Barreiras e facilitadores a realização do exame preventivo e as formas de prevenção do câncer do colo do útero: profissionais de saúde do SUS

Abstract

To understand the barriers and facilitators related to cervical cancer screening and prevention strategies from the perspective of Primary Health Care professionals in Manaus, Amazonas. Method: qualitative study conducted between July and October 2025 with 12 health professionals from two Primary Health Care Units, using semi-structured interviews. The analysis followed the COREQ recommendations and employed the Thematic Networks method articulated with the WHO Social Determinants of Health framework. Results: three organizing themes emerged — social structures and living conditions; organization of care and accessibility to services; and informational and psychosocial processes. The main barriers included women’s overload and lack of time, gender relations marked by control and power asymmetry, embarrassment and negative experiences related to the examination, bureaucratization of processes, failures in information systems, scarcity of educational materials, and the influence of fake news on HPV vaccination. Facilitators included the linkage between social benefits and health goals, daily availability of screening collection, the presence of female nurses, active search strategies, actions developed through the School Health Program, and the central role of health education directed toward women, families, and caregivers. Conclusion: adherence to the Pap smear test and HPV vaccination results from the interaction between social, organizational, and symbolic factors, making it essential to strengthen Primary Health Care through intersectoral interventions, continuous educational practices, and territorially organized care in order to expand preventive coverage and reduce the impact of cervical cancer.