THE CERVICAL-CANCER SCREENING-PROGRAM IN MEXICO - PROBLEMS WITH ACCESS AND COVERAGE

A cross-sectional study was carried out in two geographic regions of M exico-Oaxaca (rural area) and Mexico City (urban area) - to determine the main factors for predicting participation in Cervical Cytology Scr eening Programs (CCSP), in populations with high mortality due to cerv ical cancer. We included 4,208 women aged between 15 and 49 years, ran domly selected through a national household-sample frame. Knnowledge o f what the Pap test is used for strongly predisposes use of CCSP in Me xico City (odds ratio [OR] = 46.1, 95 percent confidence interval [CT] = 33.1-64.1) and Oaxaca state (OR = 61.5, CI = 42.0-89.9), as well as high socioeconomic level (Mexico: OR = 2.0, CI = 1.1-7.6; Oaxaca: OR = 4.1, CI = 3.1-5.3), high education level (Mexico: OR = 3.6, CI = 1.5 -8.8; Oaxaca: OR = 5.3, CI = 2.8-10.0), and access to social security (Mexico: OR = 1.7, CI = 1.4-2.2; Oaxaca: OR = 2.2, CI = 1.8-2.7). Low coverage of the CCSP is confirmed as an important problem in Mexico.