CERVICAL CYTOPATHOLOGY IN PRIMARY HEALTH CARE: KNOWLEDGE, PRACTICES AND ACCESS BARRIERS AMONG WOMEN IN IMPERATRIZ, MARANHÃO, BRAZIL

Abstract

Cervical cancer remains a relevant public health problem in Brazil. This study analyzed knowledge, practices and access barriers related to cervical cytopathology (Pap test), as well as factors associated with where the last test was performed, among women attending Primary Health Care Units in Imperatriz, Maranhão, Brazil. This cross-sectional, descriptive and exploratory study included a non-probabilistic sample of 205 women aged 18 years or older, analyzed using Pearson’s chi-square and Fisher’s exact tests (p < 0.05). The test was known by 84.4% of participants, but only 62.4% knew its recommended frequency. Screening within the previous three years was reported by 71.9% of the 192 women with classifiable information, and 20.3% had never been tested. The main barriers were unsuccessful scheduling attempts (28.4%), mostly due to lack of available appointments, unawareness of the collection schedule (77.7%) and the test never being offered. Use of the private sector was associated with income (p = 0.012) and education (p < 0.001), but not with scheduling difficulties. Knowledge does not fully translate into preventive practice, and organizational barriers and socioeconomic inequalities shape access to the test in Primary Health Care.