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      Seguimiento a mujeres con resultado citológico positivo en una Empresa Social del Estado. Medellín, Colombia. 2011- 2012. Translated title: Monitoring of women with positive cytological result in a state-owned company, Medellín, Colombia, 2011- 2012 Translated title: Acompanhamento a mulheres com resultado citológico positivo em uma empresa do estado. Medellín, Colômbia. 2011- 2012

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          Abstract

          Resumen En Colombia el cáncer cérvico-uterino (Cacu) es una de las principales causas de muerte. Anualmente se diagnostican 7.000 casos y se registran 3.300 muertes, el 50% por diagnóstico tardío y falta de acceso a tratamientos especializados. Objetivo: describir el seguimiento a mujeres con resultado citológico positivo en una ESE de Medellín, 2011-2012. Metodología: estudio descriptivo transversal en 277 mujeres con resultado citológico positivo para lesiones sugestivas de alto grado y/o alteraciones glandulares. Se empleó muestreo estratificado y sistemático. Se utilizaron fuentes de información primaria y secundaria. La sistematización de datos se realizó en el programa SPSS, y se calcularon medidas de frecuencia, tendencia central y dispersión. Se empleó análisis descriptivo uni-bivariado para variables sociodemográficas, clínicas y relacionadas con la atención recibida. Resultados: el 10,7% de mujeres con lesiones de alto grado o invasoras no culminaron el tratamiento. La oportunidad total del seguimiento fue del 52,3% y las fases con mayores tiempos de espera para la atención fueron las citas para diagnóstico y tratamiento. Conclusión: A pesar de los esfuerzos para mejorar la cobertura del cribado y búsqueda activa de pacientes con citología positiva evidenciada en el estudio aún se presentan obstáculos en la atención de pacientes para un diagnóstico y tratamiento oportuno, lo que lleva en varios casos al avance de la enfermedad e incluso la muerte.

          Translated abstract

          Abstract In Colombia, the Cervical Cancer (CC) is one of leading causes of cancer death in women. Annually 7,000 cases and 3,300 deaths are diagnosed; from which the 50% have been recorded died for late diagnosis and lack of access to specialized treatments. Objective:This study aims to monitor women who have had a positive cytological results in a state-owned company in Medellin from 2011 to 2012. Methodology:This is a cross-sectional descriptive study conducted on 277 women who had positive cytological results for lesions suggestive of high grade and/or glandular disorders. This research used stratified systematic sampling, and primary and secondary information sources. SPSS was implemented to systematize data like frequency, central tendency, and dispersion measurements were calculated. A descriptive univariate-bivariate analysis was implemented for sociodemographic and clinical related variables, and those related to the healthcare subjects received. Results:10.7% of women with high grade or invasive lesions did not complete the treatment. The total monitoring opportunity was 52.3%, and the phases with the longest-waiting times were waiting for appointments for diagnosis and treatment. Conclusion: Despite efforts to improve screening coverage and to actively seek patients with a positive cytology evidenced in the study, there are still obstacles that impede patients’ prompt diagnosis and treatment, and this is something that in various cases leads to the progression of the disease and even death.

          Translated abstract

          Resumo Na Colômbia, o câncer cérvico-uterino (Cacu) é uma das principais causas de morte. Na atualidade, diagnosticam-se 7.000 casos e registram-se 3.300 mortes. 50% das mortes acontece por diagnóstico tardio e falta de aceso a tratamentos especializados. Objetivo: descrever o acompanhamento a mulheres com resultado citológico positivo em uma Empresa Social do Estado (ESSE) de Medellín, 2011-2012. Metodologia: estudo descritivo transversal em 277 mulheres com resultado citológico positivo para lesões sugestivas de alto grau e/ou alterações glandulares. Utilizou-se amostragem estratificada e sistemática. Consultaram-se fontes de informação primárias e secundárias. Utilizou-se o programa SPSS para sistematizar os dados, e calcularam-se medidas de frequência, tendência central e dispersão. Fez-se análise descritiva uni-bivariada para variáveis sócio-demográficas, clínicas e relacionadas com o atendimento recebido. Resultados: 10,7% das mulheres com lesões de alto grau ou invasoras terminaram o tratamento. A oportunidade total do acompanhamento foi de 52,3% e as fases com tempos de espera mais prolongados para o atendimento foram as consultas diagnósticas e o tratamento. Conclusão: apesar dos esforços para aumentar a percentagem de detecção e para buscar ativamente pacientes com citologia positiva evidenciada, no estudo se evidenciam obstáculos no atendimento de pacientes para seu diagnóstico e tratamento oportunos, ocasionando o avanço da doença e até a morte em vários casos.

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          Incidence and mortality of cervical cancer in Latin America

          Cervical cancer incidence and mortality estimates for 2000 are presented for the 21 Latin American countries, using estimates from the statistical package GLOBOCAN 2000. Additional data on time-trends are also presented, using the WHO mortality database. By the year 2000, some 76 000 cervical cancer and almost 30 000 deaths were estimated for the whole region, which represent 16% and 13% of the world burden, respectively. Thus, Latin American countries are among those with highest incidence rates in the world, together with countries from Sub-Saharan Africa, South and South East Asia. Variation in incidence among countries is large. Very high rates are found in Haiti (ASR 93.9 per 100 000), Nicaragua (ASR 61.1 per 100 000) and Bolivia (ASR 58.1 per 100 000). It seems unlikely that differences in risks in the region can be explained as the result of screening activities. Several descriptive studies carried out to evaluate the screening programmes in Latin America have pointed out problems related to insufficient coverage and frequency of screening. Other related problems include inadequate collection and reading of cytological samplings as well as incomplete follow-up of women after the test. The main challenge for Latin America countries remains on how to organize effective screening programmes, and for this, a real and urgent commitment from public health services and decision-makers in the region is needed.
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            Cervical cancer, a disease of poverty: mortality differences between urban and rural areas in Mexico

            OBJECTIVE: To examine cervical cancer mortality rates in Mexican urban and rural communities, and their association with poverty-related factors, during 1990-2000. MATERIAL AND METHODS: We analyzed data from national databases to obtain mortality trends and regional variations using a Poisson regression model based on location (urban-rural). RESULTS: During 1990-2000 a total of 48 761 cervical cancer (CC) deaths were reported in Mexico (1990=4 280 deaths/year; 2000=4 620 deaths/year). On average, 12 women died every 24 hours, with 0.76% yearly annual growth in CC deaths. Women living in rural areas had 3.07 higher CC mortality risks compared to women with urban residence. Comparison of state CC mortality rates (reference=Mexico City) found higher risk in states with lower socio-economic development (Chiapas, relative risk [RR]=10.99; Nayarit, RR=10.5). Predominantly rural states had higher CC mortality rates compared to Mexico City (lowest rural population). CONCLUSIONS: CC mortality is associated with poverty-related factors, including lack of formal education, unemployment, low socio-economic level, rural residence and insufficient access to healthcare. This indicates the need for eradication of regional differences in cancer detection.
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              Validez en la evaluación de escalas

              Las escalas como instrumento de medición adquieren particular importancia cuando la variable o entidad que se pretende medir es subjetiva, es decir, que tanto su definición como sus componentes tienen un alto nivel de variabilidad. Dentro de las características que deben estar presentes en cualquier instrumento de medición se incluyen su reproducibilidad, utilidad y validez. La validez permite hacer inferencias y evaluar hipótesis acerca de las personas sobre las cuales estamos empleando las escalas como instrumento de medición. El propósito de este artículo es presentar la importancia y la utilidad de la validez en el proceso de evaluación de escalas. Se describen las diferentes clases de validez y su forma de aplicación en un contexto clínico, para determinar la presencia de este atributo como parte del proceso de validación de escalas.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rfnsp
                Revista Facultad Nacional de Salud Pública
                Rev. Fac. Nac. Salud Pública
                Universidad de Antioquia (Medellín, Antioquia, Colombia )
                0120-386X
                January 2017
                : 35
                : 1
                : 27-38
                Affiliations
                [2] Antioquía orgnameUniversidad de Antioquia Colombia
                [1] Antioquía orgnameUniversidad de Antioquia Colombia marleny.valencia@ 123456udea.edu.co
                Article
                S0120-386X2017000100027
                10.17533/udea.rfnsp.v35n1a04
                a0b34b8e-1061-4a26-83a9-34a6482bbf37

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 16 December 2015
                : 28 October 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 37, Pages: 12
                Product

                SciELO Colombia


                diagnosis,Colombia,Estudos de acompanhamento,Teste de Papanicolaou,neoplasias cervicais,esfregaço vaginal,prevenção secundária,diagnóstico,Colômbia,Estudios de seguimiento,Prueba de Papanicolaou,neoplasias de cuello uterino,frotis vaginal,prevención secundaria,diagnostico,Monitoring studies,Pap smear,Uterine Cervical Neoplasms,vaginal smear,secondary prevention

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