Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.
Department of Health Management and Informatics, University of Missouri School of Medicine, One Hospital Drive, CE707 CS&E Bldg, Columbia, MO 65212, United States.
Prev Med. 2018 Jan;106:216-223. doi: 10.1016/j.ypmed.2017.11.002. Epub 2017 Nov 8.
In 2004 the Brazilian National Cancer Institute (INCA) established breast cancer screening guidelines for women in Brazil: annual clinical breast exam for women age 40-49 and biennial mammogram for women age 50-69. Healthcare provider's adherence to these guidelines is currently unknown. The objective of this study is to describe the perceptions and practices related to breast cancer screening among physicians, nurses, and health unit coordinators working in the network of primary healthcare units (HCUs) in Brazil. In 2011, 1600 primary HCUs were randomly sampled from all regions in Brazil. At each HCU the coordinator and one health professional were asked to participate in a telephone survey to gathered information on their knowledge, attitudes, and practices related to breast cancer screening. Participation rates for coordinators, physicians, and nurses were 78%, 34%, and 65% respectively. Health unit coordinators identified numerous barriers that prevent patients from receiving appropriate screening, many (44%) were unaware of INCA cancer screening guidelines. Despite a high perceived impact of INCA guidelines, a majority of physicians and nurses did not follow them. Most physicians and nurses recommended mammograms on an annual basis (~75%) and 50.9% of nurses and 25.1% of physicians initiated routine breast cancer screening in women under age 40. Physicians and nurses in Brazil screen at younger ages and more frequently than recommended by INCA guidelines. Given that primary HCUs are the source of health care for many women, interventions that educate healthcare providers on the appropriate ages and intervals for breast cancer screening may prove useful.
2004 年，巴西国家癌症研究所（INCA）为巴西女性制定了乳腺癌筛查指南：40-49 岁女性每年进行临床乳房检查，50-69 岁女性每两年进行一次乳房 X 光检查。目前尚不清楚医疗服务提供者对这些指南的遵循情况。本研究的目的是描述在巴西初级保健单位（HCU）网络中工作的医生、护士和卫生单位协调员对乳腺癌筛查的看法和做法。2011 年，从巴西所有地区随机抽取了 1600 个初级 HCU。在每个 HCU，协调员和一名卫生专业人员被要求参加电话调查，以收集他们与乳腺癌筛查相关的知识、态度和实践信息。协调员、医生和护士的参与率分别为 78%、34%和 65%。卫生单位协调员确定了许多阻止患者接受适当筛查的障碍，其中许多（44%）不知道 INCA 癌症筛查指南。尽管 INCA 指南被认为具有很大的影响，但大多数医生和护士并未遵循这些指南。大多数医生和护士建议每年进行一次乳房 X 光检查（约 75%），50.9%的护士和 25.1%的医生开始对 40 岁以下的女性进行常规乳腺癌筛查。巴西的医生和护士比 INCA 指南建议的年龄更早、更频繁地进行筛查。鉴于初级 HCUs 是许多女性获得医疗保健的来源，对医疗保健提供者进行有关乳腺癌筛查适当年龄和间隔的教育干预可能会证明有用。
