Rede Goiana de Pesquisa em Mastologia – HC/UFGOBJECTIVE: To evaluate the cost of screening and the evolution of the mammographic coverage performed by the Unified Health System (SUS) in Brazil, macroregions, Federal Units (UF) and Federal District (DF) from 2008 to 2016. METHODS: Ecological time series study, with analysis of information regarding mammograms performed by SUS, available in the Outpatient Information System (SIA/DATASUS) for women 50-69 years. Data analysis was done using Joinpoint Regression for calculating the Annual Percentage Change (APC) with a confidence interval (CI) of 95% and statistical significance at p<0.05. RESULTS: In Brazil, from 2008 to 2016, about 19 million mammograms were performed by SUS in the female population aged 50 to 69 years, costing approximately R$ 844 million. The MPA estimate allowed us to infer that mammographic coverage in Brazil increased from 2008 to 2012 and stabilized in the following years. The Northeast macroregion was for a single one that presented increased coverage throughout the studied period, while a South was for which initially presented increase, with subsequent reduction. As North, Southeast and Center-West macroregions increased, followed by stabilization. Of the 26 UF, 31% (eight) showed a significant increase in mammographic screening coverage over the study period, 19% (five) had MPA stabilization, (Eleven) stabilized and 0.8% (one) coverage reduction. Another UF presented the initial stabilization, followed by an increase. The DF showed a stabilization for an initial period and reduction after this period. CONCLUSION: The temporal evolution showed that the coverage of mammography performed by SUS in Brazil doubled; which can be inferred that the public policies were effective, although insufficient for an organized tracking, as advocated by WHO. The growth was uneven between the macro regions and between the UF and this situation is aggravated when the analysis of the annual percentage change of the last quadrennium of the study showed stabilization of the mammographic coverage.Breast Cancer; Screening Programs; Mammography; Health Services Coverage.
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COST OF BREAST CANCER SCREENING AND EVOLUTION OF THE MAMOGRAPHIC COVERAGE OF THE PUBLIC HEALTH SYSTEM IN BRAZIL, FROM 2008 TO 2016
Danielle Cristina Netto Rodrigues, Ruffo Freitas-Junior, Rosemar Macedo Sousa Rahal, João Emílio Peixoto, Rosangela da Silveira Corrêa
Rede Goiana de Pesquisa em Mastologia – HC/UFGOBJECTIVE: To evaluate the cost of screening and the evolution of the mammographic coverage performed by the Unified Health System (SUS) in Brazil, macroregions, Federal Units (UF) and Federal District (DF) from 2008 to 2016. METHODS: Ecological time series study, with analysis of information regarding mammograms performed by SUS, available in the Outpatient Information System (SIA/DATASUS) for women 50-69 years. Data analysis was done using Joinpoint Regression for calculating the Annual Percentage Change (APC) with a confidence interval (CI) of 95% and statistical significance at p<0.05. RESULTS: In Brazil, from 2008 to 2016, about 19 million mammograms were performed by SUS in the female population aged 50 to 69 years, costing approximately R$ 844 million. The MPA estimate allowed us to infer that mammographic coverage in Brazil increased from 2008 to 2012 and stabilized in the following years. The Northeast macroregion was for a single one that presented increased coverage throughout the studied period, while a South was for which initially presented increase, with subsequent reduction. As North, Southeast and Center-West macroregions increased, followed by stabilization. Of the 26 UF, 31% (eight) showed a significant increase in mammographic screening coverage over the study period, 19% (five) had MPA stabilization, (Eleven) stabilized and 0.8% (one) coverage reduction. Another UF presented the initial stabilization, followed by an increase. The DF showed a stabilization for an initial period and reduction after this period. CONCLUSION: The temporal evolution showed that the coverage of mammography performed by SUS in Brazil doubled; which can be inferred that the public policies were effective, although insufficient for an organized tracking, as advocated by WHO. The growth was uneven between the macro regions and between the UF and this situation is aggravated when the analysis of the annual percentage change of the last quadrennium of the study showed stabilization of the mammographic coverage.Breast Cancer; Screening Programs; Mammography; Health Services Coverage.