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[巴西统一国家卫生系统中早期乳腺癌诊断的可及性:来自健康信息系统的数据分析]

[Access to early breast cancer diagnosis in the Brazilian Unified National Health System: an analysis of data from the Health Information System].

作者信息

Azevedo E Silva Gulnar, Bustamante-Teixeira Maria Teresa, Aquino Estela M L, Tomazelli Jeane Glaucia, Dos-Santos-Silva Isabel

机构信息

Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.

Universidade Federal de Juiz de Fora, Juiz de Fora, Brasil.

出版信息

Cad Saude Publica. 2014 Jul;30(7):1537-50. doi: 10.1590/0102-311x00156513.

Abstract

The recent reduction in breast cancer mortality in high-income countries resulted from improvements in early detection and treatment. Breast cancer is the most common cancer in Brazilian women. Since 2004, the government has recommended annual clinical breast examination for women aged ≥ 40 years and biannual mammograms for those aged 50-69. This article investigates the degree of implementation of these guidelines using data from the Brazilian Unified National Health System for 2010 according to major geographic region and age group. The findings showed low national mammogram coverage in the target population (32% in the 50-59-year group; 25% from 60 to 69 years). The percentage of women with abnormal radiological findings who underwent biopsy was also low (27% for 50-59 years; 63% for 60-69 years). The number of breast cancer surgeries exceeded the number of cases detected by mammography but was well below the estimated number of incident breast cancer cases in 2010. There are striking regional inequalities in access to early detection and surgery, being the lowest access in the North Region and the highest in the South Region.

摘要

高收入国家近期乳腺癌死亡率的降低源于早期检测和治疗的改善。乳腺癌是巴西女性中最常见的癌症。自2004年以来,政府建议40岁及以上女性每年进行一次临床乳房检查,50至69岁女性每两年进行一次乳房X光检查。本文根据主要地理区域和年龄组,利用巴西统一国家卫生系统2010年的数据,调查了这些指南的实施程度。研究结果显示,目标人群的全国乳房X光检查覆盖率较低(50至59岁组为32%;60至69岁组为25%)。接受活检的放射学检查结果异常的女性比例也较低(50至59岁组为27%;60至69岁组为63%)。乳腺癌手术数量超过了通过乳房X光检查发现的病例数量,但远低于2010年估计的乳腺癌发病病例数量。在早期检测和手术的可及性方面存在显著的地区不平等,北部地区可及性最低,南部地区最高。

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