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. 2019 Jul 18;19(1):959.
doi: 10.1186/s12889-019-7278-z.

Temporal changes in breast cancer screening coverage provided under the Brazilian National Health Service between 2008 and 2017

Danielle Cristina Netto Rodrigues  1 , Ruffo Freitas-Junior  2 , Rosemar Macedo Sousa Rahal  2 , Rosangela da Silveira Corrêa  2 , Pollyana Alves Gouveia  2 , João Emílio Peixoto  3 , Edésio Martins  4 , Leonardo Ribeiro Soares  2
Affiliations

Temporal changes in breast cancer screening coverage provided under the Brazilian National Health Service between 2008 and 2017

Danielle Cristina Netto Rodrigues et al. BMC Public Health. .

Abstract

Background: In Brazil, 70% of the population depends on the public healthcare system. Since early detection is considered crucial, this study aimed to evaluate temporal changes in breast cancer screening coverage provided under the Brazilian National Health Service (SUS) according to the different regions of the country between 2008 and 2017.

Methods: This ecological study analyzed data on breast cancer screening within the SUS for women aged 50-69 years. Coverage was calculated from the ratio between the number of screening tests conducted and the expected number for the target population. Joinpoint regression analysis was used to calculate annual percent changes (APC) in coverage.

Results: Around 19 million mammograms were performed in 50-69-year old women within the SUS between 2008 and 2016. The estimated APC indicates that breast cancer screening coverage increased by 14.5% annually in Brazil between 2008 and 2012 (p < 0.01), with figures stabilizing between 2012 and 2017 as shown by an APC of - 0.4% (p = 0.3). In the five geographic regions of the country, the APC initially increased, then stabilized in the north, northeast and southeast and decreased in the south and Midwest. Of the 26 states, coverage increased in seven and remained stable in six. In the other 13, there was an initial increase followed by stabilization in 11, and a reduction in coverage in two. In the Federal District, coverage remained stable throughout the study period.

Conclusion: Evaluation of the temporal changes in breast cancer screening coverage provided under the Brazilian National Health Service revealed an initial increase, confirming that public policies were effective, although insufficient to ensure organized screening. There appears to be a lack of uniformity between the different regions and states and this situation is highlighted in the final 5-year period, with the APC reflecting stabilization of breast cancer screening coverage.

Keywords: Brazilian National Health Service; Breast cancer; Healthcare coverage; Mammography; Screening programs.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Trends in breast cancer screening coverage provided under the Brazilian National Health service for the female population of 50–69 years of age between 2008 and 2017
Fig. 2
Fig. 2
Trends in breast cancer screening coverage provided under the Brazilian National Health Service for the female population of 50–69 years of age between 2008 and 2017 according to the different geographic regions of the country. a) north; b) northeast; c) southeast d) south e) midwest
See this image and copyright information in PMC

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