Maselli-Schoueri Jean Henri, De Carvalho Luis Eduardo Werneck, De Melo Sette Claudia Vaz, de Abreu Luiz Carlos, Fonseca Fernando Luiz Affonso, Adami Fernando, da Silva Paiva Laercio
Laboratório de Epidemiologia e Análise de Dados, Centro Universitário Saúde ABC, Av. Lauro Gomes 2000, Vila Sacadura Cabral, Santo André, São Paulo, 09060-870, SP, Brazil.
Oncológica do Brasil Ensino e Pesquisa. Belém, Pará, Brasil.
BMC Cancer. 2025 Mar 4;25(1):392. doi: 10.1186/s12885-025-13742-8.
Female breast cancer (FBC) is a well-known public health issue worldwide. However, male breast cancer (MBC), though rare, may be overlooked by both public health authorities and clinicians. Both diseases exhibit similarities, and understanding their behavior over time is crucial to grasping their annual impact on many citizens. Furthermore, analyzing if medical personnel are well allocated and influence disease outcomes in a limited setting such as the Public Health System (PHS) is of utmost importance.
This ecological study utilized secondary data from 2008 to 2020 to explore the relationship between the number of doctors per 100,000 inhabitants and mortality from FBC and MBC in Brazil. All data were sourced from Brazil's PHS. Mortality rates were analyzed by age and standardized according to the World Health Organization's population figures. The number of physicians was calculated per 100,000 inhabitants. A linear regression analysis was performed using a stepwise selection/backward elimination approach.
Between 2008 and 2020, Brazil recorded 195,969 breast cancer-related deaths among adults, including 2,220 male victims. The majority of these deaths occurred in the Southeast region among patients older than 50 years. Although both MBC and FBC demonstrated increasing trends over the study period, no correlation was found between the number of physicians and mortality rates for MBC. Conversely, an increase in primary care physicians over the years was positively correlated with mortality rates for FBC (p < 0.05). In addition, the number of physicians in the PHS (β = -0.163; 95% CI: -0.240 to -0.085; p = 0.002), oncologists (β = -0.507; 95% CI: -0.881 to -0.134; p = 0.015), and radiotherapists (β = -6.402; 95% CI: -12.357 to -0.446; p = 0.039) all showed an inverse association with FBC mortality.
The increasing trends in FBC and MBC underscore the need for urgent monitoring. Lower FBC mortality correlates with higher numbers of physicians and specialized care, highlighting the critical role of healthcare workforce capacity and the strategic allocation of specialized personnel in enhancing patient outcomes.
女性乳腺癌（FBC）是全球公认的公共卫生问题。然而，男性乳腺癌（MBC）虽然罕见，但可能被公共卫生当局和临床医生忽视。这两种疾病存在相似之处，了解它们随时间的变化情况对于掌握它们每年对众多公民的影响至关重要。此外，分析在公共卫生系统（PHS）这样的有限环境中医疗人员是否得到合理分配以及对疾病结局的影响至关重要。
这项生态学研究利用2008年至2020年的二手数据，探讨巴西每10万居民中的医生数量与FBC和MBC死亡率之间的关系。所有数据均来自巴西的PHS。死亡率按年龄进行分析，并根据世界卫生组织的人口数据进行标准化。计算每10万居民中的医生数量。采用逐步选择/向后剔除方法进行线性回归分析。
2008年至2020年期间，巴西记录了195,969例与乳腺癌相关的成人死亡病例，其中包括2220名男性患者。这些死亡大多发生在东南部地区50岁以上的患者中。虽然在研究期间MBC和FBC均呈上升趋势，但未发现医生数量与MBC死亡率之间存在相关性。相反，多年来初级保健医生数量的增加与FBC死亡率呈正相关（p < 0.05）。此外，PHS中的医生数量（β = -0.163；95%置信区间：-0.240至-0.085；p = 0.002）、肿瘤学家数量（β = -0.507；95%置信区间：-0.881至-0.134；p = 0.015）和放射治疗师数量（β = -6.402；95%置信区间：-12.357至-0.446；p = 0.039）均与FBC死亡率呈负相关。
FBC和MBC的上升趋势凸显了紧急监测的必要性。较低的FBC死亡率与更多的医生数量和专科护理相关，突出了医疗劳动力能力以及专科人员的战略分配在改善患者结局方面的关键作用。
