da Silva Alanna Gomes, Silva Thales Philipe Rodrigues da, Vasconcelos Nádia Machado de, Santos Filipe Malta Dos, Oliveira Greice de Campos, Malta Deborah Carvalho
School of Nursing, Graduate Program in Nursing, Department of Maternal-Child and Public Health Nursing, Federal University of Minas Gerais (UFMG), Avenida Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, 30130-100, Minas Gerais, Brazil.
Women's Health Nursing Department, Paulista School of Nursing, Federal University of São Paulo (Unifesp), Rua Napoleão de Barros,754, Vila Clementino, São Paulo, 04023-062, Brazil.
BMC Womens Health. 2024 Jul 31;24(1):436. doi: 10.1186/s12905-024-03278-7.
Breast and cervical cancer are major public health issues globally. The reduction in incidence and mortality rates of these cancers is linked to effective prevention, early detection, and appropriate treatment measures. This study aims to analyze the temporal trends in the prevalence of mammography and Papanicolaou test coverage among women living in Brazilian state capitals between 2007 and 2023, and to compare the coverage of these tests before and during the Covid-19 pandemic.
A time series study was conducted using data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey from 2007 to 2023. The variables analyzed included mammography and Papanicolaou test coverage according to education level, age group, race/skin color, regions, and Brazilian capitals. The Prais-Winsten regression model was used to analyze the time series, and Student's t-test was employed to compare the prevalence rates between 2019 and 2023.
Between 2007 and 2023, mammography coverage showed a stationary trend (71.1% in 2007 and 73.1% in 2023; p-value = 0.75) with a declining trend observed among women with 12 years or more of education (APC= -0.52% 95%CI -1.01%; -0.02%). Papanicolaou test coverage for all women aged between 25 and 64 exhibited a downward trend from 82% in 2007 to 76.8% in 2023 (APC= -0.45% 95%CI -0.76%; -0.13%). This decline was also noticed among those with 9 years or more of education; in the 25 to 44 age group; among women with white and mixed race; and in the Northeast, Central-West, Southeast, and South regions. When comparing coverage before and during Covid-19 pandemic, a reduction was noted for both tests.
Over the years, there has been stability in mammography coverage and a decline in Papanicolaou test. The COVID-19 pandemic negatively impacted the number of these tests carried out among women, highlighting the importance of actions aimed at increasing coverage, especially among the most vulnerable groups.
乳腺癌和宫颈癌是全球主要的公共卫生问题。这些癌症发病率和死亡率的降低与有效的预防、早期检测及适当的治疗措施相关。本研究旨在分析2007年至2023年居住在巴西各州首府的女性中乳房X线摄影术普及率和巴氏试验覆盖率的时间趋势，并比较新冠疫情之前和期间这些检测的覆盖率。
采用2007年至2023年慢性病风险和保护因素电话调查监测系统的数据进行时间序列研究。分析的变量包括根据教育水平、年龄组、种族/肤色、地区和巴西各州首府划分的乳房X线摄影术和巴氏试验覆盖率。使用普雷斯-温斯坦回归模型分析时间序列，并采用学生t检验比较2019年和2023年的患病率。
2007年至2023年期间，乳房X线摄影术覆盖率呈平稳趋势（2007年为71.1%，2023年为73.1%；p值=0.75），在接受12年及以上教育的女性中观察到下降趋势（年度百分比变化=-0.52%，95%置信区间-1.01%；-0.02%）。所有25至64岁女性的巴氏试验覆盖率呈下降趋势，从2007年的82%降至2023年的76.8%（年度百分比变化=-0.45%，95%置信区间-0.76%；-0.13%）。在接受9年及以上教育的人群中、25至44岁年龄组中、白人和混血种族女性中以及东北部、中西部、东南部和南部地区也注意到了这种下降。比较新冠疫情之前和期间的覆盖率时，两种检测的覆盖率均有所下降。
多年来，乳房X线摄影术覆盖率保持稳定，巴氏试验覆盖率下降。新冠疫情对女性进行的这些检测数量产生了负面影响，凸显了旨在提高覆盖率的行动的重要性，尤其是在最脆弱群体中。
