Vasconcellos-Silva Paulo Roberto, Sormunen Taina, Craftman Åsa Gransjön
Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil,
Sophiahemmet University, Estocolmo, Suécia.
Cien Saude Colet. 2018 Apr;23(4):1303-1312. doi: 10.1590/1413-81232018234.14082016.
Delays in diagnosis due to low Breast Cancer awareness are widespread in Brazil maybe owing to ineffective strategies to raise attention on early diagnosis. As a proxy of collective interest in BC screanning (BCS) we studied the monthly accesses to BC and BCS webpages in INCA's website along 48 months. A log analyzer built a time serie (2006-2009) of BC and BCS monthly means, which oscilations were studied by analysis of variance (ANOVA). We found significant increasing accesses to BC and transient "attention peaks". Enlargement in BC/BCS differences along all period were caused by increasing accesses to BC and decreasing/minor/stable oscillations to SBC pages. These results are consistent with previous reports on increasing interest to BC contrasting with indifference on BCS. In the context of an exploratory study, we discussed some aspects: weakness of a "prevention culture"; lack of confidence in health system and screening programs; "celebrity effect" in the context of media framing; collective perception of risks heightened by perception of social vulnerability. Findings suggest that culture-tailored communication strategies would be necessary to inform Brazilian people about BCS. Future research is needed to study social perceptions and constructions on BC topics.
由于对乳腺癌认识不足导致的诊断延误在巴西普遍存在，这可能是由于提高对早期诊断关注度的策略无效。作为对乳腺癌筛查（BCS）集体兴趣的一种代理指标，我们研究了48个月内巴西国家癌症研究所（INCA）网站上乳腺癌及乳腺癌筛查网页的月访问量。一个日志分析器构建了一个乳腺癌及乳腺癌筛查月均值的时间序列（2006 - 2009年），通过方差分析（ANOVA）研究其波动情况。我们发现乳腺癌网页的访问量显著增加以及出现短暂的“关注峰值”。在整个时间段内，乳腺癌/乳腺癌筛查差异的扩大是由于乳腺癌网页访问量增加以及乳腺癌筛查网页访问量的下降/微小/稳定波动所致。这些结果与之前关于对乳腺癌兴趣增加而对乳腺癌筛查漠不关心的报道一致。在一项探索性研究的背景下，我们讨论了一些方面：“预防文化”的薄弱；对卫生系统和筛查项目缺乏信心；媒体框架背景下的“名人效应”；因社会脆弱性认知而增强的集体风险认知。研究结果表明，需要制定针对文化的沟通策略，以便让巴西民众了解乳腺癌筛查。未来需要开展研究以探讨关于乳腺癌主题的社会认知和构建。
