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Cervical cancer prevention: a theoretical framework to analyze Papanicolaou test access and use

Several studies have indicated that the prevailing high incidence and mortality rates of cervical cancer, mainly in developing countries, are due to the low quality and coverage of the cervical smear or Papanicolaou (Pap) test. This article intends to analise some aspects related to measures of control and prevention of cervical cancer, such as the effectiveness of the Pap test, the operational and scientific rationale of public health policies for the prevention of cervical cancer and coverage of the Papanicolaou test in many countries. It also intends to review the explanatory models that have been proposed to analyze access to this service. For this latter objective, we investigated the factors associated to the use of the Pap test described within the epidemiological literature and we proposed a new approach in the investigation of these factors, incorporating social, cultural and organizational aspects in the analysis of access to and use of this practice so that measures of prevention and control may be more coherent with the needs and the rights of women.

Cervix neoplasms; Vaginal smears; Preventive health services; Health services


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