Cervical cancer mortality and socioeconomic determinants of the practice of Pap smear in Argentina
Cervical cancer (CC) is the third most incident cancer in women in Argentina, with previous evidence at national level of an inverse association between CC mortality and quality of life. Objectives: a) To identify provincial CC mortality profiles and their preventive practice of PAP in Argentina; b)...
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2022
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/39076 |
| Aporte de: |
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I10-R327-article-39076 |
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ojs |
| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
| repository_str |
R-327 |
| container_title_str |
Revista de la Facultad de Ciencias Médicas de Córdoba |
| format |
Artículo revista |
| topic |
cérvix de cáncer screening method social determinants of health mortality cáncer de cervix método de screening determinantes sociales de la salud mortalidad |
| spellingShingle |
cérvix de cáncer screening method social determinants of health mortality cáncer de cervix método de screening determinantes sociales de la salud mortalidad Sarmiento, D Pereyra, S Pou, S Scruzzi, G Cervical cancer mortality and socioeconomic determinants of the practice of Pap smear in Argentina |
| topic_facet |
cérvix de cáncer screening method social determinants of health mortality cáncer de cervix método de screening determinantes sociales de la salud mortalidad |
| author |
Sarmiento, D Pereyra, S Pou, S Scruzzi, G |
| author_facet |
Sarmiento, D Pereyra, S Pou, S Scruzzi, G |
| author_sort |
Sarmiento, D |
| title |
Cervical cancer mortality and socioeconomic determinants of the practice of Pap smear in Argentina |
| title_short |
Cervical cancer mortality and socioeconomic determinants of the practice of Pap smear in Argentina |
| title_full |
Cervical cancer mortality and socioeconomic determinants of the practice of Pap smear in Argentina |
| title_fullStr |
Cervical cancer mortality and socioeconomic determinants of the practice of Pap smear in Argentina |
| title_full_unstemmed |
Cervical cancer mortality and socioeconomic determinants of the practice of Pap smear in Argentina |
| title_sort |
cervical cancer mortality and socioeconomic determinants of the practice of pap smear in argentina |
| description |
Cervical cancer (CC) is the third most incident cancer in women in Argentina, with previous evidence at national level of an inverse association between CC mortality and quality of life. Objectives: a) To identify provincial CC mortality profiles and their preventive practice of PAP in Argentina; b) To analyze the socioeconomic determinants (SED) of PAP practice in women, 2018.
A multigroup ecological study was conducted (n=24 geographic units of Argentina), using secondary data sources (National Survey of Risk Factors -NSRF- 2018; census data; vital statistics from the National Ministry of Health). Age-standardized mortality rates (ASMR) due to CC, weighted prevalence (%) of PAP practice (last 2 years) in women aged 25-65 years, as well as the proportion of women with secondary education incomplete, occupation, health insurance, overcrowding, and access to network gas (as public service) were estimated by geographic unit. A principal components analysis and hierarchical clusters were performed to identify provincial profiles; thematic maps were obtained using QGIS. At the individual level (n=11496 women aged 25-65y; NSRF 2018), a test of difference of proportions (α=0.05) was applied for the prevalence of PAP according to selected SED.
In Argentina, the average ASMR for CC (±SD) was 5.57 (±2.3) deaths per 100,000. Three provincial profiles were identified (explained variance= 78%) called: (1) Higher CC mortality with socioeconomic vulnerability and low preventive practice (NEA and NOA provinces); (2) Lower CC mortality with access to public services (Pampean, Cuyo, and Patagonia regions); (3) Higher prevalence of PAP with favorable socioeconomic conditions (CABA, Tierra del Fuego). The mean percentage of PAP practice was 66%. The prevalence of PAP was significantly higher (p<0.01) in women aged 25-49 years (70.3% vs. 63.8% in 50-65y), married/couple (70.4% vs. 65.3 % without a partner), without overcrowding (68.6% vs. 56.5% with overcrowding), with health insurance (73.8% vs. 56.3% without it), in the highest income quintile (80.9% vs. 55.1% in inferior), and with complete secondary studies (74.5% vs. 56.7% incomplete).
Concluding, there are different profiles and SED related to CC mortality and PAP practice in Argentina, which should be considered in targeted strategies against CC. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2022 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/39076 |
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I10-R327-article-390762024-04-15T16:14:45Z Cervical cancer mortality and socioeconomic determinants of the practice of Pap smear in Argentina Mortalidad por cáncer cervicouterino y determinantes socioeconómicos de la realización de PAP en Argentina Sarmiento, D Pereyra, S Pou, S Scruzzi, G cérvix de cáncer screening method social determinants of health mortality cáncer de cervix método de screening determinantes sociales de la salud mortalidad Cervical cancer (CC) is the third most incident cancer in women in Argentina, with previous evidence at national level of an inverse association between CC mortality and quality of life. Objectives: a) To identify provincial CC mortality profiles and their preventive practice of PAP in Argentina; b) To analyze the socioeconomic determinants (SED) of PAP practice in women, 2018. A multigroup ecological study was conducted (n=24 geographic units of Argentina), using secondary data sources (National Survey of Risk Factors -NSRF- 2018; census data; vital statistics from the National Ministry of Health). Age-standardized mortality rates (ASMR) due to CC, weighted prevalence (%) of PAP practice (last 2 years) in women aged 25-65 years, as well as the proportion of women with secondary education incomplete, occupation, health insurance, overcrowding, and access to network gas (as public service) were estimated by geographic unit. A principal components analysis and hierarchical clusters were performed to identify provincial profiles; thematic maps were obtained using QGIS. At the individual level (n=11496 women aged 25-65y; NSRF 2018), a test of difference of proportions (α=0.05) was applied for the prevalence of PAP according to selected SED. In Argentina, the average ASMR for CC (±SD) was 5.57 (±2.3) deaths per 100,000. Three provincial profiles were identified (explained variance= 78%) called: (1) Higher CC mortality with socioeconomic vulnerability and low preventive practice (NEA and NOA provinces); (2) Lower CC mortality with access to public services (Pampean, Cuyo, and Patagonia regions); (3) Higher prevalence of PAP with favorable socioeconomic conditions (CABA, Tierra del Fuego). The mean percentage of PAP practice was 66%. The prevalence of PAP was significantly higher (p<0.01) in women aged 25-49 years (70.3% vs. 63.8% in 50-65y), married/couple (70.4% vs. 65.3 % without a partner), without overcrowding (68.6% vs. 56.5% with overcrowding), with health insurance (73.8% vs. 56.3% without it), in the highest income quintile (80.9% vs. 55.1% in inferior), and with complete secondary studies (74.5% vs. 56.7% incomplete). Concluding, there are different profiles and SED related to CC mortality and PAP practice in Argentina, which should be considered in targeted strategies against CC. El cáncer cervicouterino (CC) es el tercero más incidente en mujeres de Argentina, existiendo antecedentes nacionales de asociación inversa entre mortalidad por CC y calidad de vida. Objetivos: a) Identificar perfiles provinciales de mortalidad por CC y su práctica preventiva PAP en Argentina; b) Analizar los determinantes socioeconómicos (DSE) de realización de PAP en mujeres, 2018. Se condujo un estudio ecológico multigrupal (n=24 unidades geográficas de Argentina), empleando fuentes secundarias de datos (Encuesta Nacional de Factores de Riesgo –ENFR– 2018; datos censales; estadísticas vitales del Ministerio de Salud Nacional). Se estimaron, por unidad geográfica, tasas de mortalidad ajustada por edad (TME) por CC, prevalencias ponderadas (%) de realización de PAP (últimos 2 años) en mujeres de 25-65 años, así como la proporción de éstas con educación secundaria incompleta, ocupación, obra social, hacinamiento, y acceso al servicio público gas de red. Se realizó un análisis de componentes principales y clústeres jerárquico para identificar perfiles provinciales; se construyeron mapas temáticos empleando QGIS. A nivel individual (n=11496 mujeres 25-65 años; ENFR 2018), se aplicó un test de diferencia de proporciones (α=0,05) para la prevalencia de PAP según DSE seleccionados. La TME por CC promedio (±DS) fue 5,57 (±2,3) defunciones por 100.000 en Argentina. Se identificaron tres perfiles provinciales (varianza explicada= 78%) denominados: (1) Mayor mortalidad por CC con vulnerabilidad socioeconómica y baja práctica preventiva (provincias del NEA y NOA); (2) Menor mortalidad por CC con acceso a servicios públicos (región Pampeana, Cuyo y Patagonia); (3) Mayor prevalencia de PAP con condiciones socioeconómicas favorables (CABA, Tierra del Fuego). El porcentaje medio de realización de PAP fue 66%. La prevalencia de PAP fue significativamente superior (p<0,01) en mujeres de 25-49 años (70,3% vs. 63,8% en 50-65 años), casadas/unidas (70.4% vs. 65,3% sin pareja), sin hacinamiento (68,6% vs. 56,5% con hacinamiento), con obra social (73,8% vs 56,3% sin cobertura), en quintil superior de ingresos (80,9% vs. 55,1% en inferior), y con secundario completo (74,5% vs. 56,7% secundario incompleto). Concluyendo, existen distintos patrones y DSE relacionados a mortalidad por CC y práctica de PAP en Argentina, que debieran ser considerados en estrategias focalizadas contra el CC. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2022-10-26 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto texto texto https://revistas.unc.edu.ar/index.php/med/article/view/39076 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 79 No. Suplemento JIC XXIII (2022): Suplemento JIC XXIII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 79 Núm. Suplemento JIC XXIII (2022): Suplemento JIC XXIII Revista da Faculdade de Ciências Médicas de Córdoba; v. 79 n. Suplemento JIC XXIII (2022): Suplemento JIC XXIII 1853-0605 0014-6722 http://creativecommons.org/licenses/by-nc/4.0 |