Câmara Alice Barros, Moraes Luizaga Carolina Terra de, Pereira Baltar Cury Lise Cristina, Contreras Carlos Alberto Huaira, López Rossana Verónica Mendoza, Duarte Luciane Simões, Carvalho André Lopes, Basu Partha, Wünsch-Filho Victor
Department of Epidemiology, School of Public Health, University of São Paulo and Oncocentro Foundation of São Paulo, Brazil.
Oncocentro Foundation of São Paulo, Brazil.
Cancer Epidemiol. 2025 Aug;97:102852. doi: 10.1016/j.canep.2025.102852. Epub 2025 May 27.
Identifying barriers to cancer screening is essential for developing effective strategies to enhance organized screening programs. Currently, limited studies address Brazilian women's perceptions of these barriers and the influence of sociodemographic factors. This study aims to investigate the impact of sociodemographic factors on barriers to breast cancer screening in the state of São Paulo, a region marked by significant socioeconomic disparities.
A cross-sectional study was conducted using a representative sample of women aged 50-69 years residing in São Paulo, who were users of the Brazilian Unified Health System (SUS). Data were gathered through a semi-structured questionnaire designed to assess sociodemographic factors and barriers to breast cancer screening. Barriers were classified into two categories: those related to women and those associated with the healthcare system. Multinomial logistic regression models were used to examine the relationships between the sociodemographic factors and these barriers.
The main barriers to breast screening were pain experienced during mammography, long waiting times, and scheduling difficulties. Lower education levels and Brown or Black skin color were associated with perceptions of longer waiting times, while pre-existing health conditions were linked to fear of diagnosis. Employment status was associated with forgetfulness, scheduling challenges, and longer waiting times. Furthermore, residence area was associated with feelings of embarrassment, pain, and scheduling difficulties.
Barriers to breast cancer screening differ based on sociodemographic factors. Brown or Black skin color, residence in the Metropolitan Region of São Paulo (MRSP), employment status, and chronic diseases were predictors of women-related barriers. On the other hand, Brown or Black skin color, lower education levels, employment status, and living in the MRSP were predictors of system-related barriers. The findings offer valuable insights for designing targeted strategies to improve breast cancer screening coverage.
识别癌症筛查的障碍对于制定有效的策略以加强有组织的筛查计划至关重要。目前，针对巴西女性对这些障碍的认知以及社会人口学因素影响的研究有限。本研究旨在调查社会人口学因素对圣保罗州乳腺癌筛查障碍的影响，圣保罗州是一个社会经济差距显著的地区。
采用横断面研究，以居住在圣保罗、年龄在50 - 69岁且使用巴西统一卫生系统（SUS）的女性为代表性样本。通过一份半结构化问卷收集数据，该问卷旨在评估社会人口学因素和乳腺癌筛查障碍。障碍分为两类：与女性相关的障碍和与医疗保健系统相关的障碍。使用多项逻辑回归模型来检验社会人口学因素与这些障碍之间的关系。
乳腺筛查的主要障碍是乳房X光检查时的疼痛、等待时间长和预约困难。教育水平较低以及棕色或黑色皮肤与认为等待时间更长的认知相关，而既往健康状况与对诊断的恐惧有关。就业状况与健忘、预约挑战和等待时间长有关。此外，居住地区与尴尬感、疼痛和预约困难有关。
乳腺癌筛查的障碍因社会人口学因素而异。棕色或黑色皮肤、居住在圣保罗大都市区（MRSP）、就业状况和慢性病是与女性相关障碍的预测因素。另一方面，棕色或黑色皮肤、教育水平较低、就业状况以及居住在MRSP是与系统相关障碍的预测因素。这些发现为设计有针对性的策略以提高乳腺癌筛查覆盖率提供了有价值的见解。
