Regional and Socioeconomic Differences in the Coverage of the Papanicolau Test in Brazil: Data from the Brazilian Health Survey 2013

Abstract

<b>Purpose</b> To evaluate the coverage of the Papanicolaou test in Brazil and the associated factors. <b>Methods</b> Cross-sectional study based on data from the Brazilian Health Survey 2013 comprising the proportion of 25- to 64-year-old women who had undergone a Papanicolaou test within the previous 3 years, categorized by sociodemographic variables and access to healthcare services. <b>Results</b> The screening coverage in Brazil was of 79.4% (95% confidence interval [95%CI]: 78.4-80.3), showing significant differences between the different states of the country, with the highest rate in the state of Roraima (86.5; 95%CI: 83.5-89.4), and the lowest one in the state of Maranhão (67.7; 95%CI: 61.3-74.0). Undergoing the test was significantly more frequent among married women (83.6%; 95%CI: 82.4-84.8), those with higher educational levels (88.7%; 95%CI: 87.0-90.5), of white ethnicity (82.6%; 95%CI: 81.3-83.9) and who reside in urban areas (80.1%; 95%CI: 79.1-81.2). Those who had undergone the test more than three years prior to the survey and the ones who had never undergone it were associated with a lower level of education, being of black or brown ethnicity, single or divorced, and rural dwellers. <b>Conclusions</b> The coverage of cervical cancer screening in Brazil is below the recommended rate and presents regional and sociodemographic disparities.