Cervical cancer prevention strategies the comprehensive cervical cancer prevention strategy developed by the Ministry of Health currently consists of: primary prevention: vaccine against HPV, prevents against two types of HPV (16 and 18), which cause 70% of cases of cervical cancer. It is recommended for use in girls before sexual intercourse.

It is applied free of charge to girls aged 11 years from October 2011 (born in 2000 and beyond).4 48 COURSE IN SOCIAL AND COMMUNITY HEALTH 5. Cancer Institute. Ministry of health of the nation. 6. IARC: IARC Handbooks of Cancer Prevention, Volume 10, Cervix Cancer Screening, IARC Press, Lyon, 2005.

The test that is effective in preventing cervical cancer

Secondary prevention: screening in the context of an organized program, using the Pap test. As already mentioned, screening involves applying to a certain group of women without symptoms a test to identify those women at greater risk of developing precancerous lesions or cancer. The test that is effective in preventing cervical cancer is PAP. PAP is an effective screening method, which detects lesions (cellular abnormalities) in the cervix and treats them before cancer develops.

It is a very simple and generally painless procedure, which involves taking a sample of the flow cells surrounding the cervix with a wooden spatula, depositing that sample in a glass and sending it to be analyzed in a pathological anatomy and cytology laboratory. Doctors and other specialized health team professionals – medical assistants, health promoters, obstetricians, midwives, midwives and nurse practitioners-can perform PAPs tests.5 screening for cervical cancer precursor lesions between the ages of 35 and 64 using PAP in a high-quality program reduces the incidence of cervical cancer by 80% or more.

Scientific evidence indicates that cervical – uterine cancer develops more frequently in women from the age of 40, reaching a peak around the age of 50. Therefore, in women under 35, screening has less impact.6 however, it has been shown that the use of PAP as a screening method tends to be concentrated in the group of women who generally have the least risk of developing the disease.

Difficulties of access to the Health Center

In general, younger women have greater access to PAP than women over the age of 35, since in our country, PAP is performed mainly to those women who attend health facilities to perform gynecological consultations or control their pregnancy (in reproductive age). In addition, in general, there are few strategies to actively seek out women in this age group for such controls. In addition, despite the fact that the PAP is a simple and painless test, there are several barriers that hinder its realization: geographical barriers: distance and / or difficulties of access to the Health Center.

Economic barriers: lack of money to move, illiteracy or low educational level associated with poverty, which prevents proper reception of health messages and recommendations.

Institutional barriers. Schedules not adapted to the needs of women.  Shift delay. 49 some complex health problems 7. Arrossi, et al: Reproductive Health Matters, 2008. Missing female staff for paps shooting. Lack of extended-time PAPs offices. Lack of attention to spontaneous demand. Lack of education and dissemination.

Lack of trained and available staff. Subjective and cultural barriers. Women’s perception that PAP performance is a painful or conflictive situation. Feelings of discomfort, shame or anxiety that arouses be checked, especially if it is male gynecologists. The lack of knowledge about the PAP, its importance, how to proceed with its results. The conception of cervical cancer as an inevitable fatality and not as a preventable disease.

They don’t have health coverage

These barriers explain some of the obstacles that need to be overcome to facilitate access to the PAP. In general, women who belong to one or more of the following groups are at increased risk of falling out of cervical cancer prevention strategies7: they live in the NOA/ NEA/ Cuyo regions. They’re over 40. They have no education or only primary education. They live in poverty. They don’t have health coverage. They don’t use contraceptives.

Activity we propose that you investigate with the rest of the community team and reflections with the tutor about: a. Which of the aforementioned institutional barriers identify in the local health system (the health team, the health center, the hospital, the local government) for achieving high coverage in the performance of Pap ? 50 COURSE IN SOCIAL AND COMMUNITY HEALTH

National survey of Risk Factors. Ministry of health of the nation. 2005. Do they identify other situations that act as facilitators for achieving high coverage? Thinking about the community that serves the Health Center / Community Integration Center: what situations may be operating as subjective and cultural barriers for women to perform the Pap test?

The experience of developed countries indicates

Do they identify other actions that can be carried out from the Health Center / Community Integration Center that facilitate the implementation of the PAP and, therefore, improve coverage? National Cervical Cancer Prevention Program scientific evidence indicates that invasive cervical cancer develops more frequently in women from 35 to 64 years, showing very low incidence in women under 25 years. In our country, the National Survey of Risk Factors (2009) reveals that in 2009, on average, 39.5% of women aged 35 and over had not had a PAP in the 2 years prior to the survey.

But in some regions, such as the North-East and North-East of our country, this percentage is even higher and amounts to 65 per cent in the same period.8 some complex health problems if we analyze the coverage according to the educational level reached of women, we find that only 40.3% of the population with incomplete primary had undergone a PAP in the two years prior to the survey.

These differences are deepened by looking at this data by region, in the NOA region only 27% of them were covered. The experience of developed countries indicates that up to 80 per cent of cervical cancer incidence and mortality can be prevented through organized prevention programmes. That is why in 2008 The Ministry of health of the nation relaunched the national program for the Prevention of cervical-uterine cancer.

The final purpose of the National Program is to reduce the incidence and mortality from cervical-uterine cancer in Argentina. One of the objectives of the National Programme is to strengthen the provincial programmes by establishing an organized prevention strategy that unifies the criteria for action while taking into account the particular needs of each province, and to this end, it works in conjunction with the references of the provincial programmes for the strengthening of measures to prevent cervical uterine cancer in each and every jurisdiction.