An update on the status of breast cancer screening in Brazil after the covid-19 pandemic

Abstract

We have previously reported the impact of covid-19 pandemic on breast cancer screening, in Brazil: among women aged 50–69 years, mammography attendance decreased by 42% in public healthcare (SUS), comparing 2019 and 2020. In this short communication, we wish to present: a) an update of the number of mammograms performed, in 2021; b) an exploratory analysis of the characteristics of the screened population between 2019 and 2021. A total of 1.675.307 mammograms were performed in 2021, nearly 15% lower than pre-pandemic levels. Almost a third, 29.5% of them, had intervals greater than three years. In accordance with our previous study, the number of patients with palpable lumps on physical exam increased. The consequences of postponing breast cancer screening during the pandemic are still uncertain. Unfortunately, as of December 2021, screening attendance has not resumed. On the contrary, our results show an increase in the fraction of women with mammography delayed beyond three years.

Noteworthy impacts of COVID-19 pandemic on cancer screening: A systematic review

“…Seven studies [ 31 , 32 , 36 , 39 , 58 , 65 , 74 ] scored 1 point because of statistical differences in the most or second-most important factors. Forty-five studies [ [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , 33 , 34 , 37 , 38 , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [53] , [54] , [55] , [56] , [57] , [59] , [60] , [61] , [62] , [63] , [64] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , 75 , 76 ] scored 0 point in view of the lack of control over the most or second-most important factors in the comparability domain.…”

The COVID-19 pandemic and the increase in mortality of cancer patients in Brazil

“…We highlight that this region, which in 2019 already had the worst mammography coverage by the SUS in Brazil [33], showed the most signi cant increase in mortality from female breast cancer in 2022. Also, the situation remained unfavorable in 2021: 15% fewer exams than in 2019 in Brazil [34]. Analysis that compared new cases of colorectal and anal cancer in the outpatient clinics of a reference center for cancer treatment in São Paulo, reported a decrease in newly diagnosed patients referred and an increase in locally advanced disease from March to July 2020 compared to the same period in 2019.…”

COVID-19 and Breast Cancer Diagnosis in Brazil: An Analogy to the Sinking of the Titanic

“…During the pandemic, a reduction occurred in the number of cases of screening-diagnosed breast cancer 5 while symptom-diagnosis increased. 3 , 5 This finding is particularly concerning in a country in which breast cancer screening within the public health care system was already previously low, 2 , 6 with a mean reported rate of 36.71% between 2013 and 2019.…”

“… 2 Other reports have corroborated these data. 3 , 4 After the restrictive measures of the pandemic were eased and vaccination implemented, the consequent contraction in SARS-CoV-2 infection rates and COVID-19–related mortality proved insufficient to restore breast cancer screening coverage to pre-COVID levels. 2 , 3 Indeed, in 2021, an increase was found in the number of women who had not undergone screening for more than 3 years.…”

“… 2 , 3 Indeed, in 2021, an increase was found in the number of women who had not undergone screening for more than 3 years. 3 …”