Desigualdades sociais no câncer de mama entre mulheres brasileiras

Abstract

Objective: To identify social inequalities (educational, racial and by area of ​​residence) in the performance of mammography, clinical breast examination (CBE) and the diagnosis of breast cancer among women. Design: Cross-sectional study, using data from the National Health Survey (PNS), 2019. Participants: 46,869 women over 18 years of age participated in this study. The outcomes were: CME, mammography and breast cancer. Women were stratified by race/skin color, area of ​​residence and education. Measures: Simple and complex measures of inequality were used, such as the Inequality Slope Index (SII) and the Relative Inequality Index (RII). Results: Inequality measures showed that access to requesting mammography and undergoing mammography and MCE was greater among white women, from urban areas and with higher education. Likewise, white women (SII: 0.52, 95% CI: -0.69;1.74), brown women (SII: 0.10, 595% CI: -0.63;0.83) and urban areas (SII: 0.53, 95% CI: -0.23;1.28) with higher education had a higher prevalence of breast cancer than black women, residents of rural areas and with less education. Conclusion: We concluded that inequality privileged the access of white women, more educated and living in urban areas to mammography and CME, consequently, to the diagnosis of breast cancer. Therefore, tracking programs, awareness campaigns and public policies with easier access to health services for black and brown women, residing in rural and less educated areas, are necessary as a way to reduce health inequalities.