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© 1998 Oxford University Press

research-article

Evaluation of the cervical cancer screening programme in Mexico: a population-based case-control study

Mauricio Hem´ndez-Avilaa, Eduardo César Lazcano-Poncea,, Patricia Alonso de Ruízb and Isabelle Romieuc

aCentro de investigaciones en Salud Poblacional-Center for Research In Populational Health, National Institute Public Health-Instituto Nacional de Salud Pública, Cuernavaca State of Morelos, Mexico
bUNAM (Universidad Nacional Autónorna de Mexico-National Autonomous University of Mexico, School of Medidne) Pathology Unit of the Mexico City General Hospital Ministry of Health
Institute for Human Ecology and Health, Pan American Health Organization Metepec, Edo, de Mexico, (PAHO)

Reprint requests: Dr Eduardo César Lazcano-Ponce, Instituto Nacional de Salud Pública, Centro de Investigaciones en Salud Pobiadonal, Avenida Universldad 655, colonia Sta. Ma. Ahuacatitl´n. C.P. 62508 Cuernavaca, Moreios, México. E-mail: elazcano{at}insp3.insp.mx

BACKGROUND: This study presents the evaluation of the Mexico City Cervical Cancer Screening Programme (CCSP). Uterine cervical cancer (CC) is still a major public health problem in Mexico. Various actions aimed at reducing mortality from CC have been unsuccessful with an estimated 62 000 deaths reported between 1980 and 1995.

METHODS: The authors performed a study of cases and controls chosen on a population basis that included a sample of 233 cases of cancer in situ, and 397 cases of invasive cervical cancer obtained from eight hospitals, and a sample of 1005 controls representative of the general population. The results are presented stratified by case type, classified according to whether the cancer is invasive or not.

RESULTS: The results show low impact of the cervical cancer screening programme in Mexico, Women who had a history of use of the Papanicolaou smear (PAP), who did not seek testing due to gynaecological symptoms and who had received their PAP results, had a 2.63 times lower risk of developing invasive cervical cancer (OR é 0.38; 95% CI : 0.28–0.52).

CONCLUSIONS: The principal findings of this study in relation to the low impact of the screening programme in Mexico, are the low level of existing coverage and late use of health services by women at risk.

Keywords Cervical cancer, screening, epidemiology, Papanicolaou

Accepted 16 October 1997


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