Avaliação das mamografias no Sistema Único de Saúde da cidade de Chapecó - SC nos anos de 2022 e 2023

Abstract

Breast cancer is the most prevalent neoplasm among women in Brazil, with over 60,000 annual cases and high mortality rates, particularly in the southern and southeastern Brazil. Various biological and environmental factors contribute to its development and despite the critical importance of prevention and screening, discrepancies in guidelines and access challenges affect the effectiveness of early detection and mortality outcomes. This epidemiological study on the city of Chapecó, Santa Catarina aimed to analyze mammograms conducted by the Brazilian Unified Health System (SUS) in 2022 and 2023 and to understand the coverage and efficacy of breast cancer screening programs. The analysis encompassed age groups and BIRADS classifications. Statistical analysis was performed using Fisher’s Exact Test, with statistical significance determined by the adjusted critical z-value. The female population of Chapecó, Santa Catarina, aged 40-69, is 38,905, with 21,208 mammograms performed by the SUS in 2022 and 2023. Of these exams, 83.7% were classified as benign, 1.2% as probably benign, 0.45% as suspicious, and 14.7% required further investigation. The study revealed a coverage rate of 54.5% for women aged 40-69, and 55.8% for women aged 50-69. In 2022, statistically significant associations were found between women aged 45-49 and BI-RADS classifications 0, 1, and 2, as well as between women aged 55-59 and the same classifications. In 2023, significant associations were observed between women aged 50-54 and BI-RADS classifications 0, 1, and 2, and between women aged 60-64 and the same classifications, indicating distinct patterns of association between age group and mammography results in the two years analyzed. The analysis revealed deficiencies in the coverage and effectiveness of breast cancer screening in Chapecó, Santa Catarina, falling below the Ministry of Health guidelines and regional averages, highlighting the need for improvements in screening programs. The discussion on the early initiation of mammograms points out to potential challenges, such as overdiagnosis and an increase in inconclusive exams, particularly in younger women. The importance of quality control for more accurate diagnoses is emphasized, underscoring the need for regular audits and continuous professional training. However, the study has limitations, such as its cross-sectional design and the lack of individualized data, which calls for more comprehensive studies.