DIAGNOSIS OF BREAST CANCER IN BRAZIL: REFLECTION ON THE IMPACT OF THE COVID-19

Abstract

Objective: The objective of this study was to verify if the COVID-19 pandemic impacted the screening of breast cancer in
women in Brazil. Methods: This is an observational, cross-sectional study with a descriptive and quantitative approach,
carried out with secondary data provided by the Cancer Information System (SISCAN/DATASUS), considering two temporal clippings — before the pandemic (2015–2019) and during the pandemic (2020 and 2021). Women diagnosed with
breast cancer who underwent mammography between 2015 and 2021 were included in the study. Review by the Research
Ethics Committee was waived because public, aggregated, and unidentified data were used. Results: Between 2015 and
2021, 17,229,218 mammograms were performed in Brazil. The temporal analysis showed a gradual upward trend in all
years, reaching 49.6% growth in the period before the pandemic (from 2,047,504 mammograms in 2015 to 3,063,618 mammograms in 2019). During the COVID-19 pandemic, there was a change in the Brazilian epidemiological behavior, as evidenced by a significant decrease in the number of examinations performed. In 2020, 1,864,891 mammograms were recorded, representing a 39.1% drop, while in 2021, 2,606,074 mammograms were recorded, representing a 39.7% increase over
the previous year, but if compared to the last pre-pandemic year, there is an important decrease in the number of mammograms performed (14.9%). Besides this, another consequence was the underdiagnosis of some diseases, such as breast
cancer. The estimate stipulated by the National Cancer Institute (INCA) for each year of the triennium between 2020 and
2022 was 66,280 new cases of breast cancer in Brazil. As with mammograms, in 2020, there was a 10.3% drop in diagnoses
(n=46,509), which represent only 70.2% of the estimate made by INCA for 2020. In 2021, this drop was even more significant
(n=24,446), representing only 36.9% of the expected for the period. Conclusion: Due to the emergence of COVID-19 and
the magnitude of the pandemic, there was an epidemiological change in public health in Brazil, significantly impacting
the screening, monitoring, and treatment of diseases with high incidence in the country. It is believed that this panorama
will reflect in the increase of cases and their severity, besides impacting the costs of public health worldwide.