TY - JOUR
T1 - The association between scheduling a gynecologic clinical visit and clinical breast examination in Rio de Janeiro
AU - Martins, Luís Felipe L.
AU - De Almeida, Liz Maria
AU - Szklo, André S.
AU - Tupinambá, Helena A.
AU - Szklo, Moyses
AU - Coeli, Cláudia M.
N1 - Publisher Copyright:
© 2015 International Federation of Gynecology and Obstetrics.
PY - 2015
Y1 - 2015
N2 - Objective To investigate factors associated with gynecology health professionals' failure to perform clinical breast examinations (CBEs) during clinical visits. Methods A cross-sectional, interview-based survey was conducted in 2010 among women aged at least 18 years who had undergone a cervical smear in 2007 at primary-care units in Rio de Janeiro, Brazil. Binomial regression was used to generate prevalence ratios and absolute differences between visits for routine examinations or gynecologic complaints. Results Analyses included 982 women, of whom 182 (18.5%) did not have a CBE during their visit. Significant interactions were observed between age and primary reason for the visit: the prevalence ratio for no CBE during a visit for gynecologic complaints versus routine examination was 3.2 for women aged at least 40 years, and 1.3 among younger women (P for multiplicative interaction = 0.001). Absolute differences were 6.4% and 18.5% for younger and older women, respectively (P for additive interaction = 0.04). Conclusion A high proportion of eligible women do not undergo a CBE during cervical smear appointments at primary-care units in Rio de Janeiro, particularly older women presenting with gynecologic complaints. Understanding of health professionals' barriers to following and implementing guidelines for secondary prevention of breast cancer is urgently needed.
AB - Objective To investigate factors associated with gynecology health professionals' failure to perform clinical breast examinations (CBEs) during clinical visits. Methods A cross-sectional, interview-based survey was conducted in 2010 among women aged at least 18 years who had undergone a cervical smear in 2007 at primary-care units in Rio de Janeiro, Brazil. Binomial regression was used to generate prevalence ratios and absolute differences between visits for routine examinations or gynecologic complaints. Results Analyses included 982 women, of whom 182 (18.5%) did not have a CBE during their visit. Significant interactions were observed between age and primary reason for the visit: the prevalence ratio for no CBE during a visit for gynecologic complaints versus routine examination was 3.2 for women aged at least 40 years, and 1.3 among younger women (P for multiplicative interaction = 0.001). Absolute differences were 6.4% and 18.5% for younger and older women, respectively (P for additive interaction = 0.04). Conclusion A high proportion of eligible women do not undergo a CBE during cervical smear appointments at primary-care units in Rio de Janeiro, particularly older women presenting with gynecologic complaints. Understanding of health professionals' barriers to following and implementing guidelines for secondary prevention of breast cancer is urgently needed.
KW - Breast neoplasms
KW - Cancer screening program
KW - Clinical protocol adherence
KW - Early detection
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U2 - 10.1016/j.ijgo.2015.06.033
DO - 10.1016/j.ijgo.2015.06.033
M3 - Article
C2 - 26404756
AN - SCOPUS:84945249342
SN - 0020-7292
VL - 131
SP - 289
EP - 292
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 3
ER -