O acesso ao diagnóstico das lesões escamosas intraepiteliais cervicais em mulheres brasileiras: o institucional, o vivido e o compreendido (revisão de escopo)

Abstract

Cervical cancer has been documented as one of the major health problems in the world, and in Brazil it has a high mortality rate among women. The control of the disease is based on public actions and screening of the target population, so the challenges imposed require strategies for clarification of access to diagnosis. This work aims to analyze the institutional capabilities of health education in primary care around the access to diagnosis of cervical cancer, identifying the socioeconomic, cultural, racial and political variables experienced by Brazilian women, as well as their understandings on the subject. A scoping review was carried out on articles indexed in national and international databases, according to the scoping review methodology. The collected publications were from 2013 to 2022, in MEDLINE, SCIELO, LILACS, Scopus, CAPES and Web of Science databases, using the following keywords and bolena operators: "Squamous Intraepithelial Lesions of the Cervix" OR "Uterine Cervical Neoplasms" AND "Diagnosis" OR "Health Services Accessibility". Initially, 1,174 articles were found, of which 22 met the inclusion criteria and were added to the review. There were mentioned working actions of Primary Health Care that favor the connection of professionals and the population, however public and professional improvements are needed for interventions to incorporate a larger audience. Disadvantages of access among Brazilian municipalities were identified, in addition to influences on access to diagnostic services from several angles, which are linked to the socioeconomic, cultural and racial context experienced by women. In the analysis of the female population's understanding about cervical cancer, the lack of knowledge or inadequate knowledge of women was observed, indicating improvements to be applied in the health education system. It was possible to observe that health education interventions when well applied and improved favor adherence to diagnostic tests for cervical cancer. The improvement of actions in Primary Health Care are potential strategies to ensure access to diagnostic tests and improve the information burden of Brazilian women.