Primeiro rastreamento organizado regional no Brasil: barreiras relacionadas á realidade do exame de mamografia
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Data
2009-03-03
Autores
Lourenço, Tânia Silveira [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A mamografia constitui o método populacional mais eficaz na redução da mortalidade por câncer de mama, visto a elevação do diagnóstico de lesões precoces. Países em desenvolvimento apresentam uma elevação na incidência e mortalidade por câncer de mama, decorrente da limitação do exame de mamografia e de programas efetivos de rastreamento. Há inúmeras barreiras relacionadas a não realização do exame de mamografia, podendo estar relacionadas ao sistema de saúde, à educação e à adesão da paciente. Iniciou-se em 2003 na DRS-V um rastreamento mamográfico, controlando as variáveis relacionadas ao sistema de saúde e educação. Na região da DRS/V do Estado de São Paulo, constituída por 19 cidades, iniciou-se um rastreamento mamográfico organizado, a mulheres na faixa etária dos 40-69 anos, através de uma Unidade Móvel de Prevenção (UMP) contendo um mamógrafo, ou em uma unidade fixa, em local onde havia limitação prévia a realização deste exame. Avaliou-se as características de 17.964 mulheres atendidas nos dois primeiros anos do projeto, sendo avaliado as características desta população; e após a cobertura populacional de 50,3% das mulheres, foram entrevistadas 550 mulheres que nunca haviam realizado o exame de mamografia anteriormente. Nas mulheres refratárias foi aplicado questionário avaliando o conhecimento sobre o auto-exame da mama, a importância da mamografia, bem como estratégias para identificação desta população refratária ao exame. No início do projeto o Programa de Saúde da Família foi o principal fator motivador a realização do exame de mamografia (46,8%) e a maioria dos exames foi realizada em UMP (63,7). Cerca de 42,1% das mulheres nunca havia realizado o exame de mamografia na vida, sendo que as mulheres que não haviam realizado o exame previamente constituído principalmente de mulheres da faixa etária 40-69 anos, baixa...
Mammography breast screening is related to early breast cancer diagnosis and the reduction of breast mortality is related to the increase in early breast cancer diagnosis. Developing countries have an increase in incidence and mortality for breast cancer is related to low income of mammography and the absence of organized screening. There are barriers related to the low adherence to mammography exam, and the main reasons are related to health system, education and adherence to guidelines. In 2003 started in DRS-V a mammography screening controlling the factors related to health system and knowledge. We began a mammographic screening in São Paulo state DRS/5 region, consisted with 19 cities, a mammographic breast cancer screening in women between 40-69 years old using a Mobile Unit with a mammography or in a fixed unit. We evaluated the characteristics of 17.964 women screened from the first two years of the project. When 50,3% of women had been screened we found 550 women non adherent to the project and applied questions related to the knowledge about breast clinical examination or reasons related to non adherence to mammography exam, and we analyze the strategies used to find these women. The “Programa de Saúde da Família” was the main factor related to adherence to mammography (46,8%) and the main local related to exams was the Mobile Unit (63,7%). There were 42,1% of the women who hadn’t done de mammography in their life’s and these women were principally between 40-49 years old, low socio-economic status and low income. There was an inverse relation in mammography previously and years of schooling and income. There was 39,2% early breast cancer diagnosis. The 550 women had low years of schooling (84,7%), low income (66,8%) and were between 42-49 years old (43,8%). The clinical frequently doesn’t realize breast examination (14,9%), and low women know how to do this exam... (Complete abstract click electronic access below)
Mammography breast screening is related to early breast cancer diagnosis and the reduction of breast mortality is related to the increase in early breast cancer diagnosis. Developing countries have an increase in incidence and mortality for breast cancer is related to low income of mammography and the absence of organized screening. There are barriers related to the low adherence to mammography exam, and the main reasons are related to health system, education and adherence to guidelines. In 2003 started in DRS-V a mammography screening controlling the factors related to health system and knowledge. We began a mammographic screening in São Paulo state DRS/5 region, consisted with 19 cities, a mammographic breast cancer screening in women between 40-69 years old using a Mobile Unit with a mammography or in a fixed unit. We evaluated the characteristics of 17.964 women screened from the first two years of the project. When 50,3% of women had been screened we found 550 women non adherent to the project and applied questions related to the knowledge about breast clinical examination or reasons related to non adherence to mammography exam, and we analyze the strategies used to find these women. The “Programa de Saúde da Família” was the main factor related to adherence to mammography (46,8%) and the main local related to exams was the Mobile Unit (63,7%). There were 42,1% of the women who hadn’t done de mammography in their life’s and these women were principally between 40-49 years old, low socio-economic status and low income. There was an inverse relation in mammography previously and years of schooling and income. There was 39,2% early breast cancer diagnosis. The 550 women had low years of schooling (84,7%), low income (66,8%) and were between 42-49 years old (43,8%). The clinical frequently doesn’t realize breast examination (14,9%), and low women know how to do this exam... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Mamas - Cancer, Família - Saúde - Planejamento, Adherence and guidelines, Breast cancer, Mammography
Como citar
LOURENÇO, Tânia Silveira. Primeiro rastreamento organizado regional no Brasil: barreiras relacionadas á realidade do exame de mamografia. 2009. 99 f. Dissertação (mestrado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2009.