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      Early detection of breast cancer in Brazil: data from the National Health Survey, 2013 Translated title: Detecção precoce do câncer de mama no Brasil: dados da Pesquisa Nacional de Saúde, 2013

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          ABSTRACT

          OBJECTIVE

          To analyze whether the actions of early detection of breast cancer, initiated with the medical request for mammography, differ between users of the Brazilian Unified Health System (SUS) and those who have private health insurance.

          METHODS

          From the data collected in the National Health Survey, we estimated the proportions of women who had medical request for mammography according to presence or absence of private health insurance. For assessing the factors related to having mammography medical request, we estimated crude and adjusted odds ratios and respective 95%CI by logistic regression. We also analyzed the main reasons reported for not having performed mammography after medical request, as well as the time between examination and result.

          RESULTS

          Of the women interviewed, 66.7% had a medical request for mammography (59.4% among SUS users and 83.9% among those with private health insurance). Having private health insurance, higher education level, and being white were positively associated with having the medical request. Only 5.4% (95%CI 4.8–6.0) of women who received medical request failed to perform mammography – 7.6% were SUS users and 1.7% had health insurance. The most reported reasons for not being able to perform the examination were: not thinking it was necessary; having the test scheduled, but not yet performed; and not being able to schedule it. More than 70% of women received the result with less than one month from its execution.

          CONCLUSIONS

          The barriers to access a medical request for mammographic screening for breast cancer are higher among women who depend exclusively on SUS.

          RESUMO

          OBJETIVO

          Analisar se as ações de detecção precoce para o câncer de mama, iniciadas com o pedido médico de mamografia, diferem entre usuárias do Sistema Único de Saúde (SUS) e aquelas que possuem plano de saúde privado.

          MÉTODOS

          A partir dos dados coletados na Pesquisa Nacional de Saúde, foram calculadas as proporções de mulheres que tiveram pedido médico para realização de mamografia segundo ter ou não plano de saúde privado. Para avaliar os fatores relacionados a ter pedido médico de mamografia, foram calculadas odds ratios brutas e ajustadas e os respectivos IC95% por regressão logística. Foram também analisados os principais motivos informados para não ter realizado mamografia após ter o pedido médico, assim como o tempo entre ter realizado o exame e o recebimento do resultado.

          RESULTADOS

          Das mulheres entrevistadas, 66,7% tiveram um pedido médico para mamografia (59,4% entre as que eram usuárias do SUS e 83,9% entre as portadoras de plano de saúde privado). Ter plano de saúde privado, maior nível de escolaridade e ser de cor branca se associaram positivamente a ter o pedido médico. Apenas 5,4% (IC95% 4,8–6,0) das mulheres que receberam solicitação médica não conseguiram fazer mamografia – 7,6% eram dependentes do SUS enquanto 1,7% eram portadoras de plano de saúde. Os motivos mais reportados de não conseguir realizar o exame foram: não achar necessário; ter o exame marcado, mas ainda não realizado; e não ter conseguido marcar. Mais de 70% das mulheres receberam o resultado antes de completar um mês da realização.

          CONCLUSÕES

          As barreiras de acesso a ter pedido médico para rastreamento mamográfico para o câncer de mama são maiores entre mulheres que dependem exclusivamente do SUS.

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          Most cited references21

          • Record: found
          • Abstract: found
          • Article: not found

          Harms of Breast Cancer Screening: Systematic Review to Update the 2009 U.S. Preventive Services Task Force Recommendation.

          In 2009, the U.S. Preventive Services Task Force recommended biennial mammography screening for women aged 50 to 74 years and selective screening for those aged 40 to 49 years.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Controle do Câncer de Mama: Documento de Consenso

            (2004)
              Bookmark
              • Record: found
              • Abstract: not found
              • Book: not found

              Inquérito familiar sobre comportamentos de risco e morbidade referida de doenças e agravos não transmissíveis: Brasil, 15 capitais e Distrito Federal 2002-2003

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                Author and article information

                Journal
                Rev Saude Publica
                Rev Saude Publica
                rsp
                Revista de Saúde Pública
                Faculdade de Saúde Pública da Universidade de São Paulo
                0034-8910
                1518-8787
                1 June 2017
                2017
                : 51
                : Suppl 1
                : 14s
                Affiliations
                [I ]Departamento de Epidemiologia. Instituto de Medicina Social. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
                [II ]Laboratório de Informações em Saúde. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
                Author notes
                Correspondence: Gulnar Azevedo e Silva. Rua São Francisco Xavier, 524, Pavilhão João Lyra Filho, 7º andar, bl. D, Maracanã 20550-013 Rio de Janeiro, RJ, Brazil. E-mail: gulnar@ 123456ims.uerj.br

                Authors’ Contribution: Conception and planning of the study: GAS and CLS. Data analysis and interpretation: GAS, CLS, PRBSJr, GND. Writing of the manuscript: GAS, CLS, PRBSJr, GND. All authors approved the final version of the manuscript.

                Conflict of Interest: The authors declare no conflict of interest.

                Article
                10.1590/S1518-8787.2017051000191
                5676402
                28591356
                1329696a-4fdf-41da-b128-87f4bb2077a9

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 9 August 2016
                : 6 September 2016
                Page count
                Figures: 0, Tables: 10, Equations: 0, References: 22, Pages: 1
                Categories
                Original Articles

                breast neoplasms, diagnosis. mammography, utilization,early detection of cancer,mass screening,health surveys,neoplasias da mama, diagnóstico. mamografia, utilização,detecção precoce de câncer,programas de rastreamento,inquéritos epidemiológicos

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