Estratégias utilizadas por enfermeiros da atenção primária na prevenção do câncer de colo do útero: revisão integrativa / Strategies used by primary care nurses in the prevention of cervical cancer: integrative review

Objetivo: identificar, na literatura científica, as estratégias utilizadas por enfermeiros da Atenção Primária para a prevenção do câncer de colo do útero. Métodos: revisão integrativa nas bases de dados EMBASE, LILACS (BVS), SCOPUS e Web of Science, entre março e abril de 2023. Após a busca, seguiu-se com leitura na íntegra dos artigos selecionados e extração dos dados para análise. A amostra final foi constituída por 5 estudos. Resultados: as principais estratégias utilizadas foram intervenções educativas, com predominância de palestras e posterior convite ou coleta de material para a realização do exame preventivo. Também foram utilizadas rodas de conversa (círculo de cultura), orientações por contato telefônico e oferta de ficha clínica auto preenchível na consulta de enfermagem. Conclusões: os estudos possibilitaram identificar estratégias positivas na prevenção do câncer de colo do útero, podendo direcionar enfermeiros a investir cada vez mais em metodologias voltadas a uma maior autonomia das mulheres

Objective: to identify, in the scientific literature, the strategies used by primary care nurses to prevent cervical cancer. Methods: An integrative review of the EMBASE, LILACS (BVS), SCOPUS, and Web of Science databases between March and April 2023. After the search, the selected articles were read in full, and the data were extracted for analysis. The final sample consisted of 5 studies. Results: the main strategies used were educational interventions, with a predominance of lectures and subsequent invitations or collection of material to carry out the preventive exam. Conversation circles (culture circles), telephone guidance, and the provision of a self-completed clinical form during the nursing consultation were also used. Conclusions: the studies made it possible to identify positive strategies for preventing cervical cancer, which could direct nurses to increasingly invest in methodologies aimed at increasing women's autonomy

Cognition of prevention and control of cervical cancer and influencing factors of HPV vaccination intention among college students in Xiangyang / 公共卫生与预防医学

Objective The knowledge of cervical cancer prevention and control，the cognition of human papillomavirus (HPV) vaccine and the willingness to vaccinate HPV vaccine among college students in Xiangyang were investigated and analyzed to provide a reliable scientific basis for the primary prevention of cervical cancer prevention and control in Xiangyang. Methods By means of stratified sampling method and self-made questionnaire, this paper conducted a questionnaire survey among college students in 3 universities in Xiangyang. Results A total of 8 523 college students participated in the questionnaire survey, and 4 473 of them had sufficient knowledge of cervical cancer prevention and control and HPV vaccine, with the awareness rate of 52.48%. Male students, rural residents and non-medical majors were the influencing factors of insufficient knowledge of cervical cancer prevention and control and HPV vaccine. Among the 6 459 female college students who participated in the survey, 5,993 (92.79%) were willing to be vaccinated, and 859 (13.30%) were already vaccinated. Major, educational background, living expenses and cognitive scores were the influencing factors of HPV vaccination intention. Conclusion College students in Xiangyang City are relatively deficient in the knowledge of cervical cancer prevention and control and HPV vaccine. Targetable science popularization and education can improve college students' correct understanding of cervical cancer prevention and control knowledge, promote the HPV vaccine vaccination plan, and reduce the occurrence of HPV-related diseases and cervical cancer.

Construction of an Information Platform for Cervical Cancer Prevention in the Digital Era / 中国医学科学院学报

The advent of the digital era brings new challenges and opportunities for cervical cancer prevention and research.With the development of digital techniques in China,the construction of an information platform for cervical cancer prevention based on the current achievements has become an important trend.This paper expounds the importance,existing problems,and challenges of the data integration of population-based cervical cancer screening and the information platform construction,and puts forwards effective measures to promote its construction.The establishment of an information platform for cervical cancer prevention in the digital era has far-reaching significance for the global elimination of cervical cancer.

El impacto de la prueba de VPH en los programas de tamizaje en América Latina: el caso de Argentina / The impact of the HPV test in screening programs in Latin America: The case of Argentina

Resumen: Objetivo: Evaluar el impacto de la prueba de VPH (prueba de VPH) en los problemas que históricamente afectaron al tamizaje de cáncer cervical en América Latina, tomando como caso al Proyecto Demostración para la Introducción de la prueba de VPH en Jujuy (PDJ), Argentina. Material y métodos: Se sintetizó la evidencia sobre los problemas del tamizaje cervical en la región. Se analizó el impacto en los problemas a partir de la introducción de la prueba de VPH. El impacto se clasificó en directo/indirecto y positivo/negativo. Resultados: El impacto directo-positivo se dio en los problemas de adherencia a la edad/frecuencia de tamizaje, laboratorios de citología, baja/moderada sensibilidad de la citología y baja cobertura. El impacto directo-negativo se vinculó con el triaje de autotoma y el envío/etiquetado de muestras. El impacto indirecto-positivo se relacionó con la reorganización programática realizada para introducir la prueba de VPH. Conclusiones: La prueba de VPH representa una ventana de oportunidad para el mejoramiento del tamizaje pero no resuelve los problemas programáticos.

Abstract: Objective: To assess the impact of HPV testing on longstanding problems faced by screening programs in Latin America, using the case of the Jujuy Demonstration Project (JDP) in Argentina. Materials and methods: The study measured the level of impact produced by the introduction of HPV-testing on problems faced by cytology programs by analyzing modifications on specific problems produced during the JDP. Impact was classified as direct/indirect, and positive/ negative. Results: Direct/positive impact was found in issues concerning age and screening frequency, cytology laboratories and screening sensitivity, and low coverage. Direct/negative impact was mainly related to the adherence to triage cytology by HPV+ women with self-collected-tests, and the delivery and labelling of samples. Indirect impact of HPV-Test was mostly positive, and related to the programmatic reorganization which was facilitated by the introduction of HPV testing. Conclusions: HPV testing provides an opportunity window for improving primary screening, but does not solve programmatic problems.

Evaluation of a training workshop on the use of visual inspection with acetic acid in cervical cancer screening / Philippine Journal of Obstetrics and Gynecology

Objective@#The Department of Health developed a program for Cervical Cancer Prevention and Control in the Philippines and this involves training of health care providers on Visual Inspection with Acetic Acid (VIA). The evaluation of this training program aims to determine the effectivity of the training workshop in increasing the knowledge and skills of healthcare providers in VIA and whether this would translate to practice in their workplaces. @*Method@#The first run of the training program was evaluated and the approach used was Kirkpatrick’s model. Participants were asked to complete an evaluation questionnaire for Level 1 evaluation. A pre-test, post-test and performance checklist were accomplished for Level 2 evaluation. For Level 3 evaluation, randomly selected participants were interviewed via mobile phone. Data analysis involved descriptive methods and inferential statistics (T-test and McNemar test) for Level 2. @*Results@#Level 1 evaluation demonstrated a high over-all satisfaction rating from the participants (x ?=4.59) and the training workshop was found to be relevant and useful to their practice. Level 2 evaluation showed a significant increase in the knowledge of the participants (P=.001) particularly in the core topics of cervical cancer epidemiology (P=.001) and VIA (P=.006). There was likewise a significant improvement in the performance of VIA from the first to the last patient encounter (P=.000). Level 3 evaluation showed that the participants interviewed have realized the importance of VIA @*Conclusion@#The training workshop was effective in increasing the knowledge base and clinical skills required of health care professionals who will provide cervical cancer screening services using visual inspection with acetic acid. As a direct effect of the increase in knowledge and skills, the participants have started to incorporate their new learnings into their practice.

Adopción e implementación del ofrecimiento de la autotoma VPH por agentes sanitarios en Jujuy, Argentina / Adoption and implementation of HPV self-collection sampling by CHWs in Jujuy, Argentina

Resumen: Objetivo: Evaluar la adopción e implementación en escala de la estrategia orientada a ofrecer puerta a puerta la autotoma de la prueba del virus del papiloma humano (AT-VPH), por parte de agentes sanitarios (AS), en Jujuy, Argentina. Material y métodos: Se aplicó una encuesta autoadministrada a 478 AS. Las dimensiones de adopción e implementación fueron evaluadas con el modelo RE-AIM. Resultados: Adopción: 81.8% de los AS ofreció la AT-VPH y 86.4% expresó gratificación con la estrategia. Implementación: los problemas encontrados fueron la demora en la entrega de tubos (61.3%) y resultados (70.0%); falta de recursos humanos (28.3%), y dificultades al obtener turnos para realizar el triage (26.1%). El principal obstáculo fue la sobrecarga de trabajo (50.2%), mientras que la capacitación (38.0%) y el listado de mujeres a contactar (28.7%) fueron los elementos facilitadores. Conclusiones: La adopción de la AT-VPH fue alta entre los AS. Deben reforzarse las estrategias programáticas para motivar a los AS y reducir su carga de trabajo al implementar la AT-VPH.

Abstract: Objective: To evaluate adoption and implementation of scaling up of HPV self-collection (SC) strategy offered door-to-door by Community Health Workers (CHWs) in Jujuy, Argentina. Materials and methods: A self-administered questionnaire was applied to 478 CHWs. RE-AIM model was used to evaluate adoption and implementation dimensions. Results: Adoption: 81.8% offered SC and 86.4% were satisfied with the strategy. Implementation: main problems were delays in the delivery of tubes (61.3%) and results (70.0%), lack of human resources (28.3%) and difficulties in obtaining an appointment for triage (26.1%). The main obstacle was the excessive workload of CHWs (50.2%). Training (38.0%) and the list of women to be offered the test (28.7%) were identified as facilitators. Conclusions: The adoption of SC strategy was high among CHWs. Program strategies should be strengthened to motivate and reduce the excessive workload of CHWs when implementing SC strategy.

HPV vaccine implementation and monitoring in Latin America / Implementación y monitoreo de la vacuna contra el VPH en América Latina

Abstract: Objective: To describe HPV vaccine program implementation, monitoring and evaluation experiences in Latin America. Materials and methods: We reviewed published articles in peer-reviewed journals and reports from government websites, as well as the PAHO/WHO/UNICEF Joint Reporting form and the ICO/IARC HPV Information Centre database. Results: By December 2016, 13 countries/territories in Latin America (56%) have introduced HPV vaccines. The majority have done so in the past three years, targeting 10-12 year old girls with a two dose schedule, through school programs. Vaccine coverage ranges from 30 to 87%. Safety monitoring is well established, but monitoring vaccine impact is not, and data are not available. Conclusions: Although Latin America is the most advanced developing region with HPV vaccine introduction, systems for its monitoring are weak and there is a paucity of consistently available coverage data for this vaccine. Challenges remain to introduce HPV vaccines in several countries, to achieve high coverage, and to strengthen monitoring, evaluation and reporting.

Resumen: Objetivo: Describir las experiencias con la implementación, monitoreo y evaluación de programas de vacunación contra VPH en América Latina. Material y métodos: Revisamos datos publicados en revistas, informes gubernamentales, así como los informes de monitoreo de programas de inmunizaciones de la OPS/OMS/UNICEF y del centro de información del VPH del ICO/IARC. Resultados: Hasta diciembre de 2016, 13 países/territorios en América Latina (56%) han introducido vacunas contra VPH. La mayoría lo han hecho en los últimos tres años, apuntando a niñas de 10 a 12 años con un calendario de dos dosis, a través de programas escolares. La cobertura de vacunas varía entre 30 y 87%. La vigilancia de la seguridad está bien establecida, pero el monitoreo del impacto de la vacuna no, y los datos no están disponibles. Conclusiones: Aunque América Latina es la región en desarrollo más avanzada en la introducción de la vacuna contra VPH, los sistemas para su monitoreo son débiles y hay una escasez de datos de cobertura disponibles. Sigue habiendo desafíos para introducir vacunas contra VPH en varios países, para lograr una alta cobertura y para fortalecer el monitoreo, la evaluación y la presentación de informes.

Development of a clinical protocol for detection of cervical cancer precursor lesions / Desenvolvimento de protocolo clínico para detecção de lesões precursoras do câncer de colo uterino / Desarrollo de protocolo clínico para detección de lesiones precursoras del cáncer de cuello uterino

ABSTRACT Objective: to develop and validate the content of a clinical protocol aimed at prevention of cervical cancer in primary care. Method: technological research according to the steps: (1) submission of the project to the research ethics committee; (2) bibliographic survey; (3) elaboration of the clinical protocol; and (4) content validation. In the third step, the information was collected through bibliographic research and gynecology specialists were consulted. For the final step, four judges were selected to evaluate the clinical protocol according to AGREE 2. Domains that reached the minimum level of agreement of 75% in the scores were considered validated. Results: the scores obtained in each domain of the instrument were as follows: domain 1 (scope and purpose) = 87.5%; domain 2 (stakeholder involvement) = 83.3%; domain 3 (development rigor) = 79.7%; domain 4 (clarity of presentation) = 76.3%; domain 5 (applicability) = 78.1%; and domain 6 (editorial independence) = 85.4. Conclusion: the clinical protocol proved to be a validated material with scores above the minimum required. The protocol obtained positive recommendations with modifications and went through adjustments in order to make it more effective.

RESUMO Objetivos: desenvolver e validar o conteúdo de um protocolo clínico direcionado à prevenção do câncer cervical na atenção primária. Método: Trata-se de uma pesquisa de desenvolvimento tecnológico em saúde(8) realizada em quatro etapas: (1) submissão do projeto ao comitê de ética em pesquisa; (2) levantamento bibliográfico; (3) elaboração do protocolo clínico; e (4) validação de conteúdo. Na terceira etapa, as informações foram levantadas mediante pesquisa bibliográfica e consultados especialistas em ginecologia. Para a etapa final, foram selecionados quatro juízes que avaliaram o protocolo clínico segundo o AGREE 2. Foram considerados validados os domínios que obtiveram nível de concordância mínimo de 75% nas pontuações. Resultados: as pontuações obtidas, em cada domínio do instrumento, foram as seguintes: domínio 1 (escopo e finalidade)=87,5%; domínio 2 (envolvimento das partes interessadas)=83,3%; domínio 3 (rigor do desenvolvimento)=79,7%; domínio 4 (clareza da apresentação)=76,3%; domínio 5 (aplicabilidade)=78,1%; e domínio 6 (independência editorial)=85,4. Conclusão: o protocolo clínico mostrou-se um material validado com pontuações superiores ao mínimo exigido. Obteve recomendações positivas com modificações e passou por ajustes a fim de torná-lo mais efetivo.

RESUMEN Objetivos: desarrollar y validar el contenido de un protocolo clínico dirigido a la prevención del cáncer cervical en atención primaria. Método: investigación tecnológica conforme a las etapas: (1) sujeción del proyecto al comité de ética en investigación; (2) levantamiento bibliográfico; (3) elaboración del protocolo clínico; y (4) validación de contenido. En la tercera etapa, las informaciones fueron levantadas mediante investigación bibliográfica y consultados especialistas en ginecología. Para la etapa final, fueron seleccionados cuatro jueces que evaluaron el protocolo clínico según el AGREE 2. Fueron considerados válidos los dominios que obtuvieron nivel de concordancia mínimo de 75% en las puntuaciones. Resultados: las puntuaciones obtenidas, en cada dominio del instrumento, fueron las siguientes: dominio 1 (alcance y finalidad) = 87,5%; dominio 2 (implicación de las partes interesadas) - 83,3%; dominio 3 (rigor del desarrollo) = 79,7%; dominio 4 (claridad de la presentación) = 76,3%; dominio 5 (aplicabilidad) = 78,1% y dominio 6 (independencia editorial) = 85,4. Conclusión: el protocolo clínico se mostró como un material válido con puntuaciones superiores al mínimo exigido. Obtuvo recomendaciones positivas con modificaciones y pasó por ajustes a fin de hacerlo más efectivo.

Evaluación de un programa de detección temprana de cáncer cervicouterino en Colombia / Evaluation of A Cervical Cancer Early Detection Program In Colombia

Resumen Objetivo: Evaluar el proceso de atención del programa de detección temprana de cáncer cervicouterino enfocado en cobertura de tamización, oportunidad de atención y adherencia en el direccionamiento del diagnóstico y tratamiento en seis municipios de Colombia. Métodos: Estudio observacional descriptivo de corte transversal a partir del análisis de fuentes secundarias de información del programa de detección temprana de cáncer cervicouterino de una aseguradora en salud de personas afiliadas con vinculación laboral y capacidad de pago. El procesamiento y análisis de los datos fueron realizados mediante el programa estadístico SPSS® versión 22 con la identificación de frecuencias absolutas, relativas, medidas de tendencia central y variabilidad. Resultados: Para el 2014, se tomaron 28.442 citologías cervicales, el 2,3% fueron resultados con algún tipo de anormalidad. Se evidenció cobertura anual de tamización del 28,2% (0,0% -280,6%), oportunidad de atención; entre toma y entrega de resultado: 15 días (4 -118), entre el resultado y el diagnóstico: 18 días (2 - 294) y entre el diagnóstico y tratamiento: 49,5 días (2 -240). Para adherencia, el 81,6% evidencia cumplimiento del direccionamiento al diagnóstico a partir del resultado citológico y el 62,6% evidencia cumplimiento en el direccionamiento del diagnóstico al tratamiento. Conclusiones: El programa de detección temprana de cáncer cervicouterino presenta coberturas bajas de tamización, falencias en el cumplimiento de la oportunidad en la atención y de la adherencia en el direccionamiento del diagnóstico y del tratamiento.

Abstract Objective: To evaluate the care process of the Cervical Cancer Early Detection program focused on screening coverage, access to care, and adherence when addressing the diagnosis and treatment, in six towns of Colombia. Methods: A cross-sectional, descriptive, observational study conducted using the analysis of secondary information sources from the Cervical Cancer Early Detection program of an occupational health insurer of persons employed, and with the ability to pay. Data processing and analysis were performed using the statistical program SPSS® version 22 with the identification of absolute and relative frequencies, central tendency, and variability measurements. Results: In the year 2014, of the 28,442 PAP smear tests taken, 2.3% were found to have some kind of anomaly. An annual screening coverage of 28.2% (0.0% - 280.6%) was observed. The access to care between the date of the sample and the delivery of the result was 15 days (4 - 118), between the result of the test and the diagnosis: 18 days (2 - 294), and 49.5 days (2 - 240) between the diagnosis and treatment. For adherence, 81.6% showed adherence to the diagnosis based on the cytological result, and 62.6% showed compliance in the diagnosis-treatment approach. Conclusions: The cervical cancer early detection program has a low screening coverage, with failures in complying with timely care and adherence in addressing diagnosis and treatment.

Percepção de mulheres sobre a atenção primária no âmbito da política do câncer de colo uterino no Estado de Sergipe / Women's perception about primary healthcare within the scope of cervical cancer policies in the state of sergipe / percepción de mujeres sobre la atención primaria en el ámbito de la política del cáncer de cuello uterino en el estado de sergipe

Este estudo objetivou avaliar a percepção das mulheres usuárias do serviço de saúde sobre a atenção básica quanto às ações de prevenção do câncer de colo do útero no Estado de Sergipe. Trata-se de uma pesquisa exploratória e descritiva, com abordagem quali-quantitativa, realizada com usuárias nas sedes das sete regionais de saúde deste estado. Foram realizadas entrevistas semiestruturadas e técnica de grupo focal, com amostra por conveniência de 840 mulheres de 25 a 59 anos de idade que realizaram o exame Papanicolau. Foi realizada distribuição de frequências dos dados quantitativos e a análise de conteúdo apontou cinco categorias: acesso e dificuldades para realização do Papanicolau; técnicas de captação de público-alvo; estrutura para encaminhamento; abrangência das secretarias; aspectos comportamentais das mulheres; e orientações ao público-alvo quanto à prevenção de colo uterino. A análise qualitativa demonstrou divergências entre os relatos das usuárias quanto ao acesso e dificuldades na realização do exame e técnicas de captação de público-alvo. Houve relatos importantes sobre aspectos comportamentais e, principalmente, sobre dificuldades de encaminhamento e condições de tratamento dos casos detectados. Torna-se necessário um profundo repensar por parte da equipe e, especialmente, dos gestores tendo como base os princípios que regem o conceito da atenção básica em saúde.

The goal of the present study was to access the perception of women users of health services about primary healthcare regarding cervical cancer prevention in the State of Sergipe, Brazil. This is an exploratory descriptive research with qualitative and quantitative approach conducted with users of the seven regional health centers of this state. We used semistructured interviews and the focal group technique with a convenience sample comprising 840 women aged 25 to 59 years, who had undergone Papanicolau tests. We obtained the frequency distribution of the quantitative data and performed content analysis which determined five categories: access and difficulties to undergo a Papanicolau test; techniques for attracting target individuals; structure for patient referral; scope of the centers; women's behavioral aspects; and guidance provided for cervical cancer prevention. The qualitative analysis indicated differences between user's reports regarding access and difficulties in undergoing the examination and techniques for attracting target individuals. There were important reports about behavioral aspects and, in particular, difficulties in patient referrals and treatments of detected cases. A profound rethinking becomes necessary on the part of

Este estudio tuvo el objetivo de evaluar la percepción de las mujeres usuarias del servicio de salud sobre la atención básica en cuanto a las acciones de prevención del cáncer de cuello uterino en el estado de Sergipe. Se trata de una investigación exploratoria y descriptiva, con abordaje cuali-cuantitativo, realizada con usuarias en las sedes de las siete regionales de salud de este estado. Fue realizada entrevista semiestructurada y técnica de grupo focal, con muestra por conveniencia de 840 mujeres de 25 a 59 años que realizaron la prueba de Papanicolau. Fue realizada distribución de frecuencias de los datos cuantitativos y el análisis de contenido señaló cinco categorías: acceso y dificultades para la realización del Papanicolau, técnicas de captación, estructura para encaminamiento amplitud de las Secretarías, aspectos de comportamiento de las mujeres y orientaciones al público blanco acerca de la prevención de cuello uterino. El análisis cualitativo demostró divergencias entre los relatos de las usuarias en cuanto al acceso y a las dificultades en la realización de la prueba y técnicas de captación del público blanco. Hubo relatos importantes sobre aspectos de comportamiento, y principalmente dificultades de encaminamiento y condiciones de tratamiento de los casos detectados. Se vuelve necesario un profundo repensar por parte del equipo y, especi

Cervical cancer screening: from Pap smear to future strategies / Triagem de câncer do colo uterino: do teste de Papanicolaou a estratégias futuras

ABSTRACT Previously, the screening for detection of cervical cancer was performed by simple cervicovaginal sample collected by the physician whenever the patient attended the medical consultation, and soon it was established as the annual"Pap smear". Since then, an elementary test has evolved into a complex process with multiple algorithms for the identification of invasive disease. The detection of human papillomavirus (HPV) has become part of the new screening recommendations, resulting in major changes in the guidelines. This review intends to emphasize the most important topics that are part of cervical cancer screening, including cervical cytology and HPV detection, and to discuss particular aspects of cervical cancer in Brazil. Despite the great benefits achieved by the cervical cancer screening programs with cytology and HPV test, there are still important issues to be discussed and improved in defining future strategies, including simplicity and possible application in different socioeconomic contexts, definition of the best test or tests to be applied and recommended interval, minimizing possible harms. After the establishment of screening algorithms well defined by leading organizations, management protocols should be disseminated among physicians and patients by education programs.

RESUMO Inicialmente, a triagem para detecção do câncer de colo uterino era feita por meio de uma simples amostra cervicovaginal colhida pelo médico, sempre que o paciente comparecia à consulta médica; logo se estabeleceu como"exame de Papanicolaou" anual. Desde então, um teste elementar evoluiu para um processo complexo, com múltiplos algoritmos para identificação de doença invasiva. A detecção do papilomavírus humano (HPV) tornou-se parte das novas recomendações de triagem, resultando em grandes mudanças nas diretrizes. Esta revisão pretende enfatizar os tópicos mais importantes que fazem parte do rastreamento do câncer de colo do útero, incluindo citologia cervical e detecção do HPV, bem como discutir aspectos particulares do câncer de colo do útero no Brasil. Apesar dos grandes benefícios alcançados pelos programas de rastreamento do câncer de colo uterino por meio do uso da citologia e do teste de HPV, existem ainda pontos importantes a serem discutidos e melhorados na definição de estratégias futuras, como simplicidade e possível aplicação em diferentes contextos socioeconômicos, definição do melhor teste ou testes a serem aplicados e intervalo recomendável, minimizando possíveis danos. Após o estabelecimento de algoritmos de rastreamento bem definidos pelas principais organizações, protocolos de manejo devem ser divulgados entre médicos e pacientes por programas de educação.

Conhecimento dos agentes comunitários de saúde sobre o exame Papanicolaou / Community health workers’ knowledge of the Pap test / Conocimiento de los agentes comunitarios de salud sobre el examen papanicolaou

Trata-se de um estudo descritivo, de abordagem quantitativa, com o objetivo de verificar o conhecimento dos agentes comunitários de saúde (ACS) sobre o exame Papanicolaou. Participaram da pesquisa 98 agentes que atuavam na estratégia de saúde da família (ESF), no município de Picos - PI. A coleta de dados foi realizada no período de março a abril de 2011, por meio de um formulário semiestruturado. Os resultados indicaram déficit de conhecimento sobre o exame Papanicolaou e o câncer de colo de útero e escassez de treinamento sobre tais temáticas. Os agentes mencionaram atuar realizando ações educativas na microárea, sendo a maior dificuldade a resistência da população em aderir às suas intervenções. Espera-se que este estudo sensibilize os enfermeiros e os gestores, para que possam compreender a necessidade de capacitar os ACS e assim atuarem com excelência nas medidas preventivas do câncer de colo uterino.

This quantitative, descriptive study aimed to ascertain community health workers’ (CHWs) knowledge of the Paptest. The participants were 98 CHWs with Family Health Strategy teams in Picos, Piauí. Data were collected from March to April 2011 using a semi-structured questionnaire. The results indicated a lack of knowledge about the Pap test and cervical cancer, and scanty training on these subjects. The CHWs mentioned doing educational work in their micro-area, the main difficulty being people’s reluctance to follow their recommendations. It is hoped that this study will sensitize nurses and managers to the need totrain CHWs, to enable them to take preventive measures against cervical cancer with excellence.

Se trata de un estudio descriptivo, de enfoque cuantitativo, con el objetivo de evaluar lo conocimiento de agentes comunitarios de salud sobre el examen Papanicolaou. Participaron de la investigación 98 agentes que trabajan en salud de la familia en el municipio de Picos – PI – Brasil. La recolección de datos se llevó a cabo entre marzo y abril de 2011, a través de un instrumento semiestructurado. Los resultados indicaron falta de conocimiento acerca del examen Papanicolaou, del cáncer decuello uterino y falta de formación sobre estos temas. Los agentes mencionaron hacer trabajo educativo en la micro área, siendo la resistencia de la población a sus intervenciones la principal dificultad. Se espera que este estudio sensibilice los enfermeros ylos administradores para que puedan entender la necesidad de capacitar los agentes y por lo tanto actuar con excelencia en las medidas de prevención contra el cáncer cervical.

Calidad del programa detección temprana y control de cáncer de cuello uterino en hospitales públicos de municipios con altas tasas de mortalidad, Antioquia, Colombia, 2010 / Quality of the program for timely detection and control of cervical cancer in public hospitals located in municipalities with high mortality, Antioquia, Colombia, 2010

Introducción: en Colombia se creó el Programa Detección temprana y control cáncer de cuello uterino para intervenir esta enfermedad. Aunque la reforma del Sistema General de Seguridad Social en Salud incluye la calidad de la atención en salud entre sus componentes, la prestación de los servicios de prevención de la enfermedad se realiza mediante actividades desarticuladas, deteriorándose los procesos de atención y control. Objetivo: evaluar la calidad del Programa Detección temprana y control de cáncer de cuello uterino, en hospitales públicos de nueve municipiosde Antioquia, Colombia con altas tasas de mortalidad. Materiales y métodos: estudio descriptivo transversal; se incluyeron nueve municipios con tasas de mortalidad más altas que el promediode Antioquia durante 2000 a 2006...

Introduction: the program for timely detection and control of cervical cancer was created in Colombia to intervene in this disease. Although the reform of the General System of Social Security in Health includes the quality of health care among its components, the provision of disease prevention services is made through unarticulated activities, which disrupts the processes of health care and control. Objective: to assess the quality of the program for timely detection and control of cervical cancer in public hospitals of nine municipalities of Antioquia with high mortality rates. Materials and methods: a descriptive study was conducted. It included ninemunicipalities with mortality rates higher than the mean in Antioquia between 2000 and 2006...