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Background: Understanding the overuse and underuse of cervical cancer (CC) screening plays a role in preventing such behaviours, allowing to maximize the CC screening uptake. Aim: To assess the predictors of being over-screened and never/under-screened in CC screening in Northeast Portugal. Methods: This is a part of a larger cross-sectional survey carried out in two public health centres in Northeast Portugal (October 2017 to June 2018). Data collection was based on a face-to-face interview. This analysis included 764 women (aged 25–60 years) classified according to the use of CC screening into guideline-consistent screened, over-screened and unscreened/under-screened. Multivariate logistic regression models were conducted to assess predictors of being over-screened and never/under-screened. Adjusted odds ratio (OR) and respective 95% confidence interval (95% CI) were obtained. Results: One-fourth (n = 197) of participants were unscreened/under-screened and 50.0% (n = 382) of them were classified as over-screened. Regular visits with primary care physicians (OR = 0.44; 95% CI: 0.26–0.76) and higher age (OR = 0.98; 95% CI: 0.96–1.00) reduced the odds of being unscreened/under-screened. Women who received prescription/recommendation for CC screening from primary care physician (OR = 1.89; 95% CI: 1.09–3.29) or both primary care physician and nurse (OR = 2.62; 95% CI: 1.10–6.22) were more likely to be over-screened. Higher level of CC health literacy decreases the odds of being over-screened (OR = 0.95; 95% CI: 0.90–1.00) and unscreened/under-screened (OR = 0.87; 95% CI: 0.82–0.92). The majority of over-screened (52.2%) and of under-screened (44.2%) women reported that their screening frequency was based on healthcare provider prescription. Among never-screened women, 60.2% reported that no one prescribed screening. Conclusion: The increase in CC health literacy can maximize CC screening uptake. Primary healthcare providers could play a role in preventing the overuse and underuse of CC screening. [ABSTRACT FROM AUTHOR]

Copyright of Portuguese Journal of Mental Health Nursing / Revista Portuguesa de Enfermagem de Saúde Mental is the property of Portuguese Society of Mental Health Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Enfermagem Referência is the property of Escola Superior de Enfermagem de Coimbra and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Portuguese Journal of Public Health / Revista Portuguesa de Saúde Pública is the property of Revista Portuguesa de Saúde Pública - Escola Nacional de Saúde Pública and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The mortality rate due to cervical cancer is higher in Portugal compared to other European countries. This study aimed to evaluate the time-trends in cervical cancer mortality rates observed in Portugal over the last six decades., Material and Methods: Age-standardized cervical cancer mortality rates reported in Portugal between 1955 and 2014, were collected from the International Agency for Research on Cancer (IARC). Joinpoint regression analysis was used to identify significant changes in mortality rates by assessing the percentage of annual variation (%AV) of the rate and respective 95% confidence interval (95%CI) according to the age groups., Results: Among women with 30-39 years, cervical cancer mortality decreased 1.9% per year (95%CI: -2.3; -1.4) throughout the time-period, reaching 0.5/100 000 in 2014. Among women aged 40-49 years, CC mortality decreased between 1971 and 1981 (%AV = -11.6; IC 95%: -14.6; -8.6). Rates then increased by 2.4% per year (95%CI: 1.0; 3.8) until 2001 and such trend reverted from 2001 onwards (%AV = -5.2; IC 95%: -7.7; -2.6), reaching 3.0/100 000 in 2014. In women aged 50-64, 65-74 and 75 years or older, cervical cancer mortality rates decreased from 29.2 to 6.7/100 000, from 34.3 to 7.7/100 000 and from 24.7 to 9.2/100 000. The decline in mortality rates in these three age groups occurred mainly between 1970 and 1980, and there have been no significant changes in the last three decades., Discussion: In Portugal, the most impressive decline in cervical cancer mortality rates occurred in the 1970s concurrently with changes in the National Healthcare System. The most important changes were the increased access to early diagnosis and the improvement in therapeutic approaches. The plateau that we observed among older women over the last three decades can be partially explained by factors with negative impact on adherence to cervical screening., Conclusion: There was a marked decrease in mortality due to CC among all age groups. However, we observed a plateau of this indicator in more advanced age groups over the last three decades. These findings suggest the need of promoting adherence to cervical screening in Portugal.