COVID-19 and breast cancer in elderly women in Brazil

Abstract

Objective: There are no publications on the impact of the COVID-19 pandemic on screening and clinical staging of breast
cancer in women over 70 years of age. In Brazil, women over 70 years of age are not the target group for whom the Unified
Health System (SUS) recommends mammography screening. This study aimed to evaluate the impact of the pandemic
in Brazil on screening and clinical staging of breast cancer in women of this age group. Methodology: This is an ecological time-series study. Data and trends, as well as the staging of breast cancer in older women in the SUS, from 2013 to
2021, in Brazil and its regions were analyzed. The secondary database was created with information from the Outpatient
Information System of the Informatics Department of the SUS, the Oncology Brazil Panel, the Brazilian Institute of Geography
and Statistics, and the Supplementary Health Agency. Results: In 2018–2019, 16,035 cases of breast cancer were reported
nationwide, representing a decrease of 3.75%, and 15,434 cases were reported in 2020–2021. Screening tended to decrease
with APC -7.3 (CI -11.3 to -3.2; p<0.004). The proportion of advanced cases exceeded that of initial cases in Brazil overall.
There was an increasing trend for stages III and IV, with a coefficient of determination (r2
) of 0.86 (p<0.001) and a percentage increase of 9.4% of cases (p<0.001). Conclusion: During the pandemic, there was a significant decrease in the number
of mammograms and a significant increase in older patients with advanced tumors. It is important to provide screening
and treatment services for breast cancer in women over 70 years of age so as not to neglect the needs of these older women.