Social inequalities in access to cancer screening and early detection: A population-based study in the city of São Paulo, Brazil

Santos, Edigê Felipe de Sousa; Monteiro, Camila Nascimento; Vale, Diama Bhadra; Louvison, Marília Cristina Prado; Goldbaum, Moisés; César, Chester Luiz Galvão; Barros, Marilisa Berti de Azevedo

doi:10.1016/j.clinsp.2022.100160

Cited by 2 publications

(2 citation statements)

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“…17,18 An evaluation of trends in access to cancer screening, with a focus on mammography, Pap smears and prostate-specific antigen (PSA) testing, found inequalities in the city of São Paulo from 2003 to 2015, with access to diagnostic tests greater among more educated individuals. 19 Our results from the capital are in line with global between-country variations in the magnitude of cancer according to national levels of human development, for which a positive gradient between cancer incidence rates and HDI has been reported, notably for prostate, female breast, colorectal, and lung cancer. 20 There are however substantial differences in estimated incidence rates within countries, including Brazil, with incidence rates of breast and colorectal cancer two times higher in the southeast region (with the highest HDI), versus the northern region of Brazil (with the lowest).…”

Section: Discussionsupporting

confidence: 87%

“…Another contributory factor to the relative homogeneity is the existence of Barretos Cancer Hospital, a reference center for prevention and cancer treatment in Brazil 17,18 . An evaluation of trends in access to cancer screening, with a focus on mammography, Pap smears and prostate‐specific antigen (PSA) testing, found inequalities in the city of São Paulo from 2003 to 2015, with access to diagnostic tests greater among more educated individuals 19 …”

Section: Discussionmentioning

confidence: 99%

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Cancer inequalities in incidence and mortality in the State of São Paulo, Brazil 2001–17

et al. 2023

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BackgroundCancer disparities exist between and within countries; we sought to compare cancer‐specific incidence and mortality according to area‐level socioeconomic status (SES) in the State of São Paulo, Brazil.MethodsCancer cases diagnosed 2003–2017 in the Barretos region and 2001–2015 in the municipality of São Paulo were obtained from the respective cancer registries. Corresponding cancer deaths were obtained from a Brazilian public government database. Age‐standardized rates for all cancer combined and the six most common cancers were calculated by SES quartiles.ResultsThere were 14,628 cancer cases and 7513 cancer deaths in Barretos, and 472,712 corresponding cases and 194,705 deaths in São Paulo. A clear SES‐cancer gradient was seen in São Paulo, with rates varying from 188.4 to 333.1 in low to high SES areas, respectively. There was a lesser social gradient for mortality, with rates in low to high SES areas ranging from 86.4 to 98.0 in Barretos, and from 99.2 to 100.1 in São Paulo. The magnitude of the incidence rates rose markedly with increasing SES in São Paulo city for colorectal, lung, female breast, and prostate cancer. Conversely, both cervical cancer incidence and mortality rose with lower levels of SES in both regions.ConclusionsA clear SES association was seen for cancers of the prostate, female breast, colorectum, and lung for São Paulo. This study offers a better understanding of the cancer incidence and mortality profile according to SES within a highly populated Brazilian state.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Cancer inequalities in incidence and mortality in the State of São Paulo, Brazil 2001–17

et al. 2023

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Analysis of education level in access and use of health care services, ISA-Capital, São Paulo, Brazil, 2003 and 2015

Santos,

Louvison,

Oliveira

et al. 2023

Cad. Saúde Pública

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The great socioeconomic inequality that prevails in Brazil and the existence of a national health system with universal coverage places the need to monitor the evolution and social inequities regarding access to these services. This study aims to analyze the changes in the prevalence of health care use and the extent of social inequality in the demand, use and, access, resolution of health problems, satisfaction, and health care use of Brazilian Unified National Health System (SUS) according to education levels in the population living in the urban area of the Municipality of São Paulo, in 2003 and 2015. We analyzed data from two population-based household health surveys (Health Survey in São Paulo City - ISA-Capital) from 2003 and 2015. Dependent variables related to health care use in the two weeks preceding the survey and due to diseases included demand, access, satisfaction, problem resolution, and the public or private nature of the service. Prevalence was estimated using level of education and prevalence ratios (PR) by the Poisson regression. In the period, the demand for health care, access, resolution, and use of public health care increased from 2003 to 2015. Inequities in public health care use changed from 2003 to 2015 according to level of education. We found no social inequities in health care use in the municipality of São Paulo regarding demand, access, satisfaction, and resolution according to levels of education. Results show progress in the use and resolution of health care services, as well as the strong concentration of the use of SUS by the population with lower education. Results indicate the progress that SUS has made, but also show persistent challenges in the use and access to services.

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Social inequalities in access to cancer screening and early detection: A population-based study in the city of São Paulo, Brazil

Cited by 2 publications

References 20 publications

Cancer inequalities in incidence and mortality in the State of São Paulo, Brazil 2001–17

Cancer inequalities in incidence and mortality in the State of São Paulo, Brazil 2001–17

Analysis of education level in access and use of health care services, ISA-Capital, São Paulo, Brazil, 2003 and 2015

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