Cervical Cancer Screenning Among Rural Brazilian Women
a, Faculdade de Medicina de Ribeirão Preto, , bDepartment of Clinical Oncology, Fundação Pio XII â Hospital de Câncer de Barretos, Barretos-Brazil, , cDepartment of Gynecological Oncology, , dDepartment of Anatomic Pathology, , eDepartment of Surgery
Women living in rural regions tend to have poorer cancer survival rates than the general population. A study was designed to evaluate a method of active search of cases of cervical cancer in the rural area of Barretos, Brazil, an area of 4.132 squared kilometers were live 1.566 women above 15 years of age. The total area was divided in several smaller areas and in each one was identified a place were the examination could be performed by a nurse: community center, church houses, schools and farm houses. The women were interviewed in these places and the material for examination was collected in a mobile unit placed near by. During the week days the women were contacted by the driver of the school bus or by the volunteers of the Rural Female Police who invited then to submit to examination in the next Saturday. When a women didnât come, the mobile unit went to her house to perform the examination. Of the 1.517 women interviewed 436 didnât submit to the examination for several reasons (pregnancy, examination in the previous 6 months, virginity, etc). Of the remainder 1.081 women, 1.047 (96,9%) were examined and 34 (3,1%) refused to underwent to examination. As results were found 4 women with carcinoma in situ and 2 with invasive squamous cell carcinoma. The delivery of health care to rural women in Brazil presents a very hard work to health care providers because of their poverty, less schooling, difficult approaches to geographical areas and intermediate dependable people is needed with accessible language and already known by that population. In spite of these difficulties, this method of active search of cases proved to be feasible and efficient as can be seen by the high percentage of examined women.
Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Nice, France; February 7 - 10, 2004; in poster session 992 (Screening & detection).