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Revista Costarricense de Salud Pública

Print version ISSN 1409-1429


APARICIO LLANOS, Amada  and  MORERA SALAS, Melvin. Variabilidad geográfica en la detección temprana del cáncer cervicouterino entre servicios integrados de atención en Costa Rica, 2004-2005. Rev. costarric. salud pública [online]. 2007, vol.16, n.30, pp.54-61. ISSN 1409-1429.

Objective: To carry out a comparative analysis of the early screening results of cervico-uterine cancer, by means of the identification of geographic patterns in the three comprehensive health services of the Costa Rican Social Security system. Materials and methods: A variability analysis for carried out for the period 2004-2005 for the age-adjusted percent coverage by Pap smear using as indicators the variation ratio (RV p95-5), the coefficient of variation (CV p95-5) and a dot graphic. For the geographic representation, was used an adjusted index which compares the coverage in each health area with the national average, using the map of Costa Rica to represent the three integrated health services. Results: The health area located in the 95th. percentile showed coverage that was 2.3 times greater than that located in the 5th. percentile. Among integrated services, a moderate degree of variability in services 1 and 2 (CV= 19% and 21%, respectively) and a low degree of variability in service 3 (CV=12.9%) were observed. A geographic pattern of low Pap smear coverage was seen in the health areas of the Caribbean coastal area, the northern border with Nicaragua as well as the middle part of the country, both of which are located in integrated health services 1 and 3. Conclusions: The present coverage strategies for taking a Pap smear appear not to emphasize the priorization of the poorest health areas which also have the greatest preventable mortality due to cervicouterine cancer since we observed that this was one of the main characteristics of the areas identified as having low national coverage.

Keywords : Pap smear; geographic variability; cervicouterine cancer.

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