CEPAM - Centro de Pesquisa Avançada em Medicina da UNILAGO, Faculdade de Medicina UNILAGO, União das Faculdades dos Grandes Lagos, São José do Rio Preto, São Paulo, Brazil.
Faculdade de Medicina de Ribeirão Preto FMRP - USP, Ribeirão Preto, São Paulo, Brazil.
J Glob Health. 2022 Oct 14;12:04061. doi: 10.7189/jogh.12.04061.
Mammographic screening has been used to reduce breast cancer mortality worldwide and remains the main modality for the early detection of this disease. Women from low- and middle-income countries still lack access to periodic mammograms and efficient health care. This cross-sectional study aimed to explore opportunistic mammographic coverage in Brazil, while considering the privately insured population and its association with early breast cancer (EBC) detection.
Data on population, gross domestic product (GDP), number of mammograms performed under the Sistema Único de Saúde (SUS) public health system or private system, and women diagnosed with early-stage breast cancer from 2010 to 2019 were retrieved from publicly available databases.
A total of 39 555 636 mammograms with an average of 3 955 564 ± 395 704 mammograms were obtained per year from 2010 to 2019 in Brazil. Most examinations (58.6%) were performed in the target population (50-69 years old), while 32% were performed in women aged 40-49, and 9.4% were performed in women <40 years or >70 years of age. The 10-year mammogram coverage was 30.6% in the target population and 24.8% in the population aged 40-49 years, with significant variation across states and municipalities. The overall EBC detection rates in Brazil were 30.6% in populations aged 50-70 and 24.8% in those aged 40-50 years. We observed a positive correlation between coverage and EBC detection rate (r = 0.68; P = 0.0001 (50-70 years) and r = 0.75; P < 0.0001 (40-50 years)). According to the GDP, the municipalities with higher GDP per capita had higher mammogram coverage (P < 0.0001).
The coverage of mammographic screening for women under the SUS is far below the international guidelines. Additionally, a significant number of mammograms have been performed in non-target populations. This scenario reflects the problematic screening programs in developing countries and reflects low rates of EBC diagnosis. As Brazil is a continental country with heterogeneous socioeconomic indicators, we observed significant variations in the number of mammograms performed by age groups when separated by states and municipalities. Even when considering supplemental health system coverage, municipalities with higher GDP per capita were associated with higher mammogram coverage.
乳腺 X 线筛查已在全球范围内用于降低乳腺癌死亡率，并且仍然是早期发现这种疾病的主要方式。来自中低收入国家的妇女仍然无法定期接受乳腺 X 光检查和有效的医疗保健。这项横断面研究旨在探讨巴西的机会性乳腺 X 光检查覆盖情况，同时考虑到私人保险人群及其与早期乳腺癌（EBC）检出率的关系。
从公开数据库中检索了 2010 年至 2019 年期间的人口、国内生产总值（GDP）、在 Sistema Único de Saúde（SUS）公共卫生系统或私人系统下进行的乳腺 X 光检查数量以及诊断为早期乳腺癌的妇女数量的数据。
2010 年至 2019 年期间，巴西每年平均进行 39555636 次乳腺 X 光检查，平均每年进行 3955564±395704 次乳腺 X 光检查。大多数检查（58.6%）是在目标人群（50-69 岁）中进行的，而 32%是在 40-49 岁的妇女中进行的，9.4%是在<40 岁或>70 岁的妇女中进行的。目标人群的 10 年乳腺 X 光检查覆盖率为 30.6%，40-49 岁人群的覆盖率为 24.8%，各州和各市之间存在显著差异。巴西 50-70 岁人群的 EBC 检出率总体为 30.6%，40-50 岁人群的检出率为 24.8%。我们观察到覆盖率与 EBC 检出率之间存在正相关（r=0.68；P=0.0001（50-70 岁）和 r=0.75；P<0.0001（40-50 岁））。根据国内生产总值，人均国内生产总值较高的城市的乳腺 X 光检查覆盖率较高（P<0.0001）。
SUS 下的女性乳腺 X 光筛查覆盖率远低于国际指南。此外，大量乳腺 X 光检查是在非目标人群中进行的。这种情况反映了发展中国家筛查计划存在问题，并且反映了 EBC 诊断率低。由于巴西是一个拥有不同社会经济指标的大陆国家，我们观察到按州和市划分的不同年龄组进行的乳腺 X 光检查数量存在显著差异。即使考虑到补充健康系统的覆盖范围，人均国内生产总值较高的城市与较高的乳腺 X 光检查覆盖率相关。
Zotero 插件
