Abstract

WIESNERA, Carolina et al. Barriers for implementing the HPV-DNA test as a primary cervical cancer-screening technique in a demonstrative area of Colombia. rev.colomb.cancerol. [online]. 2013, vol.17, n.3, pp.93-102. ISSN 0123-9015.

Objective: To identify the barriers for the implementation of a cervical cancer-screening program based on human papillomavirus (HPV) testing in Colombia. Methods: The Precede-Proceed model was applied in four municipalities of Cundinamarca and two of Boyacá. Secondary and primary data were analyzed from 74 institutional surveys, 18 focus groups (with community leaders and health professionals), and 12 interviews (health authorities). Results: The most relevant barriers were identifi ed as follows: 1) Social barriers: in Duitama, the municipality with a religious tradition, HPV infection is represented as a venereal disease. 2) Epidemiological barrier: the absence of a register for defi nitive diagnosis of pre-neoplasic lesions. 3) Behavioral barriers: Pap smear laboratories are not centralized, some are not accredited and colposcopies are not standardized. 4) Health professionals overestimate Papsmear sensitivity and they are over worried about HPV infection among women younger than 30 years. 5) Administrative barriers: positive screened women need to have an authorization from Health Insurance Enterprises in order to access the diagnosis and treatment of cervical lesions. Conclusions: Colombia presents barriers to the operation of an organized screening program that make it diffi cult to achieve the expected objectives with the technological change from the use of cytology to molecular testing.

Keywords : Uterine Cervical Neoplasms; Screening; Human papillomavirus; Theoretical Models; Colombia; DNA-HPV probes; PRECEDE-PROCEDE model.

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