Postgraduate Program in Health Sciences, Federal University of Goiás, Goiânia, Brazil.
Advanced Center for Breast Diagnosis (CORA), Federal University of Goiás, Goiânia, Brazil.
Int J Public Health. 2023 Mar 3;68:1605485. doi: 10.3389/ijph.2023.1605485. eCollection 2023.
This study aimed to evaluate COVID-19 effects on breast cancer screening and clinical stage at diagnosis in patients of 50-69 years of age receiving care within the public healthcare network (SUS) in 2013-2021 in Brazil and its macro-regions. This ecological study used Poisson regression to analyze trends in screening and staging. A secondary database was formed using SUS sources: outpatient data system of the SUS network and Oncology-Brazil Panel. There was a reduction in screening, with an annual percent change of -5.9 ( < 0.022). The number of notified cases fell by 31.5% in 2020-2021 compared to 2018-2019. There was a 10.7% increase in the proportion of stage III/IV cases ( < 0.001) in 2020-2021 compared to 2013-2019, now surpassing the number of cases of early stage breast cancer. COVID-19 led to a reduction in breast cancer screening and an expressive increase in advanced tumors in users of the public healthcare network. Urgent interventions in public policies are required as the negative effects of the pandemic on the diagnosis/treatment of breast cancer are becoming apparent even earlier than expected.
本研究旨在评估 2013-2021 年期间，巴西及其各地区公共医疗保健网络（SUS）中 50-69 岁接受治疗的乳腺癌患者的 COVID-19 对其筛查和诊断时临床分期的影响。本生态研究采用泊松回归分析了筛查和分期的趋势。二级数据库通过 SUS 来源（SUS 网络的门诊数据系统和巴西肿瘤学面板）形成。筛查数量减少，年变化百分比为-5.9（<0.022）。与 2018-2019 年相比，2020-2021 年通知病例数减少了 31.5%。与 2013-2019 年相比，2020-2021 年 III/IV 期病例比例增加了 10.7%（<0.001），现在超过了早期乳腺癌病例数。COVID-19 导致公共医疗保健网络使用者的乳腺癌筛查减少，晚期肿瘤显著增加。需要紧急干预公共政策，因为大流行对乳腺癌的诊断/治疗的负面影响甚至比预期的更早显现。
