title: [Access to early breast cancer diagnosis in the Brazilian Unified National Health System: an analysis of data from the Health Information System].
abstract: The recent reduction in breast cancer mortality in high-income countries resulted from improvements in early detection and treatment. Breast cancer is the most common cancer in Brazilian women. Since 2004, the government has recommended annual clinical breast examination for women aged ≥ 40 years and biannual mammograms for those aged 50-69. This article investigates the degree of implementation of these guidelines using data from the Brazilian Unified National Health System for 2010 according to major geographic region and age group. The findings showed low national mammogram coverage in the target population (32% in the 50-59-year group; 25% from 60 to 69 years). The percentage of women with abnormal radiological findings who underwent biopsy was also low (27% for 50-59 years; 63% for 60-69 years). The number of breast cancer surgeries exceeded the number of cases detected by mammography but was well below the estimated number of incident breast cancer cases in 2010. There are striking regional inequalities in access to early detection and surgery, being the lowest access in the North Region and the highest in the South Region.
authors.affiliation: Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.
authors.forename: Gulnar
authors.initials: G
authors.lastname: Azevedo E Silva
authors.affiliation: Universidade Federal de Juiz de Fora, Juiz de Fora, Brasil.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Bustamante-Teixeira
authors.affiliation: Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil.
authors.forename: Estela M L
authors.initials: EM
authors.lastname: Aquino
authors.affiliation: Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brasil.
authors.forename: Jeane Glaucia
authors.initials: JG
authors.lastname: Tomazelli
authors.affiliation: Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, U.K.
authors.forename: Isabel
authors.initials: I
authors.lastname: Dos-Santos-Silva
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001938:Brazil; D001943:Breast Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D063005:Health Information Systems; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged