Silva Alana Ramos da, Nicolella Alexandre Chibebe, Pazello Elaine Toldo
Faculdade de Economia, Administração e Contabilidade de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil.
Cad Saude Publica. 2024 Jul 29;40(7):e00220122. doi: 10.1590/0102-311XPT220122. eCollection 2024.
The early detection of breast cancer enables more effective forms of treatment. However, widespread access to its main screening tool, mammography, remains a challenge for the Brazilian public health system. This study aimed to analyze the effect of allocating mammography equipment on women's health indicators. In 2013, of the 4,557 municipalities that lacked the equipment, 260 received it up to 2019. The main hypothesis of this study suggests that receiving the mammography device would show a heterogeneous effect between locations and that such receival would depend on observable (propensity score matching) and non-observable variables (fixed effects model). Results indicate that the Brazilian municipalities that had mammography equipment in use from 2014 onward increased their number of exams without short-term effects to diagnoses and deaths due to malignant breast neoplasia. In addition to equipment, a more complex structure involving other factors (such as access to consultations, qualified professionals, waiting time, etc.) is important to improve women's health indicators in the analyzed municipalities.
乳腺癌的早期检测能够采用更有效的治疗方式。然而，对于巴西公共卫生系统而言，广泛使用其主要筛查工具——乳房X光检查，仍是一项挑战。本研究旨在分析配置乳房X光检查设备对女性健康指标的影响。2013年，在4557个没有该设备的城市中，有260个城市在2019年前获得了该设备。本研究的主要假设表明，获得乳房X光检查设备在不同地点会产生异质性影响，且这种获得情况将取决于可观察变量（倾向得分匹配）和不可观察变量（固定效应模型）。结果表明，从2014年起使用乳房X光检查设备的巴西城市，其检查次数有所增加，但对恶性乳腺肿瘤的诊断和死亡没有短期影响。除了设备之外，一个涉及其他因素（如获得会诊、合格专业人员、等待时间等）的更复杂结构对于改善所分析城市的女性健康指标很重要。
