervals (95% CI), using Poisson regression and using the variables with p <0.05 in the bivariate.

RESULTS

A total of 4515 women incarcerated in the 67 prisons of Peru entered the study. 69% (95% CI: 67.81-70.5) performed cytological screening during the last year and this is associated with having public health insurance (aPR 1.28 , 95% CI: 1.21-1.36), go to prison health services (aPR 1.18 , 95% CI: 1.12-1.24) and have a history of cancer (aPR 1.14, 95% CI: 1.02-1.26). Age, number of children, sports activities and the type of prison were also associated with cytological screening.

DISCUSSION

There is an association between cytological screening and access to health services, sociodemographic predispositions and pathological backgrounds of women incarcerated in Peru. More research should be promoted on health prevention behaviors in this population.

[Women's health prevention indicator: a proposal for combining mammography and Papanicolaou smear]

This article proposes a women's health prevention indicator (WHPI) reflecting the combined status of mammography and Papanicolaou (Pap) smear according to the recommendations for age and considering the time elapsed since the last exam/test. The WHPI classifies prevention status into desirable, alert, or risk categories. The risk category includes women of all ages who never had a Pap smear, those aged >60 years who had a Pap smear more than 3 years ago but never had a mammography, and those aged ≥71 years who are up to date with the Pap smear but never had a mammography. The desirable category includes women with a Pap smear in the past 3 years, except women aged ≥41 who never had a mammography and those aged ≥51 years who had a mammography more than 2 years earlier. The alert category includes women whose Pap smear is more than three years old with the exception of those ≥61 years who never had a mammography and those aged ≥71 years whose mammography is more than 2 years old. For women who had experienced a Pap smear in the past 3 years, the alert category includes those aged 41-50 years who never had mammography, those aged 51-70 years with mammography older than 2 years or no mammography, and those aged ≥71 years with mammography older than 2 years. Applying the WHPI to data from the National Household Sample Survey of 2008 revealed that 24.8% of Brazilian women were at risk and 24.2% were in the alert category. The Northeast and the North had the highest risk rates (31.5% and 29.6% respectively). Of those >70 years old, 49.5% were in the risk category. The WHPI can be used to assess public initiatives and compare preventive status within and across regions.