Comparison of clinical staging and mammographic detection in women aged 40–49 years and 50–69 years in public health care system

Resumo

Objective: The aim of this study was to compare breast cancer screening and clinical stage at diagnosis in patients aged
40–49 years and 50–69 years treated in the public health system (SUS) in Brazil in the period 2013–2022. Methodology: This
ecological study analyzed the absolute and relative frequency of staging and used Poisson regression to analyze trends
in screening. A secondary database from SUS sources was used: SUS Network Outpatient Data System, Oncology Brazil
Panel, Brazilian Institute of Geography and Statistics, and National Agency for Supplementary Healthcare. Results: When
analyzing the clinical staging of breast cancer in the SUS, an increase in the rates of advanced stage (III and IV) is observed
in both age groups [40–49 and 50–69 years, with a higher prevalence in the younger group (59%) than in the 50–69 years
group (52%)] in 2022. In the 40–49 age group, a reduction trend in screening can be observed from 2013 to 2020 (APC -9.57,
p<0.05), followed by stability in the years 2020–2023. In the 50–69 age group, the proportion of mammographic coverage
remained stable. Conclusion: In view of the available evidence, it is necessary to expand access to mammography screening for women aged 40–49 years in Brazil. This includes implementing public policies that enable testing under the SUS,
raising women’s awareness of the importance of early detection, and combating misinformation.