Saúde e Sociedade
versión impresa ISSN 0104-1290
NASCIMENTO, Maria Isabel do; KOIFMAN, Rosalina Jorge; MATTOS, Inês Echemique y MONTEIRO, Gina Torres Rego. Predictors of non-adherence to the prescribed follow-up in women with high-grade squamous intraepithelial lesion (HSIL). Saude soc. [online]. 2009, vol.18, n.2, pp. 325-333. ISSN 0104-1290. http://dx.doi.org/10.1590/S0104-12902009000200015.
Cervical cancer is a tumor of multi-factorial nature that remains nowadays an a serious important public health problem. Adherence to health care procedures is a factor related to uterine cervical cancer control. The aim of this study was to evaluate factors associated with non-adherence to the prescribed follow-up in women with high-grade squamous intraepithelial lesions (HSIL), attending a public health care service in the "Baixada Fluminense", Rio de Janeiro, Brazil. This was a retrospective cohort study including women screened through cytology, entering the health care service between 01/01/2002 and 12/31/2005 and submitted to a colposcopy. Data collection ended on 12/31/07. Through the revision of 1496 medical records, 641 eligible women with a histopathological diagnosis of HSIL obtained after excision of the transformation zone were identified. After application of the exclusion criteria, the study population comprised 537 (84%) women, classified into two groups: "non-adherent" (29.4%), who abandoned the follow-up procedures and "adherent" (70.6%) who remained in follow-up along the required period. Statistical analysis was carried out though qui-square and t-tests and logistic regression. The final model contained the variables smoker (OR 1.72), not having a job outside the house (OR 1.56), having the examination carried out with a videocolposcopy (OR 1.80), age (OR 0.97) and history of three or more gestations (OR 0.49). The study disclosed a vulnerability profile pointing to individual and organizational-level determinants. Strategies to attain better follow-up must be aimed to modifiable life style factors as smoking and to structural characteristics of health care services in the studied area.
Palabras llave : Adherence; Follow-Up; High Squamous Intraepithelial Lesion; Uterine Cervix.