SCREENING MAMMOGRAPHY BEFORE AND DURING THE COVID-19 PANDEMICS IN BRAZIL: AN ANALYSIS FROM PUBLIC REGISTRIES

Resumo

Objective: The goal of this study was to evaluate the impact of the COVID-19 pandemic on breast cancer screening in the
public health system in Brazil. The Brazilian Ministry of Health recommends mammography screening every 2 years from
50 to 69 years of age. Methods: This is a cross-sectional study based on data from the Brazilian Institute of Geography
and Statistics and the System of Health Information of the public health system (DATASUS). We evaluated the absolute
number of screening mammograms performed per age group every year from 2017 to 2021. The year 2017 was considered
the reference. Results: In 2017, a total of 2,616,022 screening mammograms were performed through the Brazilian public
health system in women 50–69 years of age, in comparison to 1,456,001 (44.34% fewer) in 2020 and 1,998,097 (23.62% fewer)
in 2021. The expected number of examinations, considering the target population in 2021, would be 8.5 million. In addition, in 2018, there were 3.8% and in 2019, 5.4% fewer examinations than in 2017. Of note, the target population increased by 10% from 2017 to 2021. Regarding other age groups, the proportion of mammograms performed remained similar
over the period: 65% of the examinations were performed in the recommended range, 29.5% between 35 and 49 years, and
5.5% in patients older than 70 years Conclusion: There was a large (44.34%) decrease in the number of screening mammograms in 2020 in comparison to that in 2017. However, in the years before the pandemic (2018 and 2019), the proportion of women who underwent screening was also smaller than in 2017. More studies are needed to evaluate social and
political factors associated with the low proportion of screening mammograms and yearly fluctuations in breast cancer
screening through the public health system in Brazil.