Motivos de abandono en el proceso de atención médica de lesiones precursoras de cáncer cervicouterino

objective. to determine factors associated with medical care abandon of women with cin. material and methods. a nested case-control study in a cohort was done. patients referred to clinical dysplasia of gyneco-obstetrician services in third level hospitals were considered. cases: patients who abandoned medical care. controls: women who attend their medical appointments during follow-up. all subjects underwent structured interviews focused on social, clinical and health services factors in two different times, applied at the beginning of study and the end of follow-up. clinical records were reviewed to obtain clinical information. analysis: descriptive and inferential statistical was done. non conditional logistic regression analysis was done to obtain adjusted association. results. abandon cumulative incidence rate was 108/525 = 20.7% (i.c 95% = 17.2-24.3); 60.2% happened in diagnosis phase, 17.7% ocured during therapeutic phase and 23.1% happened in surveillance phase. we studied 108 cases and 417 controls to analysis. next adjusted risk factors were obtained: afraid to death (ora = 4.2, i.c.95% = 1.8-9.5), long appointments (ora = 6.6, i.c95% = 3.4-13.0), lack of privacity (ora = 12.5, i.c.95% = 2.6-59.8), reject to treatment (ora = 40.4, i.c.95% = 2.1-785.4), lack of information (ora = 41.9, i.c95% =14.2-124.1) and other factors. conclusions. patient perception, access and barriers in health services were the most important factors associated with medical care abandon.