Auditoría de muertes por cáncer cérvico-uterino, Servicio de Salud Metropolitano Sur-Oriente, 1995: análisis preliminar / Audit of deaths due to cervix uterine cancer in a health service of Santiago: a preliminary analysis

RESUMO

Background: Despite the epidemiological importance and the surveillance programs to detect cervix uterine cancer in Chile, its mortality continues to be high. Aim: To perform an audit of all deaths due to cervix uterine cancer, that occurred in a health service of Santiago during 1995. Material and methods: The clinical records and pathological studies of 46 women, whose death certificates indicated cervix uterine cancer as the cause of death, were audited. Results: In six women, the audit revealed that the cause of death was not a cervix uterine cancer, and they were discarded from further analyses. The higher mortality rate (36/100000) ocurred in women over 64 years old, those living in the poorest community and with less Papanicolaou vaginal smears coverage (La Pintana). The evolution prior to diagnosis was registered in only four women and was of less than one year. Most women consulted in advanced stages of the disease and only 48percent were subjected to some sort of treatment (surgery, radiotherapy or chemotherapy). Mean survival was 3 years and mean age at death was 55.5 years old. There was a great lack of clinical and epidemiological information. In only 13 women information about previous Pap smears was registered. Conclusions: Audit of deaths should be an important component of preventive programs for cervix uterine cancer, and the coverage of Pap smears should be improved