Acesso à detecção precoce do câncer de mama no Sistema Único de Saúde: uma análise a partir dos dados do Sistema de Informações em Saúde

Abstract

A redução recente na mortalidade por câncer de mama em países de alta renda é atribuída à detecção precoce e melhorias no tratamento. O câncer de mama é o tipo mais frequente de câncer feminino no Brasil, e, desde 2004, o governo recomenda o exame clínico anual das mamas para mulheres a partir dos 40 anos e rastreio mamográfico bienal entre 50 e 69 anos. Este artigo investiga o nível de implementação dessas recomendações usando os dados dos sistemas de informações do SUS de 2010 por macrorregião e grupo etário. Evidenciou-se uma cobertura baixa de mamografia entre a população alvo (32%: 50-59 anos; 25%: 60-69 anos). A proporção de mulheres com achados radiológicos anormais submetidas à biópsia também foi baixa (27%: 50-59 anos; 63%: 60-69 anos). O número de cirurgias para câncer de mama foi maior do que o número de casos detectáveis pela mamografia, mas muito inferior ao número estimado de casos incidentes para 2010. Existem marcadas desigualdades regionais no acesso à detecção precoce e à cirurgia, sendo o acesso mais baixo na Região Norte e mais alto na Região Sul.

Estimativa de pessoas com diagnóstico de câncer no Brasil: dados da Pesquisa Nacional de Saúde, 2013

“…It is also pointed out the introduction of the HPV vaccine for teenagers in 2013, which may, in the future, change the picture of infections by this virus 25 . Besides the early performing of the exam, in order to obtain a reduction on the incidence and in mortality it is necessary that all women who had results changes in screening have their treatment in a timely manner 26,27 . Another interesting fact is the high prevalence of people diagnosed in the Southern region (3.2; 2.6 -3.8), even higher to the one registered in the Southeastern region (2.1; 1.7 -2.5).…”

Opportunistic screening actions for breast cancer performed by nurses working in primary health care

“…Investments in actions for prevention, early detection and implementation of effective programs to control the disease are key measures (1,6) . Organized screening programs, prevalent in wealthier countries, have greater potential to reduce morbidity and mortality and avoid unnecessary exams (6) ; however, control and certification of screening programs implemented in the country still do not have consistent information about their effectiveness (7) .…”

Breast Cancer Mortality In Brazil: Correlation With Human Development Index

“…A set of factors has pointed to a low impact tracking measures in breast cancer mor- tality in Brazil: the low mammography coverage, inadequate tracking of suspicious radiological findings and the limited access to surgical treatment [19]. Azevedo e Silva et al [19], analyzing the number of biopsies compared to the number of cases that would require follow-up to diagnostic clarification, concluded that only 27% of women between 50 and 59 years with mammograms with BI-RADS 4 and 5 performed biopsy and 63% of those with 60-69 years. In this study, which lasted until 2012, our units of note were the States and analysis of the data shows an increase in the specific coefficient of mortality from breast cancer in all Brazilian regions and Federal District (Figure 2).…”

“…Despite being inversely associated with the incidence rates of cancer in general [14], is directly associated with the incidence of breast cancer [16]. Part of this relationship is explained by lifestyle and by access to early diagnosis of breast neoplasm [5,[16][17][18][19].…”

“…In developed countries, the rate of survival is higher due to early detection and, probably, to access to treatment, compared to less developed countries [18,19]. Among the countries of Latin America, characterized by urban poverty, which exacerbates social disparities, Brazil continues to present itself as a favorable area to study geographic patterns of mortality from breast cancer.…”