Barriers to early detection of cervical-uterine cancer in Mexico

In Mexico, a woman dies of cervical-uterine cancer every 2 hours, indicatin g a low impact by the national program for early detection of this cancer, principally because of problems related to quality and coverage. Through a qualitative study, we identified the principal barriers to use of the detec tion program from the point of view of actual and potential program users. Four focus groups were organized in standard conditions in Mexico City turb an, developed) and in the southern state of Oaxaca (rural, economically dis advantaged area). Participants were either women with at least one previous Papanicolaou (Pap) test or women who had never had the test. Barriers to P ap test use included (1) lack of knowledge about cervical-uterine cancer et iology, (2) not knowing that the Pap test exists, (3) the conception that c ancer is an inevitably fatal disease, (4) problems in doctor/medical instit ution-patient relationships, (5) giving priority to unmet needs related to extreme poverty, (6) opposition by the male sexual partner, (7) rejection o f the pelvic examination, (8) long waits for sample collection and receivin g results, and (9) perceived high costs for care. To increase coverage of t he early detection program for cervical-uterine cancer in Mexico, the needs , perceptions, and beliefs of women and their partners must be taken into a ccount when developing policy and planning, given the role these factors pl ay in the decision-making process that leads to their participation or nonp articipation in this program.