In the 50-69 age group, the main recommendation of the Ministry of Health, only 17% took the screening test in 2021
Only 17% of women between the ages of 50 and 69 had the preventive examination of the breast cancer throughout 2021, according to the Panorama of Breast Cancer survey in the SUS. In all, only 2.05 million women in this age group have had mammograms through the public health system.
The total exceeds that seen the previous year, when only 1.4 million women between the ages of 50 and 69 underwent a screening mammogram amid coronavirus restrictions and suffocation of SUS due to the pandemic. However, coverage in 2021 is down from 23% in 2019.
The survey was carried out by Avon Institute and fur Oncology Observatorybased on information from DataSUS from 2015 to 2021 and focused on women aged 50 to 69, as recommended by the Ministry of Health, which prioritizes age group in screening for the disease.
The data indicates a 40% decline in exams taken between 2019 and 2020 and 18% the following year. “This is still a reflection of the pandemic. Although services and rescheduling resumed in 2021, we still have an overload of demand from people who have stopped taking these types of exams, as well as the fear (of being infected by the covid) “, explains Nina Melo, coordinator of the Oncology Observatory.
The regions of Brazil that had the lowest mammogram coverage among women aged 50 to 69 were the North and Midwest. Between 2020 and 2021, only 9% of patients in this age group underwent the screening test, a rate well below the national average. The State of Sao Paulo had the largest number of approved procedures of the type, corresponding to 31% of the total in the country.
Also in 2020, data from the International Agency for Research on Cancer (IARC), an arm of the World Health Organization (WHO), stressed that breast cancer is already the most diagnosed type of disease. It corresponds to 24.5% of all positive diagnoses made in the world and 6.9% of deaths during that year.
While not yet having concrete data on this year, Nina believes that the screening test scenario already shows signs of stabilization of the pre-pandemic parameters. “From contacts with doctors and oncologists, they have already told us. The same communication of the tracking and the complete course of vaccination (against covid) have helped in this recovery”, she comments.
Waiting time and more serious cases
Another figure highlighted by the survey states that over 60% of all women diagnosed with breast cancer in the country between 2015 and 2021 started treatment later than recommended. According to law 12.732 / 12, the maximum waiting period in the public health system must be 60 days after the identification of the disease. In 2020, the average time of this interval reached 174 days.
“In the case of cancer, one day can make a difference,” Nina points out. “If there is scientifically founded legislation, it is because that moment is the most appropriate. If we exceed this by more than double, the chances of a cure for this patient are greatly diminished.”
Member of the Scientific Committee of Beat the Cancer Institute and oncologist of Albert Einstein Hospital, Abraão Dornellas classifies this delay between diagnosis and treatment as “inadmissible”. “It is necessary to understand that there is no point in making an early diagnosis unless early treatment is established. It is totally unacceptable for a diagnosed woman to wait that long.”
This increase in the delay in seeking the diagnosis also increased, according to the survey. Last year, only 55% of cases were identified early, compared with 61% in 2015. However, late confirmed cases followed the opposite trend and increased from 39% to 45% over the same period.
“After this shortage of pandemic exams, we have noticed that many patients are already arriving with palpable lesions. We have also realized that after the pandemic’s stemmed demand, there has been an increase in patient demand, but many at a later stage. advanced disease, “says oncologist Caroline Rocha, of the Breast Cancer Department of the AC Camargo Cancer Center Hospital.
This was the case with the retired systems analyst Maria Macedo, 67 years old. During the entire pandemic, she was afraid of leaving home and going to the hospital due to the coronavirus. When he contracted the disease in January of this year and returned to his usual tests, he discovered he had advanced breast cancer.
Dona Maria already knew she had a lump from 2019, “but it was just calcification, no problem”. “But she started to grow a lot, I suspected it and I followed him,” she says. She has already had four chemotherapy sessions since May and is still undergoing treatment, while she waits for the lump to shrink to be removed by surgery.
“The treatment is very aggressive, I thought I couldn’t do it. I felt nauseous, dizzy, I felt like vomiting, I had injuries on my body, I saw my hair and eyebrows falling out and my nervous system was also very shaken,” he reports. “It’s an unimaginable treatment. I never thought I’d go through it now because I’ve been breastfeeding for years and I’ve always taken great care of my health.”
In addition to the possibility of the cancer spreading from the breast to the body or increasing in size, late diagnosis of the disease also affects the treatment of patients, especially in Maria’s age group, 50 to 69 years. “The screened population has less aggressive treatments,” Caroline points out. “This delay in diagnosis has an impact on the size of the surgery, which could be a conservative treatment and then evolves into something more radical, such as mastectomy. The same goes for the toxicity of chemotherapy treatment “.
For Dornellas, the growth in advanced breast cancer cases is already seen with patients this year and may even increase in the coming years. “It’s a logical trend. Therefore, expanding coverage is essential. Breast cancer will not stop occurring because the test was not performed.”
wanted, the Ministry of Health did not disclose whether it plans to reduce waiting times for patients diagnosed with breast cancer or whether there are actions to expand mammography coverage in the country.
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Source: Terra
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